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The WHO is done playing nice about vaccine equity

The global health establishment got a bit of a scolding by one of its most prominent leaders, the World Health Organization (WHO) director for health emergencies Mike Ryan.

Speaking at a panel at the World Health Summit, a high-level conference held in Berlin to discuss progress in global health, Ryan described this kind of gathering as “speed dating for global consultants.” He called on to international health organizations to pay more attention to the expertise and knowledge of those working in the field rather than trusting top-down programs developed by the leaders of prominent organizations.

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“We’re all sitting here in this room, we are all privileged to be here. Do we understand that privilege, the responsibility that comes with it, the trust that people have put in us, to be here on their behalf?” he asked the audience, reminding them that the work of global health is done by people such as the female health workers treating Ebola patients in Uganda.

“We failed because of the greed of the north”

Ryan, who has been working on covid response since the beginning of the pandemic, was outspoken about the dangers of power imbalance in public health, and didn’t shy away from discussing criticism of Covax, the WHO-led program to deliver covid vaccines to low-income countries.

Since it was set up, Covax has come under attack for being unable to deliver on its promise to procure vaccines for countries that didn’t have production capabilities or budgets. Although 80% of the vaccines administered in low-income countries were delivered through Covax, most still have extremely low levels of immunization against covid. In sub-Saharan African countries, in particular, less than 20% of the population is vaccinated.

“It’s very easy to look at international institutions and multilateral institutions and say the fault was all there. There’s plenty of blame to go around in this pandemic, I can assure you,” said Ryan. But he singled out rich countries and pharma companies as bearing most of the responsibility.

“Every failure that happened in Covax happened because countries did not want to share, not because Covax was badly designed,” he said. The comment was all the more damning as Germany, the country that hosted the summit, was among the ones that sided with pharmaceutical companies in opposing patent wavers for covid-related therapeutics.

“We failed. Ask why we failed,” Ryan said. “We failed because of the greed of the north, we failed because of the greed of the pharmaceutical industry, we failed because of self-interest of certain member states that were not prepared to share.”