"We have seen extraordinary feats of scientific innovation and an enormous mobilization of public resources to develop effective vaccines, tests, and treatments," the letter continues. "But we have also seen a global response held back by profiteering and nationalism."
The signers asserted:
We are hopeful that an end to the acute stage of the Covid-19 pandemic may be in sight. Thus, the world is at a critical juncture. Decisions made now will determine how the world prepares for and responds to future global health crises. World leaders must reflect on mistakes made in responding to the Covid-19 pandemic so that they are never repeated.
There are decades of publicly funded research behind Covid-19 vaccines, treatments, and tests. Governments have poured taxpayer money by the billions into research, development, and advance orders, reducing the risks for pharmaceutical companies. These are the people's vaccines, the people's tests, and the people's treatments. Yet, a handful of pharmaceutical companies has been allowed to exploit these public goods to fuel extraordinary profits, increasing prices in the Global North while refusing to share technology and knowledge with capable researchers and producers in the Global South.
"Instead of rolling out vaccines, tests, and treatments based on need, pharmaceutical companies maximized their profits by selling doses first to the richest countries with the deepest pockets," the letter adds. "Billions of people in low- and middle-income countries, including frontline workers and the clinically vulnerable, were sent to the back of the line."
These inequities, the alliance said, resulted in over 1.3 million preventable deaths—one every 24 seconds—in the pandemic's first year alone. Even today, as the pandemic enters its fourth year, much of the Global South lacks adequate access to Covid-19 testing and treatments.
The letter's signatories urge world leaders to take immediate action to:
- Support a pandemic accord at the WHO that embeds equity and human rights in pandemic preparedness and response;
- Invest in scientific innovation and manufacturing capacity in the Global South through projects like the mRNA Technology Transfer Hub established by the WHO and partners;
- Invest in global common goods; and
- Remove the intellectual property barriers that prevent knowledge and technology sharing.
"In the AIDS pandemic, pharmaceutical monopolies have resulted in an appalling number of unnecessary deaths—and it has been the same story with Covid-19," lamented Winnie Byanyima, executive director of UNAIDS and co-chair of the People's Vaccine Alliance.
"It was only the production of inexpensive generics in developing countries that made the first generation of HIV medicines available and affordable to people in the [Global] South," she added. "But governments still have not learned that lesson. Unless they break the monopolies that prevent people from accessing medical products, humanity will sleepwalk unprepared into the next pandemic."
East Timorese President José Manuel Ramos-Horta, who also signed the letter, said that "in the Covid-19 pandemic, those of us in low and middle-income countries were pushed to the back of the line for vaccines and denied access to the benefits of new technologies."
"Three years on, we must say 'never again' to this injustice that has undermined the safety of people in every country," he added. "Steps that we take today can hasten global access to vaccines, medicines, and tests in the next pandemic, with regional hubs researching, developing, and manufacturing medical products for everyone, everywhere."
Former United Nations Secretary-General Ban Ki-moon asserted:
The great tragedy of the Covid-19 pandemic has been the failure of multilateralism and the absence of solidarity between the Global North and Global South. These past three years should act as a warning for future pandemics. We need a return to genuine cooperation between nations in our preparation and response to global threats. That requires a pandemic accord rooted in equity and human rights, which places the needs of humanity above the commercial interests of a handful of companies.
Independent Panel for Pandemic Preparedness and Response co-chair Helen Clark—who served as New Zealand's prime minister from 1999 to 2008—noted that "publicly funded science contributed a lot to the phenomenal success of Covid-19 vaccines."
"Yet, that public investment did not lead to vaccines being treated as global common goods," Clark continued. "Rather, nationalism and profiteering around vaccines resulted in a catastrophic moral and public health failure which denied equitable access to all."
"We need to fix the glaring gaps in pandemic preparedness and response today," she added, "so that people in all countries can be protected when a pandemic threat emerges."