• Calls to ban wildlife trade to prevent future zoonotic pandemics have proven to be ineffective and difficult to enforce
• Measures also risk impacting the food security, livelihoods, and cultural rights of millions of people around the world
• Policy action is needed that centres sustainable food systems rather than absolute bans on wildlife trade and continuing support for status quo industrial food systems
• Action should include support for practices that minimise the risk of zoonotic disease transmission, such as agroecology and indigenous and community conserved areas

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Zoonotic diseases are diseases transmitted from wild and domestic animals to humans. 60% of infectious diseases affecting humans are zoonotic in origin, including malaria, HIV, and various types of influenza. Over the last decade, there have been numerous zoonotic disease outbreaks, including Ebola, Zika, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS). However, the unprecedented health and economic impact and rapid global spread of COVID-19 has drawn far more attention to zoonoses prevention than previous zoonotic disease outbreaks.

Early reports linked the emergence of COVID-19 to a market in China where wild animals and meat were sold, the wildlife trade has been front-and-centre in discussions on controlling COVID-19 and preventing future zoonotic spillover events. Proposals have ranged from extreme, total bans of wildlife trade, to the moderate, managing wildlife trade carefully. For example, by better regulating sanitation and hygiene at wildlife trade markets, to focusing on restricting trade in high-risk species and more diligence about illegal, unsustainable forms of trade.

These calls have been met by policy action. In February 2020, the Chinese government imposed a ban on trade and consumption of wild meat. The Vietnamese government and the Government of Thailand took similar steps, banning wildlife imports, closing wildlife markets and enacting greater enforcement against illegal wildlife trade. The United Kingdom is also discussing wildlife trade bans in response to COVID-19. In 2020, an Early Day Motion was submitted for debate in the House of Commons to ban the international commercial trade in wild animals and wild animal products, and to play a leadership role in the end of the global wildlife trade.

Why wildlife trade bans are not the answer

The focus on banning wildlife trade to solve future pandemics is worrying, as the ineffectiveness and negative consequences of wildlife trade bans are well documented in existing research. During the Ebola outbreak in 2013 and 2016, bans placed on wild meat trade not only proved to be ineffective in halting disease transmission, but also pushed trade underground making it even more difficult to monitor and regulate, and thus potentially more risky. Similar impacts were seen during other Ebola outbreaks in Guinea and Nigeria as well.

In addition to undermining local economies and food security, wildlife trade bans can have negative consequences on wildlife conservation. Wildlife trade bans can harm legal, sustainable wildlife economies that give people motivation to conserve species and their surrounding habitats. Wildlife trade bans erode people’s trust in public health and environmental authorities as affected populations often observe ulterior motives behind bans, like preventing hunting and restricting access to natural resources.

Finally, as a key driver of hunting in both developing and developed countries is food preference and food security, new bans on wild meat consumption could increase in domestic livestock consumption. Large-scale deforestation and habitat destruction associated with commercial scale livestock farming and agriculture is a primary risk factor in zoonotic disease spillover. If the intension of banning wildlife trade is to reduce pandemic risks, any measures that could increase industrial livestock production are counterintuitive.

• Supporting sustainable, biodiversity-friendly food production systems:COVID-19 and problems created by wildlife trade bans point to the shortcomings of existing food systems. There are initiatives and movements around the world pushing for alternative food systems that could minimise the chance of future zoonotic pandemics. For example, there is scientific evidence that improving support for agroecology – agricultural practices that rely on natural synergies and harness biological diversity for food production – can contribute to improved food security and the protection of wildlife habitats while acting as buffers against zoonotic viral spillover events.

• Respecting tenure regimes that minimise the risk of zoonotic disease transmission by conserving biodiversity without impeding on the rights and wellbeing of Indigenous Peoples and Local Communities (IPLCs): conserving biodiversity reduces the risk of zoonotic diseases. Various tenure regimes contribute to preventing biodiversity loss, reducing the risk of future pandemics. Problematically, many tenure regimes (e.g. ‘Fortress Conservation’) also violate IPLC rights. ICCAs, which are formally recognised territories and areas conserved by indigenous peoples and local communities, are unique as they restore and respect IPLC rights while protecting biodiversity and creating a buffer between zoonotic disease pools and people. Support for ICCAs should be made a global priority, particularly amidst ongoing debates about the post-2020 Global Biodiversity Framework.

• Promotion of just, sustainable wildlife trade governance: in place of wildlife trade bans, improved governance of legal and sustainable wildlife trade is needed. This could include directing trade regulation and enforcement to target types of trade and species that pose serious risks for zoonotic transmission. However, calls to centralise and elevate the governance of wildlife trade risk violating IPLC rights and ignoring the often highly biodiverse and ecologically balanced nature of IPLC territories. Global institutions and governments have an opportunity to learn from IPLCs about sustainable wildlife use and consumption and improve or create new wildlife trade laws and policies that are inclusive of IPLC rights and territories.

Charis Enns is a Presidential Fellow in Socio-Environmental Systems at the Global Development Institute at the University of Manchester. She is currently working on a project titled ‘Identifying and mitigating the impacts of COVID-19 on legal and sustainable wildlife trade in Low- and Middle-Income Countries (LMICs)’.

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What is clear is that India is being overwhelmed at the present time with India’s health care system struggling to handle the huge number of people needing assistance, with many hospitals unable to handle the case load, with acute shortages reported on oxygen, ICU beds and much more. See, e.g., The Financial Times, Editorial Board, The tragedy of India’s second wave, April 26, 2021, https://www.ft.com/content/90281790-fb9e-468c-b3fa-c7549bd3bb39 (“The suffering of the Indian people in the country’s second wave of Covid-19 is a human tragedy on a vast scale. It is also a warning, and a danger, for the world. Many nations have been through dark times in the global pandemic; several with smaller populations still have higher death tolls. But with reports of people dying in the streets outside overwhelmed hospitals running short of oxygen, India today perhaps most closely resembles the worst-case scenarios painted when the virus was identified 16 months ago.”); New York Times, ‘This Is a Catastrophe.’ In India, Illness Is Everywhere, April 27, 2021, https://www.nytimes.com/2021/04/27/world/asia/India-delhi-covid-cases.html. The extent of human suffering from people not able to obtain timely care has been described by the Director-General of the World Health Organization as “beyond heartbreaking”. World Health Organization, Director-General’s opening remarks at the media briefing on COVID-19 – 26 April 2021, 26 April 2021, https://www.who.int/director-general/speeches/detail/director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-26-april-2021.

Many countries, the WHO and business organizations and others are scrambling to provide assistance to India. See, e.g., MENAFN, Euronews, EU, UK and US offer support as COVID-19 ‘swallowing’ people in India, 27 April 2021, https://menafn.com/1101987528/EU-UK-and-US-Offer-Support-as-COVID-19-Swallowing-People-in-India; Politico, Von der Leyen: EU preparing ‘rapid’ assistance to COVID-hit India, April 26, 2021, https://www.politico.eu/article/eu-india-coronavirus-crisis-variant-asia-ursula-von-der-leyen/; U.S. Chamber of Commerce Foundation, India COVID Crisis: How Businesses Can Help, April 27, 2021, https://www.uschamberfoundation.org/event/india-covid-crisis-how-businesses-can-help; Reuters, WHO steps up aid to India to stem COVID surge, 27 April 2021, https://www.reuters.com/world/india/rush-hospitals-big-gatherings-worsen-india-covid-crisis-who-2021-04-27/..

In the United States, the Biden Administration has indicated it is providing assistance and yesterday released a fact sheet on actions being taken. See White House Briefing Room, FACT SHEET: Biden-Harris Administration Delivers Emergency COVID-19 Assistance for India, April 28, 2021, https://www.whitehouse.gov/briefing-room/statements-releases/2021/04/28/fact-sheet-biden-harris-administration-delivers-emergency-covid-19-assistance-for-india/. The fact sheet is copied below.

“Reflecting the United States’ solidarity with India as it battles a new wave of COVID-19 cases, the United States is delivering supplies worth more than $100 million in the coming days to provide urgent relief to our partners in India.  In addition, U.S. state governments, private companies, non-government organizations, and thousands of Americans from across the country have mobilized to deliver vital oxygen, related equipment, and essential supplies for Indian hospitals to support frontline health care workers and the people of India most affected during the current outbreak.  U.S. Government assistance flights will start arriving in India on Thursday, April 29 and will continue into next week.

“Just as India sent assistance to the United States when our hospitals were strained early in the pandemic, the United States is determined to help India in its time of need.

“Immediate U.S. Emergency COVID-19 Assistance

“The United States is providing: 

“- Oxygen Support:  An initial delivery of 1,100 cylinders will remain in India and can be repeatedly refilled at local supply centers, with more planeloads to come.  The U.S. Centers for Disease Control and Prevention has also locally procured oxygen cylinders and will deliver them to support hospital systems in coordination with the Government of India.

“- Oxygen Concentrators: 1700 oxygen concentrators to obtain oxygen from ambient air, these mobile units provide options for flexible patient treatment.

“- Oxygen Generation Units (PSA Systems): Multiple large-scale units to support up to 20 patients each, and additional mobile units will provide an ability to target specific shortages. A team of U.S. experts will support these units, working hand-in-hand on the ground with Indian medical personnel. 

“- Personal Protective Equipment: 15 million N95 masks to protect both patients and Indian health care personnel. 

“- Vaccine-Manufacturing Supplies:  The U.S. has re-directed its own order of Astra Zeneca manufacturing supplies to India.  This will allow India to make over 20 million doses of COVID-19 vaccine.

“- Rapid Diagnostic Tests (RDTs):  1 million rapid diagnostic tests – the same type used by the White House — to provide reliable results in less than 15 minutes to help identify and prevent community spread.     

“- Therapeutics:  The first tranche of a planned 20,000 treatment courses of the antiviral drug remdesivir to help treat hospitalized patients.

“- Public Health Assistance: U.S. CDC experts will work hand-in- hand with India’s experts in the following areas: laboratory, surveillance and epidemiology, bioinformatics for genomic sequencing and modeling, infection prevention and control, vaccine rollout, and risk communication.

“U.S. Support for India from the Outset of the Pandemic 

“The United States and India have closely worked together to respond to the COVID-19 pandemic.  U.S. COVID-19 assistance has reached more than 9.7 million Indians across more than 20 states and union territories, providing life-saving treatments, disseminating public health messages to local communities; strengthening case-finding and surveillance; and mobilizing innovative financing mechanisms to bolster emergency preparedness: 

“- Partnered with more than 1,000 Indian healthcare facilities to strengthen preparedness, including training of over 14,000 people on infection prevention and control.

“- Helped keep more than 213,000 frontline workers safe — including risk mitigation training for doctors, nurses, midwives, community volunteers, sanitation workers, and others who are actively responding to COVID-19 in India.

“- Launched joint public messaging with UNICEF on COVID prevention that has reached more than 84 million people.

“- Provided 200 state-of-the-art ventilators to 29 healthcare bodog poker review facilities in 15 states to care for critically-ill COVID-19 patients.

“U.S.-India Health Partnership: Seven Decades Strong

“- For seventy years, U.S. public health experts from across the government, including USAID, HHS, CDC, FDA, and NIH, have worked in partnership with Indian officials to improve the health of India’s most vulnerable communities and the well-being of its people. 

“- Over the last 20 years, U.S. foreign assistance to India has exceeded $2.8 billion, including more than $1.4 billion for health care. 

“- The United States, India, and other partners have worked together to reduce new HIV infections by 37 percent between 2010 and 2019.

“- Since 1998, the United States and India have worked together to combat tuberculosis (TB) through improved patient-centered diagnosis, treatment and prevention, helping treat 15 million people with the disease.

“- In the last five years, the United States has helped 40 million pregnant women receive vital health information and services.

“- The United States, in partnership with the Government of India and World Health Organization, has supported initiatives at the District, State and National level to build frontline disease detection capacity.

“- The United States and India are working together to advance global health security and fight outbreaks before they become pandemics.”

Conclusion

India is a critical part of the global effort to vaccinate the world both with vaccines developed within India and with vaccines (e.g., AstraZeneca and Novavax) that are licensed for production in India with large commitments to supply COVAX for distribution to low- and middle-income countries and with other vaccines licensed from other countries (China and Russia). The immediate challenges in India has shifted the focus of the Indian government and its vaccine producers to supply almost exclusively for the Indian market while India struggles through the current surge in new cases and hospitalizations. The focus of the world on the need to help India is an interesting departure from the discussion of vaccine distribution based on population that has dominated focus through March.

Many parts of the world have been able to keep the COVID-19 pandemic under control to a large extent and hence have relatively few COVID-19 cases. Other countries — the U.S., India, Brazil, the EU countries and UK — have had far less success in controlling the spread of COVID-19 and have recorded very large numbers of cases, hospitalizations and deaths.

In a prior post, I reviewed that if one looks at percent of vaccinations compared to the percent of COVID-19 cases, there has been better matching for many countries (U.S., EU, UK, India) while a few major vaccine producers have much larger vaccinations as a percent of global vaccinations compared to the share of global COVID-19 cases they have. See April 18, 2021, WTO’s April 14th virtual meeting to review COVID-19 vaccine availability, https://currentthoughtsontrade.com/2021/04/18/wtos-april-14th-virtual-meeting-to-review-covid-19-vaccine-availability/.

Looking at current data, China has achieved the largest number of vaccinations — 235,976,000 vaccinations or 21.82% of global totals til April 28, 2021) — but a very low percent of global COVID-19 cases — 102,384 cases or 0.07% of global cases. The U.S. has the largest number of cases and second largest number of vaccinations (21.79% of cases; 21.69% of vaccinations). India has the second largest number of cases and the third largest number of vaccinations (11.61% of cases; 13.86% of vaccinations). The EU (27 countries) has 20.46% of COVID-19 cases (2nd largest if looking at the 27 countries together) and 12.75% of vaccinations. The United Kingdom has 2.99% of cases and 4.39% of vaccinations. Brazil has 9.75% of cases (3rd highest for an individual country) and 4.17% of vaccinations.

Both China and India are major vaccine producers and have comparable populations. But China has had only 0.6% of the COVID-19 cases that India has had, but has 157.45% of the vaccinations that India has accomplished. Vaccination data is from Bloomberg, More than 1.08 Billion Shots Given: Cover-19 Tracker, updated April 28, 2021, https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/.

The problems India is facing are daunting and emphasize the need for the global community to respond to emergencies as they arise while global production of vaccines continue to ratchet up in the coming months. That doesn’t mean that efforts to roll out vaccines to all countries is not an important initiative (COVAX has now shipped more than 48 million doses to 120 countries and various countries are shipping vaccines to ow- and middle-income countries outside of COVAX). But pandemics do not wreak havoc uniformly across the world. Fires need to be addressed urgently while capacities are increased to deal with all needs. The last several weeks have shown India to be suffering such a “fire”. Diverting resources from other parts of the world to India makes sense at the moment. Brazil’s fire continues as well and undoubtedly needs more attention.

While vaccines will help get the world out of the pandemic, all countries need to be vigilant on the non-vaccine tools available to minimize the spread of the pandemic within markets until there is sufficient vaccine capacity to address all needs — capacity that should be here by the end of 2021.

Terence Stewart, former Managing Partner, Law Offices of Stewart and Stewart, and author of the blog, bodog poker review|Most Popular_Congressional

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The World Health Organization puts out a publication that tracks cases and deaths on a weekly basis. COVID-19 Weekly Epidemiological Update (data as of 22 November). While it breaks countries and territories into different configuarations that the ECDC, the publication shows new cases in the period November 16-22 declining 6% in Europe and in South East Asia while increasing 11% in the Americas, 5% in the Eastern Mediterranean, 15% in Africa and 9% in the Western Pacific. Because of the large spike in cases in the September – November period in many parts of the world, deaths in the November 16-22 period increased in all regions — up 10% in Europe, 15% in the Americas, 4% in South-East Asia, 10% in the Eastern Mediterranean, 30% in Africa and 1% in the Western Pacific. The latest report is embedded below.

The graphs in the WHO publication show by region the trajectory of new cases and deaths over time. The chart showing aggregate data show a flattening of total new cases in the last weeks of November while the number of deaths globally are sharply increasing.

The WHO Africa region peaked in the summer and has declined until the last few weeks when there has been some increase in both cases and deaths.

The Americas saw a peak in both new cases and deaths in the July period with some declines in new cases until the second half of September when the current surge started and accelerated in November. Deaths declined until early October before starting to grow again.

The Eastern Mediterranean peaked in May-June for both cases and deaths, declined through August/September and have surged to new heights with continued upward trajectory as of November 22.

The WTO European Region had an early surge of cases and deaths in the March-April period. Deaths Bodog Poker receded sharply through August. While new cases have increased since summer, there was a massive increase in the September – end of October period in new cases and rising deaths through November.

The WHO South-East Asia region saw a huge increase in cases and deaths in the May-August period, peaking in early September and declining since then. Much of the data for the region reflect activity in India.

The Western Pacific Region has had several peaks in terms of deaths and in new cases, though the numbers are the lowest of any WHO region. The latest peak in new cases was in early August with some increase in the October-November period. Deaths last peaked in early September and have declined through November.

The United States

Turning back to the ECDC data, the United States continues to have more confirmed cases (13,246,651) than any other nation and more confirmed deaths from COVID-19 (266,063) than any other nation. The United States is also still experiencing a surge in new cases and rising deaths. October 31 was the first day that ECDC data show the U.S. recording 100,000 new cases in a single day. Since November 5, the U.S. has had more than 100,000 new cases every day up to November 29. It is the only country to record one million new cases in a week and the only country to record two million new cases in fourteen days. For the last fourteen days, the U.S. recorded 2,341,760 new cases. The U.S., which accounts for 4.3% of the global population, accounts for 21.27% of all COVID-19 cases that have been reported since December 2019 and accounted for 28.76% of new cases in the last two weeks. The rate of increase remains high for the United States — up 31.67% from the 1,778,530 new cases in the two weeks ending November 15. There are concerns that the number of new cases will continue to increase into the new year based on the high rate of infections in many parts of the country, major potential spreading events around holidays in November (Thanksgiving) and December, and limited compliance with basic requirements for limiting the spread of the virus.

The number of deaths from COVID-19 that the U.S. accounts for has declined from roughly 20% to 18.30% as of November 29. In the last two week, while the U.S. has the largest number of deaths in the two weeks, the percent of total deaths accounted for by the U.S. in the November 16-29 period was 14.65%. However, many cities, communities and even states are at or nearing the limits of the health care capacity with hospitalizations now about 90,000, limits on health care professionals with the surging cases and some challenges on personal protective equipment. Thus, models used by the government projects a continued rise in the number of deaths in the coming months.

While the first vaccine could receive emergency approval for distribution in the U.S. as early as December 10, and the U.S. could have two or three vaccines in distribution in early 2021, the United States will unfortunately likely be a major part of the continued high rate of infections and deaths well into 2021.

Europe

While Europe had faced early challenges in a number of western European countries in February-April and very high death rates in a number of countries, the second wave of cases following the relaxation of restrictions in time for summer vacations accounted for the vast majority of the incrase in new cases during the October and early November time period. In earlier posts, I showed that Europe and the U.S. accounted for nearly all of the increase from 5 million new cases in the two weeks ending October 22 to the more than 8 million new cases in the two weeks ending November 17. See November 17, 2020, New COVID-19 cases over a fourteen day period continue to soar past eight million, up from five million on October 22, https://currentthoughtsontrade.com/2020/11/17/new-covid-19-cases-over-a-fourteen-day-period-continue-to-soar-past-eight-million-up-from-five-million-on-october-22/

While some of the major countries, including France, Italy, Spain, the United Kingdom and others have seen significant reductions in the number of new cases in recent weeks from the extraordinary figures recorded in late October, early November, numbers remain very high for a number of countries including Poland, Portugal, Serbia, Croatia, Hungary, Lithuania and Luxembourg — all of whom had new cases/100,000 population in the last fourteen days that were higher than the United States.

Because deaths lag new cases by a number of weeks, it is perhaps less surprising that much of Europe had deaths/100,000 population in the last fourteen days that were higher than the United States, most at rates that were two-three times the U.S. rate. The rate for the world in total was 1.82 deaths per 100,000 population for the November 16-29 period. The U.S. was 3.38 times the global average at 6.22 deaths per 100,000 population in that two week period. The following 25 European countries exceeded the U.S. rate: France (11.76 deaths/100,000 population); Italy (16.04); Spain (8.31); United Kingdom (9.40); Armenia (12.81); Austria (13.47); Belgium (18.84); Moldova (6.50); Poland (16.65); Portugal (10.30); Romania (11.50); Serbia (7.11); Switzerland (14.98); Bulgaria (23.69); Croatia (15.92); Czechia (18.74); Greece (11.08); Hungary (16.12); Lithuania (8.12); Luxembourg (13.19); Malta (6.79); Slovenia (19.85); Bosnia and Herzegovina (20.75); Georgia (13.19); and North Macedonia (20.12).

With new restrictions in recent weeks bringing new cases down in a number of European countries, death rates should start to decline as well in the coming weeks. Challenges in terms of superspreader events in Europe include holiday travel and events and winter holidays and sports. Germany has proposed placing restrictions on the ski season to try to minimize increased cases from a sport popular across much of Europe. See DW, 26 November 2020, Coronavirus: Germany seeks EU-wide ban on ski trips, https://www.dw.com/en/coronavirus-germany-seeks-eu-wide-ban-on-ski-trips/a-55732273.

The EU has contracts with at least six pharmaceutical companies or groups for vaccines if approved. The EU and United Kingdom will start to see vaccine dosages within weeks assuming approval in their jurisdictions.

Other countries

While much of the rest of the world has not seen great increases in the number of cases that is not true for all countries. For example, Iran which had 136,753 new cases in the November 2-15 period showed 186,274 new cases in the November 16-29 period (+36.21%). Jordan, which has a total number of cases of 210,709 since the end of December has recorded 65.54% of that total in the last four weeks (68,698 new cases during November 2-15; 69,404 new cases during November 16-29). Similarly, Morocco which has a total of 349,688 cases since December 2019 has more than 37% recorded in the last four weeks (69,127 during November 2-15; 61,477 during November 16-29).

In the Americas the following countries in addition to the United States have two week totals to November 29 greater than 100,000 new cases: Argentina (108,531); Brazil (441,313); Colombia (108,609). The following countries besides the United States have more than one million cases since late December 2019: Argentina (1,413,362); Brazil (6,290,272); Colombia (1,299,613), Mexico (1,100,683). Eleven other countries have more than 100,000 cases (with Peru having 960,368). Other than the U.S., countries are facing different trend lines, many down, some showing increases (e.g., Brazil, Canada, Dominican Republic, Paraguay).

In Asia, while India continues to see declines in the number of new cases, Indonesia, Israel, Japan, Kazakhstan, Malaysia, Pakistan, Palestine, South Korea, showed increased in the most recent two weeks, some quite large. This is in addition to Iran reviewed previously.

In Africa, South Africa has the most cases and saw an increase from 23,730 new cases during November 2-15 to 35,967 during November 16-29. Morocco was reviewed above. Most other major countries in Africa saw declines in recent weeks.

Conclusion

The world in the first eleven months of 2020 has struggled to get the COVID-19 pandemic under control with several major surge periods. The global number of new cases seems to have plateaued over the last week or so at extraordinarily high levels and the death rates has bodog casino been climbing after a long period where deaths appeared to be declining. It is likely that the death rate will continue to increase for the rest of 2020.

After a period during the summer and early fall where restrictions in a number of countries were being relaxed, many countries in the norther hemisphere are reimposing various restrictions in an effort to dampen the spread of the coronavirus. While trade has significantly rebounded from the sharp decline in the second quarter of 2020, services trade remains more than 30% off of 2019 levels driven by the complete collapse of international travel and tourism. Many WTO members have put forward communications on actions that could be considered to speed economic recovery. The most recent was the Ottawa Group’s communication about a possible Trade and Health Initiative. See November 27, 2020, The Ottawa Group’s November 23 communication and draft elements of a trade and health initiative, https://currentthoughtsontrade.com/2020/11/27/the-ottawa-groups-november-23-communication-and-draft-elements-of-a-trade-and-health-initiative/.

The WTO TRIPS Council has a request for a waiver from most TRIPS obligations for all WTO Members on medical goods and medicines relevant to COVID-19 on which a recommendation is supposed to be forwarded to the General Council by the end of 2020 though it is opposed by a number of major Members with pharmaceutical industries. See November 2, 2020, India and South Africa seek waiver from WTO intellectual property obligations to add COVID-19 – issues presented, https://currentthoughtsontrade.com/2020/11/02/india-and-south-africa-seek-waiver-from-wto-intellectual-property-obligations-to-address-covid-19-issues-presented/.

With vaccines very close to approval in major markets like the United States and the European Union, there will be increased focus on efforts to ensure availability of vaccines and therapeutics and diagnostics globally on equitable and affordable terms. GAVI, CEPI and the WHO have been leading this initiative with the support of many governments and private sector players. Pharmaceutical companies also have global distribution plans being pursued in addition to the above efforts.

So there hopefully is light at the end of the tunnel that the COVID-19 pandemic has imposed on the world. But vaccines without vaccinations won’t solve the pandemic’s grip. So communication and outreach globally will be critical to seeing that available vaccines are properly used. And all peoples need to be able to access the vaccines, some of which will be less available simply because of the infrastructure needs to handle the vaccines.

Trade policy options to minimize trade restrictions coupled with global cooperation and coordination should result in the world being able to rebuild in 2021 and beyond as more and more of the world is vaccinated.

Multilateral efforts to help the poorest countries deal with debt, make available trade finance and other actions continue to be a pressing need. Better plans and preparation for pandemics of the future are clearly needed. Reports suggest that many of the poorest countries have experienced loss of a decade or more of economic advancement during the pandemic. Building back greener and in a sustainable manner is critical for all.

The efforts of developed country governments and others to provide the stimulus domestically to reduce the downward spiral of the individual national economies and the global economy has been critical to limiting the damage at home and abroad. But the assumption of large amounts of debt will also pose significant challenges moving forward because of the greatly heightened national debt/GDP ratios that have developed and may restrict options for individual governments moving forward.

What is certain is that 2020 will be remembered as a year in which a virus inflicted enormous damage to the global health and to the global economy. Collectively, the level of spread has been far greater than should have been possible. Many nations were not prepared. Some, like the United States, exacerbated the problems through a lack of national government planning and messaging. Others like many in Europe, having done a good job of controlling the spread in the early months, made major mistakes as they opened up for summer vacations and didn’t deal with the problems that resulted from the reopening and experienced breathtaking surges which roughly doubled the global daily rate of new cases in five-six weeks and have led to the reimposition of a series of restrictions to try to tame the pandemic a second time. We collectively are better than the results achieved to date. The number of deaths in advanced countries is simply disgraceful.

2021 offers the opportunity for the world to come together and put COVID-19 behind us. Whether we will come to the end of 2021 and feel that this global nightmare is behind us and that there are national and global game plans to rebuild in a greener and more sustainable manner with greater opportunities for all is the question. Hopefully, the answer will be yes.

Terence Stewart, former Managing Partner, Law Offices of Stewart and Stewart, and author of the blog, bodog poker review|Most Popular_Congressional

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This post looks at several recent activities of the WHO.

July 31, 2020 4th Meeting of the Emergency Committee regarding the outbreak of coronavirus disease (COVID-19)

On July 31, a meeting of health experts from around the world was convened by the WHO’s Director-General under the Inernational Health Regulations (IHR)(2005). It was the fourth meeting of the Emergency Committee regarding the outbreak of coronavirus disease (COVID-19). A statement was released from the meeting on August 1. https://www.who.int/news-room/detail/01-08-2020-statement-on-the-fourth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-coronavirus-disease-(covid-19).

Much of the work of the Emergency Committee is confidential but the statement released includes a summary of issues reviewed and advice provided to the WHO and to States Parties. As reviewed in yesterday’s post, the number of new COVID-19 cases continues to increase around the world. While most of the growth is in developing and least-developed contries, the United States continues to experience huge numbers of new cases, increasing hospitalizations and increasing deaths. Many other developed countries are seeing some resurgence of cases as bodog poker review their economies reopen. See August 2, 2020,  Review of the COVID-19 pandemic – continued growth in cases and deaths, resurgence in some countries where COVID-19 had receded, https://currentthoughtsontrade.com/2020/08/02/review-of-the-covid-19-pandemic-continued-overall-growth-in-cases-and-deaths-resurgence-in-some-countries-where-covid-19-had-receded/.

While many developing and least-developed countries have had relatively small numbers of cases, that is not true for all such countries. Moreover, the sharp contraction in GDP and trade volumes in developed countries and developing countries with large numbers of cases has meant that the economic damage for many of the poorest countries is mounting and is debilitating. The World Bank and IMF are both actively engaged in providing financial assistance to many developing and developed countries. Still the World Bank’s June 2020 Global Economic Prospects estimates that COVID-19 will result in 71-100 million people being pushed into extreme poverty. See https://www.worldbank.org/en/topic/poverty/brief/projected-poverty-impacts-of-COVID-19; World Bank, Global Economic Prospects, June 2020, https://openknowledge.worldbank.org/handle/10986/33748.

Thus, with the continued growth in global cases, the increased concentration in developing and least-developed countries and the huge economic effects occurring as countries try to reduce the spread of COVID-19, it is not surprising that the Emergency Committee “unanimously agreed that the pandemic still constitutes a public health emergency of international concern.” The WHO’s Director-General included a declaration to that effect in the statement released on August 1.

Below is the advice the Committee provided to the WHO Secretariat and the temporary recommendations to State Parties (all material to the next header is from the statement):

Advice to the WHO Secretariat

1. Continue to distill and rapidly communicate lessons learned and best practices from the COVID-19 pandemic and national
   intra-action reviews.
2. Continue to coordinate and mobilize global and regional multi- lateral organizations, partners and networks for robust political
   commitment and resourcing of COVID-19 pandemic preparedness and response, including for development of vaccines and
   therapeutics.
3. Provide nuanced, pragmatic guidance on criteria for appropriate COVID-19 response activities to reduce the risk of response fatigue in the context of socio-economic pressures.
4. Continue to support State Parties and partners in conducting active and community-based COVID-19 surveillance, through technical and operational resources, such as guidance, tools, and trainings on case definitions and identification, contact tracing, and death certifications; encourage State Parties to continue reporting relevant data to WHO through platforms such as the Global Influenza Surveillance and Response System.
5. Accelerate research into remaining SARS-CoV-2 critical unknowns, such as the animal source and potential animal reservoirs, and improve understanding of the epidemiology and severity of COVID-19 (including its long-term health effects; viral dynamics such as modes of transmission, shedding, potential mutations; immunity and correlates of protection; co-infection; as well as risk factors and vulnerabilities) and the effectiveness of public health measures.
6. Continue to work with partners to counter mis/disinformation and infodemics by developing and disseminating clear, tailored
   messaging on the COVID-19 pandemic and its effects; encourage and support individuals and communities to follow recommended public health and social measures.
7. Support diagnostics, safe and effective therapeutics and vaccines’ rapid and transparent development (including in developing countries) and equitable access through the Access to COVID-19 Tools (ACT) Accelerator; support all countries to implement the necessary clinical trials and to prepare for the rollout of therapeutics and vaccines.
8. Work with partners to revise WHO’s travel health guidance to reinforce evidence-informed measures consistent with the provisions of the IHR (2005) to avoid unnecessary interference with international travel; proactively and regularly share information on travel measures to support State Parties’ decision-making for resuming international travel.
9. Support State Parties, particularly vulnerable countries, in strengthening their essential health services and accompanying
   supply chains as well as preparing for and responding to concurrent outbreaks, such as seasonal influenza.

Temporary recommendations to State Parties

1. Share best practices, including from intra-action reviews, with WHO; apply lessons learned from countries that are successfully
   re-opening their societies (including businesses, schools, and other services) and mitigating resurgence of COVID-19.
2. Support multilateral regional and global organizations and encourage global solidarity in COVID-19 response.
3. Enhance and sustain political commitment and leadership for national strategies and localized response activities driven by science, data, and experience; engage all sectors in addressing the impacts of the pandemic.
4. Continue to enhance capacity for public health surveillance, testing, and contact tracing.
5. Share timely information and data with WHO on COVID-19 epidemiology and severity, response measures, and on concurrent disease outbreaks through platforms such as the Global Influenza Surveillance and Response System.
6. Strengthen community engagement, empower individuals, and build trust by addressing mis/disinformation and providing clear guidance, rationales, and resources for public health and social measures to be accepted and implemented.
7. Engage in the Access to COVID-19 Tools (ACT) Accelerator, participate in relevant trials, and prepare for safe and effective therapeutic and vaccine introduction.
8. Implement, regularly update, and share information with WHO on appropriate and proportionate travel measures and advice, based on risk assessments; implement necessary capacities, including at points of entry, to mitigate the potential risks of international transmission of COVID-19 and to facilitate international contact tracing.
9. Maintain essential health services with sufficient funding, supplies, and human resources; prepare health systems to cope with seasonal influenza, other concurrent disease outbreaks, and natural disasters.

Travel and Tourism

In prior posts, I have reviewed the devastating economic consequences of the pandemic on the travel and tourism sector of global economies as countries have restricted entry of people from many countries to reduce the likelihood of travelers having and spreading COVID-19. See April 30, 2020, The collapse of tourism during the COVID-19 pandemic, https://currentthoughtsontrade.com/2020/04/30/the-collapse-of-tourism-during-the-covid-19-pandemic/; May 3, 2020, Update on the collapse of travel and tourism in response to COVID-19, https://currentthoughtsontrade.com/2020/05/03/update-on-the-collapse-of-travel-and-tourism-in-response-to-covid-19/.

The airline industries around the world are in serious trouble, as are restaurants, bars, hotels, sports and entertainment venues and more. The reduced level of air traffic has greatly reduced air cargo availability which has increased costs for many products. At the same time, countries have struggled to find ways to expedite movement of medical goods and permit the travel of essential personnel (e.g., health professionals, transportation employees, etc.). There are not uniform standards being applied by countries on access of international travelers which means confusion and less movement than would happen under agreed rules.

On July 30, the WTO released a document, entitled “Public health considerations while resuming international travel”. The link follows and the document is embedded below. https://www.who.int/news-room/articles-detail/public-health-considerations-while-resuming-international-travel.

The paper advises each country to conduct a risk-benefit analysis and decide on the national priorities of permitting the return/expansion of international travel.

Bodog Poker “WHO recommends that priority should be given to essential travel for emergencies, humanitarian actions (including emergency medical flights and medical evacuation), travel of essential personnel (including emergency responders and providers of public health technical support, critical personnel in transport sector such as seafarers[5] and diplomatic officers), and repatriation. Cargo transport should also be prioritized for essential medical, food and energy supplies. Sick travellers and persons at risk including elderly travellers and people with chronic diseases or underlying health conditions, should delay or avoid travelling internationally to and from areas with community transmission.

“There is no ‘zero risk’ when considering the potential importation or exportation of cases in the context of international travel. Therefore, thorough and continuous risk assessment and management will help identify, reduce and mitigate those risks, while balancing the socio-economic consequences of travel measures (or temporary restrictions) against potential adverse public health consequences.

“The decision process should include an analysis of the situation, taking into account the local context in countries of departure and destination. The following factors should be considered: local epidemiology and transmission patterns, the national public health and social measures for controlling the outbreaks in both departure and in destination countries; public health and health service capacity at national and subnational levels to manage suspect and confirmed cases among travellers, including at points of entry (ports, airports, ground crossings) to mitigate and manage the risk of importation or exportation of the disease; and the evolving knowledge about COVID-19 transmission and its clinical features.”

All countries need to find ways to handle the travel of essential personnel and those involved with emergencies. However, as the note makes clear, while expanding international travel is important for countries, there are a host of considerations that will make movement of non-essential travel dependent on a range of considerations, including the extent to which the pandemic is under control in either the country from which passengers are travelling or in the country of entry. The EU’s list of countries from which non-essential travelers will be permitted into the EU is an example of the approach suggested by the WHO focusing on the extent of the spread in the country from which travelers would leave to arrive in the EU.

What the WHO note makes clear is that the fastest route to reopening of international travel safely is for greater cooperation among countries to both control the spread of COVID-19, for greater transparency in how governments are addressing emerging situations, and for greater attention to the level of health care preparedness to handle surges including testing, tracing and any needed quarantine capabilities.

Considering how quickly situations can change in a given country, an additional challenge for countries reopening international travel will be the flexibility and responsiveness of the country to changing health conditions in trading partners (and in its own country) over time.

Conclusion

The challenges of individual nations in addressing the COVID-19 pandemic should be made more manageable through cooperation with other nations and the work of multilateral organizations including the World Health Organization. Many countries have worked cooperatively to share information, including on research and best practices. The WHO provides a great deal of support to countries and serves as a gathering point for information to improve transparency in the health care responses around the world.

WTO Members need to address trade restrictions that have arisen as countries attempt to slow the spread of the COVID-19 pandemic. Reopening trade and keeping it open are critical to the ability of countries to minimize the economic fallout that has occurred in the first half of 2020 and will continue at least in part in the third quarter and likely beyond. Yet, the ability to keep markets open and increase international travel is complicated by the myriad differences between nations on factors like the level of COVID-19 infection, the health care infrastructure and ability of that infrastructure to handle surges where they occur. The WHO plays a critical role in helping nations understand the tools available to address the pandemic and the considerations that need to be taken into account when reopening markets, including international travel.

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