(0) Jeffrey Sachs advocates WHO Pandemic Treaty
(1) Draft Pandemic Treaty gives WHO power to censor “misinformation” and “disinformation”
(2) Jeffrey Sachs: Hegemonic Theory, Realism, Multilateralism organised around UN institutions
(3) Jeffrey Sachs said (2021) “The G20 Must Act Now to Vaccinate the World”
(0) Jeffrey Sachs advocates WHO Pandemic Treaty
by Peter Myers, Feb. 4, 2023
Jeffrey Sach, in item 2, advocates “Multilateral” Global control vested in the UN and its institutions; this would include support for the WHO’s Pandemic Treaty, and the Censorship that goes with it.
It amounts to World Government by UN Committees.
During the Covid-19 Pandemic he supported world-wide Vaccination. He seems to have supported Lockdowns & Vaccine Mandates.
In item 2, he wants to get the “Great religions” on board, but they oppose homosexuality, whereas the UN and the WEF promote LGBT.
I did a Google site search for “pandemic treaty” on Sachs’ website https://www.jeffsachs.org
There was only 1 hit, of Nov 21, 2022, which I reproduce in item 3 below. This was a statement not by Sachs, but by ‘Dr. Ryan’:
“Dr. Ryan concluded the webinar on a hopeful note, looking to the future pandemic treaty.”
Sachs himself made no comment, but posted the item to his website, implying that he supports the Pandemic Treaty.
(1) Draft Pandemic Treaty gives WHO power to censor “misinformation” and “disinformation”
February 3, 2023
WHO releases international pandemic treaty zero draft that targets “misinformation” and “disinformation”
The unelected global health agency will get new legally binding censorship powers if the treaty passes.
By Tom Parker
Posted 3:30 pm
The World Health Organization (WHO) recently released a zero draft of its international pandemic treaty which will give the unelected global health agency new powers to “tackle” anything that it deems to be “false, misleading, misinformation or disinformation” if passed.
The WHO has been pushing the treaty since December 2021 and those drafting the treaty intend to present a final report to the World Health Assembly (WHA), the WHO’s decision-making body, in May 2024.
If adopted, the treaty will be legally binding under international law and the WHO’s 194 member states (which represent 98% of all the countries in the world) would be required to comply with the treaty’s demands to target misinformation.
The zero draft is similar to previous versions of the treaty and the provisions related to misinformation are described in Article 17 (“Strengthening pandemic and public health literacy”).
This section of the treaty calls for member states to “tackle false, misleading, misinformation or disinformation, including through promotion of international cooperation.”
It also urges member states to manage “infodemics” — a term coined by the WHO that refers to “too much information including false or misleading information in digital and physical environments during a disease outbreak.” Specifically, member states are told to manage these so-called infodemics “through effective channels, including social media.”
The scope of this treaty also extends beyond the WHO’s member base. Article 16 (“Whole-of-government and whole-of-society approaches at the national level”) urges member states to collaborate with non-state actors and the private sector as part of a “whole-of-society response in decision making, implementation, monitoring and evaluation, as well as effective feedback mechanisms.”
We obtained a copy of the zero draft of the WHO’s pandemic treaty for you here.
As with any attempt to censor content that’s deemed to be misinformation, this pandemic treaty raises questions about how these so-called authorities will decide what misinformation is. Experts are now starting to admit that many claims that were once pushed as being true by authorities, such as the claim that Covid vaccines would prevent infection, are false.
And these questions are particularly pertinent in this instance because the WHO is infamous for a misleading tweet during the early stages of the pandemic that amplified claims from Chinese authorities that there was “no clear evidence of human-to-human transmission” of the coronavirus.
The WHO released this zero draft of the international pandemic treaty during its 152nd executive board meeting which began on 30 January and will end on February 7.
The international pandemic treaty will be adopted under Article 19 of the WHO Constitution if passed. This article lets the WHA impose legally binding conventions on WHO member states with a two-thirds majority vote.
Typically, elected officials vote on the laws that apply to their country, but with this WHO lawmaking process, a handful of global representatives decide the rules that apply to all countries. Regardless of whether a third of WHO member states vote against the international pandemic treaty, it will still apply to their countries under international law.
In addition to limiting politicians’ power to decide on the laws that apply to their country, this process also limits citizens’ ability to hold politicians accountable at the ballot box. WHO member state representatives are mostly unelected diplomats who remain in their positions regardless of changes in governments. And the majority of votes determining whether an international law applies to a particular country are cast by representatives from other nations.
The international pandemic treaty has the backing of many democratic countries, including the United States (US), United Kingdom (UK), Canada, Australia, New Zealand, and the European Council (EC) (which represents 27 European Union (EU) member states), despite the WHO’s undemocratic lawmaking process.
The release of this zero draft international pandemic treaty comes days after the WHO said misinformation needs to be tackled. The WHO also recently shared a video stating that “anti-vaccine activism” is deadlier than “global terrorism.”
(2) Jeffrey Sachs: Hegemonic Theory, Realism, Multilateralism organised around UN institutions
The new geopolitics
By Jeffrey Sachs
Feb 4, 2023
There is universal assent that we are in a period of geopolitical tension and flux. In a rough chronology, 1815-1914 was the era of British hegemony, the not-so-peaceful Pax Britannica.
What followed between 1914 and 1945 was a disastrous period of two world wars and the Great Depression. The end of World War II marked the rise of the United States as the new hegemon as well as the start of the Cold War between the United States and the Soviet Union. This period lasted from 1947 to 1989. The period from 1989 to around 2008 has been described (rightly or wrongly) as the unipolar world, with the United States widely regarded as the sole superpower. In the past decade or so we have entered a new geopolitical era, but of what kind?
There are at least five major theories about the current geopolitics. The first three are variants of the Hegemonic Stability Theory; the fourth is the important school of international realism. The fifth is my preferred theory of multilateralism, based on the pre-eminent importance of global cooperation to solve pressing global problems.
The Hegemonic Stability Theory, favoured by American elites in politics, government, and academia, holds that the United States remains the world’s hegemon, the sole superpower, albeit a hegemon that is challenged by a rising competitor, China, and by a lesser but nuclear-armed competitor, Russia.
The Hegemonic Competition Theory, sometimes nicknamed the Thucydides Trap theory, holds that China’s rise has ushered in a period of confrontation between the United States and China, alongside the ongoing confrontation of the United States and Russia. The U.S.-China competition is analogised to that of Sparta and Athens in the Peloponnesian Wars, with China playing the role of Athens, the rising power in the fourth century BCE Hellenic world, challenging Sparta, the incumbent power.
The Hegemonic Decline theory focuses on the fact the United States is no longer willing or able to play the role of global stabiliser (if it ever did). According to this theory, our current period will be akin to the period of British decline after World War I and before the rise of American hegemony. The Hegemonic Decline theory holds that the waning of a hegemon leads to global instability.
The Realist theory holds that geopolitics is defined by great power politics, with China, the United States, the EU, Russia, and increasingly India, playing the role of the great powers, and sharing the world stage with regional powers (such as Brazil, Indonesia, Iran, Pakistan, and Saudi Arabia, among others).
The Multilateralist theory, to which I subscribe, holds that only global cooperation and multilateralism, organised around UN institutions, can save us from ourselves, whether from war, dangerous technologies, or human-induced climate change. Multilateralism is often dismissed as excessively idealistic because it calls for cooperation among nations, yet I will argue that it is in fact more realistic than the Realist theory.
Of course, there are several other important approaches to geopolitics, including Marxist theories focusing on the interests and power of globally mobile financial capital, Immanuel Wallerstein’s core-periphery theory, and Samuel Huntington’s clash-of-civilisations theory. These are all well-known and have been widely debated. For the sake of brevity, I will focus on the three hegemonic theories, realism, and multilateralism.
Economic drivers of long-term geopolitical change
America was far and away the world’s leading power at the end of World War II. According to the estimates of historian Angus Maddison (2010), the United States produced 27.3 percent of global output (measured at international prices) as of 1950, though constituting only 6 percent of the world population (and today only 4.1 percent). The Soviet Union was the next largest economy, at roughly one-third of the United States, while China was third, at roughly one-sixth. The American advantage was not only in total GDP but in science, technology, higher education, depth of capital markets, sophistication of business organisation, and quality and quantity of physical infrastructure. American multinational companies circled the globe to create global supply chains.
The U.S. predominance has gradually declined since 1950 mainly because other parts of the world have gradually caught up with the United States in advanced technologies, skills, and physical infrastructure. As theory predicts, globalisation promoted the spread of scientific and technological know-how, higher education, and modern infrastructure. East Asia was the greatest beneficiary of globalisation. East Asia’s take-off started with Japan’s rapid postwar rebuilding during 1945-1960, followed by its decade of income doubling in the 1960s. Japan in turn provided a roadmap for the four Asian Tigers (Korea, Taiwan, Hong Kong, and Singapore), which began their rapid growth in the 1960s, and then for China starting in the late 1970s with Deng Xiaoping’s reforms and opening of the country to the world. According to Maddison’s estimates, 16 major East Asian economies produced 15.9 percent of world output in 1950, 21.7 percent in 1980, and 27.8 percent in 1990. In the 1990s, India too began an era of economic opening and rapid growth.
When the Soviet Union dissolved in 1991, the United States did not face any major competitor for global leadership. While the Western European economy was broadly comparable in size to the American economy, Western Europe remained dependent on the United States for military security and was in any event a disjoint group of nations with foreign policies generally subordinate to the United States. East Asia had grown rapidly but was even less of a geopolitical force than Europe. According to IMF measurements, China’s GDP measured in constant international dollars was 17.5 percent of American GDP despite a population that was 4.6 times the size. Its per capita income was therefore a mere 3.8 percent of the U.S. according to the IMF estimates. China’s technologies and military capacity were decades behind those of the United States, and its nuclear arsenal was small. It is perhaps understandable that policymakers in Washington assumed that the United States would be the world’s sole superpower for decades to come.
What they failed to anticipate, of course, was the ability of China to grow rapidly for decades to come. Between 1991 and 2021, China’s GDP (measured in constant international dollars) grew 14.1 times, while the American GDP grew 2.1 times. By 2021, according to IMF estimates, China’s GDP in constant 2017 international prices, was 18 percent larger than U.S. GDP. China’s GDP per capita rose from 3.8 percent of the U.S. in 1991 to 27.8 percent in 2021 (IMF estimates in constant international dollars).
China’s rapid gains in output and output per person were underpinned by rapid Chinese advances in technological knowhow, capacity to innovate, quality education at all levels, and the upgrading and modernisation of infrastructure. Naïve and sometimes racist American punditry has dismissed China’s success as nothing more than China stealing American know-how, as if the United States is the only society that can harness modern science and engineering, and as if it too doesn’t rely on scientific and technological advances made elsewhere. In fact, China has been catching up by mastering advanced technological knowledge and taking measures to become a major innovator in its own right.
Nor should we neglect the rising economic power of both India and Africa, the latter including the 54 countries of the African Union. India’s GDP grew 6.3 times between 1991 and 2021, rising from 14.6 percent of America’s GDP to 44.3 percent (all measured in international dollars). Africa’s GDP grew significantly during the same period, eventually reaching 13.5 percent of U.S. GDP in 2022. Most importantly in this context, Africa is also integrating politically and economically, with important steps in policy and physical infrastructure to create an interconnected single market in Africa.
In the past 30 years, three basic economic changes have transformed geopolitics. The first is that the U.S. share of global output declined from 21.0 percent in 1991 to 15.7 percent in 2021, while China’s rose from 4.3 percent in 1991 to 18.6 percent in 2021. The second is that China has overtaken the United States in total GDP and has become the leading trade partner for much of the world. The third is that the BRICS, constituting Brazil, Russia, India, China, and South Africa, have also overtaken the G7 countries in total output. In 2021, the BRICS had a combined GDP of $42.1 trillion (measured in constant 2017 international prices), compared with $41.0 trillion in the G7. In terms of combined population, the BRICS, with a 2021 population of 3.2 billion, is 4.2 times the combined population of the G7 countries, at 770 million. In short, the world economy is no longer American-dominated or Western-led. China is of comparable overall economic size to the United States, and the large middle-income countries are a counterweight to the G7 nations. It is notable that four G20 Presidencies in a row will be held by middle-income developing countries: Indonesia (2022), India (2023), Brazil (2024), and South Africa (2025).
Contrasting visions of geopolitics
As China has matched or overtaken the United States in economic size and has become the leading trade partner with many countries around the world, and as the BRICS have matched the G7 in overall economic size, a debate rages in the United States and globally about America’s changing role and power, and the implications for the future of global governance and international affairs. As mentioned above, there are five schools of thought, which I now review in greater detail.
The Hegemonic Stability theory remains the dominant school of thought in the United States, at least in the leadership circles and East Coast think tanks and academic centers. According to this view, the U.S. and the U.S. alone can maintain geopolitical hegemony and thereby provide stability to the world. When the United States speaks of the “rule-based order,” it is not speaking of the UN system or international law. It is speaking of an American-led order, in which Washington, in consultation with its allies, writes the global rules.
According to this view, China remains far behind the United States in all key categories of power: economic, military, technological, and soft power. Russia is viewed as a declining, nearly defunct, regional power—albeit one with a large nuclear arsenal. In this school of thought, the nuclear threat can be contained through counter-threats and deterrence. American hegemony will ensure that Russia will play no major geopolitical role in the future. This hegemonic vision, known as neoconservatism in the United States, finds its expression in a wide range of policies.
The war in Ukraine forms a central part of Washington’s strategy for continued U.S. hegemony. While American policymakers presumably bemoan the destruction and deaths in Ukraine, they also welcome the opportunity to push NATO’s eastward enlargement and bleed Russia through a war of attrition. The Washington policy elite is in no hurry to end the war.
Nor is it eager to look more deeply at the roots of the war, which was surely provoked in part by the United States in its battle with Russia for political and military influence in Ukraine. This competition turned red-hot after George W. Bush pushed NATO in 2008 to commit to enlarging to Ukraine and Georgia. This was part of a long-term game plan, outlined by Zbigniew Brzezinski in his 1997 book The Grand Chessboard, to end the ability of Russia to project its power towards Western Europe, the Eastern Mediterranean, or the Middle East.
Russia will presumably fight at all costs to prevent NATO enlargement to Ukraine. When Ukraine’s pro-Russian President Viktor Yanukovych—who favoured Ukraine’s neutrality instead of NATO enlargement—was overthrown with American financial and logistical support in early 2014, the Russo-Ukrainian war broke out. Russia retook Crimea and pro-Russian separatists claimed part of the Donbas. The war has escalated since 2014, most dramatically with Russia’s invasion on February 24th, 2022. In turn, the G7 and NATO have committed to support Ukraine for as long as necessary, with the goal of weakening Russia in the long term.
In addition to funding and arming Ukraine, the United States has now adopted the strategy of containing China, that is, hindering China’s continued economic and technological progress. The containment policy vis-à-vis China mimics the American strategy vis-à-vis the Soviet Union between 1947 and 1991. The anti-China containment policies include tariff increases on Chinese products; actions to cripple high-tech telecoms Chinese enterprises such as Huawei and ZTE; bans on exports of high-end semiconductors and semiconductor manufacturing equipment to China; decoupling American supply chains from China; creating new trade blocs, such as the Indo-Pacific Economic Framework, that exclude China; and an “entity list” of Chinese companies that are, in one way or another, barred from U.S. finance, trade, and technology. On the military front, the United States is forming new anti-China alliances such as AUKUS, with the UK and Australia, in this case to create a new nuclear submarine fleet and base in Northern Australia to police the South China Sea. The United States is also aiming to step up its military support for Taiwan, in one neocon phrase: to turn Taiwan into a “porcupine.”
The main competing vision of geopolitics today is the Hegemonic Competition theory, focusing on the coming clash between the United States and China. This theory is really a variant of the Hegemonic Stability theory. It argues that the United States may lose its hegemonic status to China, and that in any event, a bitter competition of the two countries is virtually inevitable.
The main failing of the Hegemonic Competition vision is its belief that China wants to become, the next global hegemon. True, Chinese leaders do not trust the United States nor Europe, especially in view of China’s suffering at the hands of outside imperial powers during the nineteenth and twentieth centuries. China aims for a world in which the United States is not the hegemon. Yet there is little persuasive evidence that China wants to replace America as hegemon or could do so even if it so desired.
Consider that China is still a middle-income country, with decades ahead needed to become a high-income country. Consider too that China’s population will likely decline markedly in the decades ahead. In that context, China will also age markedly, with the median age rising from 47 years today to 57 years by 2100 according to UN projections. Finally, consider that China’s statecraft over centuries has never sought a global empire. The Middle Kingdom has always sufficed. China has not fought one foreign war in 40 years, and has just a few small overseas military bases, compared with the hundreds operated by the U.S. military.
Rather than China’s hegemonic aspirations, which I believe do not actually exist, the real problem is the so-called “Security Dilemma,” according to which both China and the United States misconstrue the defensive actions of the other side as being offensive, thereby falling into an escalatory mode. For example, as China builds its military in the South China Sea, in its view to protect its vital sea lanes, Washington interprets this as an aggressive action by China aimed at American allies in the region. As the United States forms new alliances such as AUKUS and strengthens existing alliances, China regards these as blatant hegemonic attempts to contain China. Even when particular actions are truly defensive in nature—and not all of them are—they are readily misconstrued by the other side. This is indeed a major reason why the Thucydides Trap easily gives rise to war: not really because the two countries want war, but because they stumble into it by misinterpreting the actions of the other side.
The Hegemonic Decline theory is somewhat different. Instead of emphasising the battle between China and the United States, this third theory emphasises the implications of American Hegemonic Decline, which it takes for granted. The Hegemonic Decline theory starts with the idea that the world needs global public goods, such as macroeconomic stabilisation policies, arms control, and common efforts against human-induced climate change. To ensure these public goods, according to this theory, a hegemon must bear the burden of providing the global public goods. In the nineteenth century, Britain underwrote Pax Britannica. Since 1950, the United States has supplied the global public goods. Yet with the gradual decline of the United States, there is no longer a hegemon to ensure global stability. Thus, we face a world of chaos, not because of U.S.-China competition, but because no country or region can coordinate global efforts to provide global public goods.
Charles Kindleberger, the MIT economic historian, was the originator and most persuasive proponent of the Hegemonic Decline theory, applying it to the Great Depression in his insightful book The World in Depression: 1929-1939 (1973). He argued that when the Great Depression hit, global cooperation was needed to address inter-country debts, failed banks, budget deficits, and the gold standard. Yet the UK was gravely weakened by World War I and the prolonged economic crisis of the late 1920s, and so was unable to act as a hegemon. The United States, alas, was not yet ready to take over that role, and would do so only after World War II.
All three hegemonic theories presume that hegemons are central to geopolitics and will remain so. The first assumes that the United States remains the hegemon; the second assumes that the United States and China are in competition to be the hegemon; and the third bemoans the absence of a hegemon just when we need one. This third theory, even though declaring the U.S. a has-been, is in some way still flattering it: après l’Etats Unis, le deluge.
The Realist theory denies the central role of hegemony, and perhaps would question whether America was ever truly the global hegemon. According to the realists, peace requires skillful balancing among the major powers. The essence of the realist theory is that no single power can or should presume to dictate to the rest; all need to manage their policies prudently to avoid provoking a conflict with the other powers. Leading realists such as Henry Kissinger and John Mearsheimer, for example, call for a negotiated end to the Ukraine War, arguing wisely that Russia is not going to disappear from the map, or from its geopolitical importance, and emphasising that the war was partly provoked by the American misstep of crossing Russia’s redlines, notably regarding NATO enlargement to Ukraine and Georgia.
The realists argue for peace through strength, arming allies as necessary, and being on guard against aggressive actions by potential adversaries who cross American redlines. Peace, in the realist view, is achieved through the balance of power and the potential deployment of force, not through goodwill or high ideals. Deterrence matters. China is a competitor that must be matched economically, technologically, and militarily, but not necessarily a military foe. War can be avoided. The most famous historical model for the realists is Kissinger’s depiction of the Concert of Europe in the nineteenth century that kept the peace for most of the century.
The biggest challenge facing the realists is that maintaining a balance of power is very difficult when the relative capacities of the major powers is in great flux. The Concert of Europe broke down mainly because two major powers were on the rise economically. Germany surpassed Britain in GDP (on Maddison’s estimates) in 1908. The Russian empire was also growing economically, with a GDP about the size of Germany’s from 1870 onward. Britain feared Germany’s rise, and Germany feared a two-front war against Britain and Russia, which of course is exactly what transpired in 1914. According to many historians, Germany pressed for war in 1914 out of the conviction that delay would mean a more powerful Russia in the future.
Geopolitics as a problem solver?
The essential problem with these four prevailing geopolitical theories is they view geopolitics almost entirely as a game of winning and losing among the major powers, rather than as the opportunity to pool resources to face global-scale crises. The Hegemonic Decline theory recognises the need for global public goods but holds that only a hegemon will provide those global public goods.
The Multilateralist theory starts from the premise that the world urgently needs geopolitical cooperation to solve global-scale challenges such as human-induced climate change and financial instability, and to avoid war among the major powers. The core of the multilateralist vision is the belief that global public goods can be provided cooperatively by the UN member states rather than by a single hegemon. The focus is on the constructive role of international law, international financial institutions, and international treaties, all under the framework of the UN Charter and Universal Declaration of Human Rights and supported by UN institutions.
This view is often argued to be unrealistic and dismissed as too idealistic. There are many plausible reasons for doubt: the UN is too weak; treaties are unenforceable; countries free ride on global agreements; and the veto power of the five permanent members of the Security Council (China, France, Russia, the United Kingdom, and the United States) paralyses the UN. These points are true, but not decisive in my view. Cooperation can be strengthened if the case for it is better understood. Most importantly, neither the three hegemonic theories nor realism offer solutions to our global crises.
The Hegemonic Stability theory fails because the United States is no longer strong enough and interested enough to bear the burdens of providing Hegemonic Stability. In the late 1940s, the United States was ready to fund and support global public goods, including the establishment of the UN, the Bretton-Woods Institution, the GATT, the Marshall Plan, and others. Today, the U.S. does not even ratify the vast majority of UN treaties. It breaks GATT rules, shirks decarbonisation, underfunds the UN and Bretton Woods institutions, and gives a pittance of its gross national income (0.16 percent) as foreign assistance.
The Hegemonic Competition theory fails because it presages conflict rather than solutions to problems. It is as best an explanation of global turbulence but not a strategy for peace, security, or global problem-solving. It is a predication of crisis. It is crucial to recall that both Sparta and Athens suffered from the Peloponnesian Wars.
The Realist approach is far more accurate, practicable, and useful than the hegemonic theories. Yet the Realist approach also suffers from three major weaknesses. First, while it calls for a balance of power to keep the peace, there is no permanent balance of power. Past balances quickly become current imbalances.
Second, as with the game theory that underpins Realism, both game theory and Realism underestimate the potential for cooperation in practice. In the Realist approach, non-cooperation among nations is assumed to be the only feasible outcome of geopolitics because there is no higher power to enforce cooperation. Yet in experimental game theory and in practical geopolitics, there is a lot more scope for successful cooperation (e.g., in the experimental Prisoner’s Dilemma game) than the theory predicts. This point has been emphasised for decades by Robert Keohane and was also emphasised by the late John Ruggie.
Third, and most importantly, Realism fails because it fails to solve the problem of global public goods, needed to address environmental crises, financial crises, health crises, and others. No single hegemon is going to provide the needed global investments. A global cooperative approach is needed to share the costs and spread the benefits widely.
The roadmap for achieving twenty-first-century multilateralism requires a separate essay. In short, twenty-first-century multilateralism should build on two foundational documents, the UN Charter and the Universal Declaration of Human Rights, and on the family of UN institutions. Global public goods should be financed by a major expansion of the multilateral development banks (including the World Bank and the regional development banks) and the IMF. The new multilateralism should be based on globally agreed goals, notably the Paris Climate Agreement, the Biodiversity Agreement, and the Sustainable Development Goals. It should bring the new cutting-edge technologies, including digital connectivity and artificial intelligence, under the ambit of international law and global governance. It should reinforce, implement, and build on the vital agreements on arms control and denuclearisation. Finally, it should draw strength from the ancient wisdom of the great religious and philosophical traditions. There is a lot of work ahead to build the new multilateralism, yet the future itself is at stake.
Jeffrey D. Sachs, Professor of Sustainable Development and Professor of Health Policy and Management at Columbia University, is Director of Columbia’s Center for Sustainable Development and the UN Sustainable Development Solutions Network. He has served as Special Adviser to three UN Secretaries-General. His books include The End of Poverty, Common Wealth, The Age of Sustainable Development, Building the New American Economy, and most recently, A New Foreign Policy: Beyond American Exceptionalism.
(3) Jeffrey Sachs said (2021) “The G20 Must Act Now to Vaccinate the World”
(Feb 4, 2023, past 12m) No results found for site:https://www.jeffsachs.org “pandemic treaty”
Only 1 hit, recorded lectures Nov 21, 2022:
Dr. Ryan concluded the webinar on a hopeful note, looking to the future pandemic treaty
Nothing by Sachs himself==
Jeffrey D. Sachs
The G20 Must Act Now to Vaccinate the World
It is imperative that the G20 finance ministers’ meeting in Venice this week act to provide the COVID-19 vaccines needed to achieve worldwide comprehensive adult immunization by early 2022. Given current production, this should not be a problem, so long as a global plan is quickly implemented.
Jeffrey D. Sachs and Juliana Bartels
Jul 7, 2021
SIRACUSA – When G20 finance ministers meet in Venice on July 9-10, they should adopt a plan to immunize the world against COVID-19. Every vaccine-producing country will be in the room: the United States, the United Kingdom, the European Union, China, Russia, and India. Together, these countries produce enough doses to complete the immunization process for the entire globe by early 2022. Yet the world still lacks a plan to get it done.
The existing global effort to bring vaccine coverage to poor countries, known as the COVID-19 Vaccine Global Access (COVAX) facility, has fallen disastrously short of what is needed. Vaccine-producing countries have used their output to vaccinate their own populations – with many millions of doses to spare. And vaccine-producing companies have made secret deals with governments to sell vaccines bilaterally rather than through COVAX at a lower cost.
The world is plagued by the selfishness of the vaccine-producing countries, the greed of the companies, and the collapse of basic cooperative governance between the world’s major regions. We doubt that experts from the US government have ever met (even by Zoom) with their counterparts in China and Russia to plan a global vaccine campaign. The US has been more interested in shipping vaccines to Taiwan, presumably to embarrass the People’s Republic of China, than to work with China to protect the entire world.
Scientists have been sounding the alarm that delay in global vaccine coverage could prove devastating for the entire world, as new variants arise that evade the existing vaccines. That ominous breakout is already underway. Israeli scientists have reported that the Pfizer-BioNTech vaccine is only 64% effective against the Delta variant, compared to 95% effective against the original virus (though four other studies found significantly higher efficacy).
The good news is that comprehensive global vaccine coverage is feasible. Global production levels are now high enough to reach comprehensive coverage for the adult population in every country within a few months. What we need now are plans to share vaccine doses among countries worldwide, rich and poor alike, supported by logistics and financing. None of this is out of reach if the G20’s members finally start planning seriously.
Shockingly, there are no systematic, comprehensive, and up-to-date official figures on expected monthly vaccine production according to producing company and country. We have based our estimates of likely vaccine production in the coming months on the actual doses delivered and each company’s announcements, mainly in statements to investors for press releases. From this projection, we have devised a preliminary timeline to achieve a high level of global vaccine coverage. The failure of COVAX, the World Health Organization, the G20, and the vaccine-producing countries to do the same amounts to a dramatic breakdown of global cooperation.
Our estimate is the following. Monthly production by all companies producing COVID-19 vaccines that have received emergency use listing by the WHO and national regulatory authorities, and that are being widely administered between July and December 2021, will average around one billion doses.
The world’s population is 7.8 billion, and 5.8 billion are 15 or older. If we define comprehensive immunization as 80% coverage of the adult (15 and older) population in each country, the world should be aiming to immunize 4.6 billion individuals.
As of June 30, about 850 million people have been fully immunized, and about 950 million more have received the first dose of the vaccine. To achieve 80% adult vaccination coverage globally, around six billion additional doses will be required.
We have made a preliminary spreadsheet model showing that with about one billion vaccine doses delivered each month and approximately six billion doses required, we can achieve comprehensive vaccine coverage in about six months – by early 2022. The precise numbers depend on the specific combination of vaccines. But that will happen only if there is a global plan that includes a timetable to allocate the doses across all countries, a logistical plan to transport the vaccines, an implementation plan within every country, and a financing plan.
The situation is especially urgent in Africa, where only about 16 million people, or just 2% of the adult population, were fully immunized as of June 30. This is incredibly low, especially compared with full vaccination rates of 17% of the worldwide adult population outside of Africa, and far higher rates in the vaccine-producing countries: 57% of the adult population in the US, 59% in the UK, 40% in the EU, 15% in Russia, and 6% in India as of June 30, and 19% in China as of June 10.
There are enormous global risks. The Delta variant is now surging through Africa, auguring a monumental catastrophe unless immunization coverage is dramatically accelerated. The Africa Task Force of the Lancet COVID-19 Commission has issued an urgent appeal for 300 million vaccine doses for Africa.
Moreover, new variants with a greater ability to evade the existing vaccines may soon emerge. And the global anti-vax movement and disinformation campaigns have spurred vaccine hesitancy, which means that even when doses are available, uptake falls well below comprehensive adult coverage.
In short, we are still profoundly unsafe – everywhere. The four million confirmed COVID-19 deaths to date (excess death figures indicate that actual deaths are probably many times higher) are the tragic result of the world’s failure to respond to COVID-19 with clarity, cooperation, and compassion. The G7 pledge last month to donate 870 million doses, enough to immunize around 435 million people fully, remains far short of a global plan.
It is imperative that the G20 come together and act to provide the needed vaccines. The world’s health depends on what happens in Venice this week.
Jeffrey D. Sachs
Health leaders discuss Mechanisms and Coordination of Global Health Governance and Finance
On November 21, 2022, SDSN and the Center for Sustainable Development at Columbia University (CSD) hosted the second of three webinars to discuss the Lancet COVID-19 Commission’s findings and recommendations, as presented in their final report: The Lancet Commission on lessons for the future from COVID-19.
The Lancet COVID-19 Commission, which ran from July 2020 to October 2022, was an interdisciplinary initiative encompassing the health sciences, business, finance, and public policy. From 2020 – 2022, the Commissioners and Task Forces focused on four main themes: (1) recommendations on how to best suppress the epidemic; (2) addressing the humanitarian crises arising from the pandemic; (3) addressing the financial and economic crises resulting from the pandemic; and (4) rebuilding an inclusive, fair, and sustainable world.
The Webinar on Global Health Finance and Governance presented opportunities for global health leaders to discuss the mechanisms and coordination of international financing efforts for pandemic preparedness and recurrent health systems costs; collaboration between the development finance institutions and normative health bodies like the World Health Organization (WHO); and national and regional plans for health system needs and governance.
Prof. Jeffrey Sachs, Chair of the Lancet COVID-19 Commission, framed the high stakes and challenge of poor health systems and preparedness succinctly: the COVID-19 pandemic has had an estimated death toll of 18 million. He then summarized the relevant recommendations of the Commission for global health governance:
Countries should strengthen national health systems on the foundations of public health and universal health coverage.
Each country should determine and expand national pandemic preparedness plans. Countries in the Asia-Pacific region that dealt with SARS in 2003-2004 were best prepared to respond to COVID-19, as their specific readiness plans resulted in lower burdens of disease and death even before vaccines were introduced in 2021.
Funding for LICs and LMICs must be a centerpiece of the global response. A unified Global Health Fund (GHF) should be created that is closely aligned with WHO and draws together the existing funds for health: Gavi; COVAX; The Global Fund for AIDS, TB, and Malaria; and the new Pandemic Preparedness Financial Intermediary Fund (FIF) at the World Bank.
UN member states and the G20 should adopt a new financial architecture to scale financing for LICs and LMICs to meet the urgent challenges of pandemic preparedness and the SDGs.
Prof. Jeffrey Sachs stressed that Universal Health Care (UHC) does not exist yet, and that the shortfall is most dire in the poorest parts of the world. He emphasized, “There is nothing that prevents us moving the resources to achieve UHC, but poverty remains the biggest killer.” He presented maps to show that 30-year gaps in life expectancy between high-income countries such as Japan and low-income countries in sub-Saharan Africa correspond closely to gaps in health expenditure that vary by two orders of magnitude. These maps also corresponded to those showing COVID-19 vaccine coverage. Prof. Sachs expressed hope for a breakthrough of funding to be announced at the 2023 Global Summit on UHC in September 2023 at the UN General Assembly.
Dr. Mike Ryan, Executive Director of the WHO Health Emergencies Programme, pointed out that global targets for UHC (Sustainable Development Goal 3.8) do not include public health functions to address epidemics and pandemics. He argued that essential health care and essential public health services should be delivered at the same time through a primary health care-led system that is fully integrated and interoperable, stating, “The last mile of health delivery – primary healthcare – is the first mile of health security.”
Dr. Ryan outlined the five essential functions for emergency health preparedness and response: safe scalable care, community protection, collaborative surveillance, access to countermeasures, and coordination. These require greater levels of sustainable financing to fill the gap (estimated at more than 10 billion USD a year), aligned and coordinated through multilateral funding mechanisms with an effective governance system. Dr. Ryan cautioned that the Pandemic FIF at the World Bank does not address at-risk funding for downstream access to countermeasures, which may need a commitment (triggerable fund) to scale up funding in the event of an epidemic or other emergency. He lamented the disintegration of the preparedness system into hundreds of vertically funded plans rather than one national plan, which drives corruption and fractures support. Dr. Ryan also spoke of the progress toward the global pandemic accord, and welcomed the close collaboration of the World Bank, the G20, and the WHO on health governance.
Prof. Sachs clarified the two kinds of funding being discussed. The first was ongoing funding for health systems, which face the fundamental problem of poverty, as government budgets in a significant part of the world cannot cover recurrent costs. The second was funding for emergency responses to pandemics, which requires an elastic supply of financing, as was seen in the trillions of dollars spent to combat COVID-19 in the rich countries, whereas financing for mechanisms like COVAX was almost impossible to raise.
Dr. Juan Pablo Uribe, Global Director for Health, Nutrition & Population, and the Global Financing Facility at the World Bank, provided context on the World Bank’s Pandemic FIF. He acknowledged that although the FIF is confronted with needs and expectations many times bigger than the 1.5 billion USD already committed, it has brought together institutions, governments, and civil society, and there are many opportunities to strengthen its governance, decide on the guiding results framework, and bring sustainable additionality to low-income countries. He clarified that the FIF is not exclusively for IDA countries; it is also for IBRD and middle-income countries. COVID-19 provided lessons about the need for countries to work together regionally, and Dr. Uribe praised examples of strong coordination in Africa for the regional CDC and vaccine procurement mechanisms.
Speaking from his experience in his home country of Colombia, Dr. Uribe stated the need for national pandemic preparedness plans, as recommended by the Commission, and the necessity of investment in country-level capacities. He also mentioned the Bank’s $34 billion portfolio of country-owned projects for health systems strengthening, most of them focused on primary healthcare and UHC. The Bank tries to align platforms and instruments behind country leadership for a bottom-up and country-driven approach.
Dr. Uribe concluded by outlining the Bank’s main concerns. First, the 2023 report on UHC prepared with WHO anticipates a backslide of progress towards UHC. Second, without a properly trained and sustained workforce, health systems will not function. And third, 75-80% of the costs associated with pandemics are recurring costs, which are not sustainably funded at this point. Pandemic preparedness and prevention are long-term measures and are part of health systems created through decades of continuous and sustained investment. This requires political leadership and confrontation of the determinants of health — poverty, inequity, and discrimination.
Prof. Sachs praised the strong link of WHO and the Bank. He laid out the arithmetic to show the fundamental need of development finance to cover recurrent costs as well as capital costs using the illustrative case of the national budget of a developing country. If country at a per capita GDP of $1000 USD raises between 15-20% of GDP in government revenues and can manage even 4% of GDP in health outlays, that is still only $40 per person, which is not enough to run a health system. The recurrent costs – mainly for salaries – of a health system therefore cannot be found in the national budget. These recurrent costs can be covered by debt finance if the terms of the debt are concessional: 30–40-year loans at 4% interest to raise between 500 billion to 1 trillion USD per year.
Ms. Joy Phumaphi, Co-Chair of the Global Preparedness Monitoring Board (GPMB), emphasized the importance of finance for research and development, innovation, access to countermeasures, social protection, and mental and psychosocial health. She argued that multisectoral preparedness in terms of trade, travel, and supply chains also hampered the global response to the pandemic and called for an examination of the human development aspect of the issues, include health workforce training.
She stated that GPMB calls for a whole-system multi-sectoral approach to preparedness, with a coordinating governance mechanism to link national and regional players from the private sector and international processes. As the GPMB prepares its new monitoring framework, it is seeking to address what needs to be financed, and how to ensure more sustainable and deliberately structured finance. Ms. Phumpahi asserted that that the Lancet COVID-19 Commission report takes the world in the right direction, but a broader and more ambitious approach with more stakeholders involved is necessary to adequately strengthen accountability for preparedness.
Prof. Mariana Mazzucato, professor of the Economics of Innovation and Public Value at University College London and Chair of the WHO Council on the Economics of Health for All, proposed that Health for All should be our public purpose, from which we backtrack to design an economy to deliver that goal. She stressed that the economic cost of not investing in global health systems is much greater than the cost of action, just like for climate change. Her talk addressed four aspects of the combination of public purpose and health for all: value, innovation, financing, and public sector capacity on the ground.
First, Prof. Mazzucato argued that value is not only created in the private sector. She asked what it means to collectively create value and share the rewards of value creation, seeing the people who do care work in our economy (who are often women) as value creators, and properly supporting and paying them. She mentioned, for example, that public investment in drug innovation is not accounted for in private drug pricing. Next, she argued for a pre-distributive approach to collaboration between public and private actors for health innovation regarding intellectual property for health commodities such as vaccines. If the mission had been to vaccinate the entire world, then Prof. Mazzucato argued that the patents and prices of the eight vaccines for COVID-19 would have been structured very differently and provided for the common good.
Prof. Mazzucato said that financing is not neutral, and it matters how we structure finance with attention to access, universality, and quality. Finance for science must be patient and long-term. Global funding from the IMF and the Bank needs to increase rather than decrease the fiscal space for developing countries to invest in their own requirements for preparedness, and it must be governed transparently, inclusively, and universally. Finally, Prof. Mazzucato called for a better analysis of how austerity measures have led to the outsourcing and undermining of the public sector capacity of the healthcare system. She asked what it would mean to invest in outcomes-oriented procurement policy and argued for well-supported civil service and local administrations to strengthen our health systems and deliver on clear moonshots for Health for All.
In summary of the speakers’ presentations, Prof. Sachs proposed that to overcome fragmentation and splintering of the health systems, WHO should create a basic template of an integrated framework for health finance to facilitate a common approach.
The speakers then addressed questions from the audience posed by the moderator of the session, Ms. Juliana Bartels, a member of the Secretariat of the Lancet COVID-19 Commission. The first question asked whether there should be deliberate actions taken to stem the trend of the migration of health workers from poor countries to countries with better health systems. Dr. Ryan responded that the brain-drain from developing countries to feed health capacity in the Global North is due not only to the amount of money paid to a health worker, but also to the continuity and security of remuneration, career prospects, and merit-based promotion. Addressing this requires a sophisticated systems approach to incentivize health workers to stay in their home systems. Dr. Uribe agreed, stressing the need for a harmonization of regulatory frameworks to reduce the burdens of migration. Ms. Phumaphi added that lack of access to medicines, diagnostics, and laboratory networks also contributes to health worker migration.
The next question asked the panelists to consider how to address austerity measures that often require countries to cut health and education funding. In response, Prof. Sachs spoke about the SDG Stimulus Plan called for by UN Secretary-General António Guterres as a framework to increase the fiscal space for the SDGs, with MDBs as the primary instrument for expanded development finance. Dozens of countries will face budget crises in the next year, as they are hit hard by rising interest rates; sharp increases of food, energy, and fertilizer prices; existing debts; and tightening financial conditions. These countries require quality, long-term development finance for increased investments in the SDGs. Prof. Sachs also noted that national accounts should reclassify health and education spending as investments rather than consumptions. Dr. Uribe agreed that there is a lot of pressure on MDBs to step up capital and lending capacities and to restructure the operational models of the banks towards the mission of global public goods.
Dr. Ryan concluded the webinar on a hopeful note, looking to the future pandemic treaty and the re-assessment of the International Health Regulations to support nationally owned sovereign plans for health security that engage NGOs, civil society, and other stakeholders. He put forth a call to action, claiming that at a moment of historic risk, we have an unprecedented opportunity to protect and restore health.