Sir Peter Gluckman
President-Elect, International Science Council
Director, Koi Tū: The Centre for Informed Futures, University of Auckland
Right from the first appearance of the Covid-19 virus, nationalistic and domestic politics in many countries compromised the global response. From China and the USA throwing arrows at each other about the pandemic’s origin, to the substantive delay in notifying the emerging epidemic (as expected by all global citizens and required in the International Health Regulations), through to the delays by the World Health Organization in declaring a pandemic, and how each country has chosen to respond to the viral invasion – both domestic and international politics have played a disproportionate role in determining how the pandemic has played out. The heavy political shadow on an effective domestic pandemic response is arguably most evident in the human tragedy that has played out in the USA, and it had global echoes with the USA transiently exiting the WHO. While many aspects of science have been critical to the management of the pandemic, a closer inspection will show how much the phrase ‘we are following the science’ has been widely used as an excuse for domestic and international political positioning.
The current, justified celebration of the massive scientific and industrial effort that led quickly to some effective vaccines becoming available within a year of the virus coming to global attention, must be tempered by the overt overlay of nationalistic politics. A few wealthy countries have dominated the purchase of the limited vaccine supplies; COVAX (the international alliance established to purchase vaccines for low-income countries) has had a faltering start; and some countries and the European Commission have restricted the export of vaccines. Vaccine nationalism has made its way into foreign aid: vaccine supply issues to developing countries will have potential geopolitical consequences.
Even with vaccines starting to be available for an increasing number of countries (but still very few low income countries) and already becoming widely available in many developed countries, the reality is that a coordinated global response is needed if we are to return the world to a semblance of normality. The issues in dealing with Covid-19 and reducing the impacts of the future and inevitable pandemics are not only scientific but are increasingly diplomatic and political: without a global and more integrated response, any return to stability will be prolonged and patchy. As we and others have suggested new arrangements are likely needed to manage the inevitable next pandemic.
Politicians in many countries are getting mileage from simply celebrating the arrival of the first vaccine (which is primarily a triumph of science and industry, not politics, albeit political decisions were made to fund the work). The political rationale for providing vaccines for one’s own citizen’s first is understandable. After all, many of us would want to be at the front of the queue. But self-centered rationality must be balanced against the need to ensure global and regional coverage if free trans-national movement across borders is to return.
In our backyard, in the Pacific States, we have a historical, moral and legal relationship with some of the most vulnerable populations to the disease. Confounders like type two diabetes greatly impact the severity of Covid, and sadly the most vulnerable countries in the world in that regard are in the Pacific. These countries have no Covid because, like New Zealand, they rapidly closed their borders before the virus had done harm. Their health services will not cope if the pandemic reaches them. Furthermore, even much more than us, they depend on open borders to survive – they depend almost totally on tourism for income. It is therefore in New Zealand’s interests to assist them to early and comprehensive vaccine access. The tragedy of Samoa facing the ‘Spanish flu’ introduced by NZ soldiers in 1918 should be a reminder.
The issue of when to open the so-called trans-Tasman ‘bubble’ is not primarily a scientific one, even as this essay is written in a time of Auckland’s fourth lockdown. Inevitably, countries that took an elimination approach like Australia and New Zealand will have episodes like this into the future until they can move beyond elimination. They will have to be managed with localised restraints and rapid testing and contact tracing (using technologies New Zealand is still slow to adopt). Epidemiologists, virologists and public health experts on both sides of the Tasman have from very early on been much aligned in their general thinking and approach to pandemic management. Putting politics aside, they could very quickly develop common and integrated standards for testing, contact tracing, quarantine, and local or regional lockdowns or imposing other controls for the inevitable occasional flare-up. What is needed is a common oversight, decision-making system, and an information-sharing process between jurisdictions – this could allow things to open very quickly. Without them, unilateral decision making with all its problems will be continually disruptive.
But the understandable issue that impedes progress is one of sovereignty. Federal systems in countries where health is mostly a matter of State, not federal jurisdiction, have limited many countries from developing a unified internal approach, and Australia is not immune in that regard. A joint ANZAC system for pandemic decision making would be logical, if only the systems could get beyond political hubris by letting go a little bit of sovereignty to a joint scientific and political decision system. After all, we have done so in some other areas associated with economic relationships and food safety. It would mean joint decision making on border controls, and as to when transient restrictions might be needed to manage a local outbreak. But the reality is that in our part of the world as elsewhere, such pragmatic approaches seem utopian as political realities continue to dominate.
Globally many challenges require more aligned and cohesive diplomatic leadership. It is extraordinary that the United Nations has not yet called a global summit of leaders to address some of these issues. New Zealand could provide some leadership, given its current standing and that of our Prime Minister, and its ability to be a broker without having significant geostrategic self-interest.
Developing a system for better global pandemic alerting and management must be high on the global agenda. Another zoonosis of this scale is inevitable – the only unknown is when. Several commentaries, including the interim report of the Independent Pandemic Preparedness and Response Panel formed by the WHO and co-chaired by Helen Clark, are urging urgent action towards a less political and more effective, responsive system.
Vaccine availability for a limited fraction of the world’s population is but one important step into the next phase of the pandemic as it evolves. But it could be well into 2024 before adequate immunisation of the global population is reached. The faster that is achieved, the less likely secondary consequences of global impact will emerge. This requires most people to be immune through vaccination as total eradication at a global scale is not possible. In time we will move towards low but likely uneven levels of global endemicism – when we are able to deal with the virus as we would with other endemic infections such as measles. The strategy for getting there is both global and national. As the virus continues to mutate, at what point are we satisfied sufficiently with our vaccine coverage that controls are removed and we can accept the risks of low-level endemic exposure? These are both scientific and political decisions.
There are many unknowns ahead of us: the behaviour of the virus and any new variants, the efficacy and duration of vaccine coverage, the availability of vaccine, the population response in the face of misinformation and vaccine hesitancy, the commitment to ongoing social distancing and other protective measures, the risk of pandemic fatigue, domestic politics, nationalism, geostrategic considerations, and diplomacy. Many diplomatic considerations, including vaccine passports, vaccine financing, and the level of global cooperation, will all play into determining our future.
The International Science Council, working with the world’s preeminent Covid experts and many leading natural and social scientists, has embarked on urgent scenario exploration (see associated article in Lancet) to help policy makers understand the criticality of the decisions they will make in coming months in determining how this pandemic will unfold. Science has done much to get to this point. Now diplomatic considerations must also be high on the agenda in determining how long it is before we can think of Covid like the common cold – which after all can be caused by another coronavirus.