Last month, officials from 194 countries clashed over how to cooperate on the next pandemic—while battles over the current one raged on.
“People do not get the same gist from the same message,” says Reyna, a problem that bedevils public health communications. If you say, for example, there’s a 5% prevalence rate of COVID-19 in the community, some might think: “That’s good.
It means 95% of the people don’t have it.” Others would be rightly alarmed, given that, before vaccines were available,was considered by the World Health Organization to be grounds for governments to maintain lockdowns. “The verbatim is the same,” she says, but depending on your underlying knowledge, “the gist that you extract from it is different.” Unlike many critics, Reyna does not view US public health messaging as a total failure. She points to elderly Republicans in Florida who, in early 2021, lined up in droves to get the initial COVID-19 vaccines because the message had gotten through: Older people were at higher risk. “If that had not happened, many more people would have died,” she says. Public health guidance lands most effectively when a trusted messenger delivers it. At the height of the monkeypox outbreak, which predominantly affected men who have sex with men, the White House selected Dr. Demetre Daskalakis to serve as the deputy response coordinator. Daskalakis, a relentless advocate for LGBTQ+ health who serves as director of the CDC Division of HIV Prevention, took the federal government’s vaccination and treatment drive to gay pride events, after years spent raising awareness at such venues. As Reyna explains, people “have to have the right information, trust the source, have enough background knowledge, and connect to their values, even when they’re dug in politically. It’s not one message and you’re done.”On a Saturday evening in March 2020, a group of top business executives arrived at the White House, eager to help cut through the Darwinian chaos of the federal government’s COVID-19 response. They found themselves explaining to President Trump’s son-in-law, Jared Kushner, that they had secured commitments from dozens of major corporations to manufacture ventilators, create a system for contact tracing, and more,Due to the finite supply of personal protective equipment, states were bidding against each other and driving prices up, one attendee explained. The group urged Kushner to get President Trump to invoke the Defense Production Act, a law dating to the Korean War that could compel American companies to manufacture goods for the US government and guarantee a market for them. According to three people who attended the meeting, Kushner dismissed their concerns and rejected their offers of assistance. Rick Bright, a former Health and Human Services official who ran a federal office that partners with industry to develop advanced medical treatments, says “irreparable damage” was caused by the lack of national coordination and “the omission of the private sector at the table” from the early US pandemic response. As the federal government floundered, Bright adds, “It was the companies that really took risks while waiting for Trump to get on the ball.” The Trump administration eventually did find a winning formula with Operation Warp Speed, which enabled new vaccines to be developed in record time. In it, the US government put a four-star Army general in charge of logistics, partnered with vaccine developers, and facilitated and incentivized their work. That success has prompted calls for an enhanced partnership between the public and private sectors. Testifying before the House Select Subcommittee on the Coronavirus Crisis in December, Bright recommended establishing a pandemic preparedness council that would bring together government officials, academics, and representatives from the private sector to advise the White House on an ongoing basis.. The objective is to produce accurate diagnostic tests, effective treatments, and globally available vaccines within 100 days of a new disease outbreak. But Chandresh Harjivan, a consultant to numerous government agencies who worked on Operation Warp Speed, said the 100-day goal is just a “fairy tale” unless governments can protect participating companies against financial risk and put leaders at the helm who are not “beholden to the budgets of agencies.” The 100-day goal also requires transparency among international governments. After all, there’s no way to get the jump on a new virus if the country of origin doesn’t promptly or fully report its discovery.On December 5, a team of US public health officials and diplomats arrived at the World Health Organization in Geneva, Switzerland, to resume deliberations on the creation of something entirely new: a legally binding global pandemic accord that could lay the groundwork for greater transparency and resource-sharing when the next outbreak inevitably occurs. In the executive boardroom of WHO headquarters, deliberations almost immediately fractured, with Northern countries including the US demanding prompt disclosure of potential global health threats, and Southern countries refusing to sign off until their demands for equitable access to lifesaving treatments and vaccines were met. As a representative from Mexico put it, “Nothing is agreed until everything is agreed.” According to Lawrence Gostin, director of the WHO Collaborating Center on National and Global Health Law, “The South won’t give [the North] what they want unless they get equity, and the North wants to focus on scientific sharing, so that’s a huge impasse that’s almost impossible to bridge.” Another participant called it “the most contentious global South, global North verbal war that I have ever heard before,” adding that there is still “unbelievable disagreement over how the globe becomes better prepared.” “This Shouldn’t Happen”: Inside the Virus-Hunting Nonprofit at the Center of the Lab-Leak ControversyA WHO spokesperson said the organization is there to “facilitate and support” negotiations, which are led by member states.
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