Covid-19: The Price of Unfulfilled Promises

Javier Surasky
Cepei 
j.surasky@cepei.org

March 26, 2020


In December 2015, the international society celebrated the end of a successful year in multilateralism history. UN members had negotiated and adopted the Addis Ababa Agenda on Financing for Development, the 2030 Agenda for Sustainable Development, and the Paris Agreement to fight climate change. However, far from the limelight, the media, and marketing strategies, other processes were quietly underway.

Late in 2013, in Guinea-Bissau, a 2-year-old boy named Emile Ouamouno passed away. He was infected with Ebola. It seemed to be one more death, one of those that the world daily accepts as part of nature, especially when they take place in impoverished areas. But this time it was different: Emilie was the first of more than 11,000 people killed as a result of the Ebola epidemic that spread throughout the African territory.

The Ebola outbreak cannot be understood as an isolated health care crisis. Since the beginning of the current century, four outbreaks of the Middle East respiratory syndrome (SROM), the H1N1 and H5N1 influenza pandemics, and an outbreak of severe acute respiratory syndrome (SARS) took place. 

In April 2015, former UN Secretary-General Ban Ki-moon launched a High-level Panel on the Global Response to Health Crises, to propose recommendations to strengthen national systems and international prevention and response to future possible health crises. At the end of its work, the High-level Panel published the report “Protecting humanity from future health crises“, where 27 specific recommendations for action were made.

By that time, the 2030 Agenda had already been adopted. However, health risk  management was included among the Sustainable Development Goals. Under SDG 3 on health and well-being, target 3.d expresses the commitment to “Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.” Two indicators are used to monitor that target: indicator 3.d.1 “International Health Regulations capacity and health emergency preparedness,” and 3.d.2Reduce the percentage of bloodstream infections due to selected antimicrobial-resistant organisms.”

The International Health Regulations are a legally binding international agreement for almost 196 States whose purpose is to prevent and respond to severe cross-border risks to public health. Public health emergency of international importance is defined in that treaty as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response.” This definition implies a situation that is serious, sudden, unusual, or unexpected; it carries implications for public health beyond the affected State’s national border, and may require immediate international action.

The “International Health Regulations capacity” is an index arising from the combination of 13 variables (see details here). The data comes from national self-evaluation reports that countries should present every year. In 2018 the content of the reports was modified, so the prior data is not directly comparable with that of 2018, the last year for which official information is available. Despite that, please check out the following tables:


These two tables clearly showcase the worldwide weakness regarding health crisis preparedness. The World’s aggregate average is 64 percentage points, and even the region with the best results, Europe, shows an average of 73 points. What will happen when COVID-19 impacts some of the weaker countries and regions forcefully? 

With the aim to continue the work carried out by the High-level Panel on the Global Response to Health Crises after its dissolution in 2016, the World Health Organization and the World Bank teamed up to created the Global Preparedness Monitoring Board. This independent monitoring and accountability body seeks to strengthen global readiness to face health crises. The Board published its first annual report in September 2019 under the title ‘A world at risk’, to which we have already referred in a previous blog post. The report included a warning of the possible tragedy coming up. A tragedy also announced by the data associated to indicator 3.d.1. 

Going back in time, in the Preface of the 2016 High-level Panel on the Global Response to Health Crises final report, Jakaya Mrisho Kikwete former President of Tanzania, stated: 

“Too often, global panic about epidemics has been followed by complacency and inaction. For example, the 2009 influenza pandemic prompted a similar review of global preparedness, but most of its recommendations were not addressed. If they had been implemented, thousands of lives could have been saved.”


“The United States of America represents approximately 85% of the cases and 84% of the deaths in region. All 50 States, District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands have reported confirmed COVID-19 cases with varying levels of community transmission (defined or widespread) in all but 11 reporting states of the US”.

PAHO, March 25, 2020.

Check out the updated information day after day 👉 Coronavirus Disease (COVID-19)


Other blogs of the series

Covid-19: Financing versus Financing | March 26, 2020

COVID-19: It’s foolishness, stupid! | March 20, 2020

The COVID-19 pandemic and the virtual limitations of development governance | March 18, 2020

What does COVID-19 tell us about Sustainable Development and the 2030 Agenda? | March 11, 2020