Five years after Covid-19 was declared a pandemic, experts worry the world has still not learnt its lessons, saying it is a question of when - not if - a deadly, new “Disease X” strikes.
Scientific shorthand for an unknown or hypothetical pathogen, Disease X could cause an international epidemic or pandemic that again sweeps the world - and health experts are united in believing one will come.
The spread of bird flu in the United States, mpox outbreaks in African countries and respiratory infections in China have all raised questions over the strength of global health systems.
In 2022, a panel set up by the World Health Organisation (WHO) found that the world is no better prepared for a new pandemic than it was when coronavirus emerged in 2019 - and may actually be in a worse place, given the economic toll.
So what lessons were learnt from Covid-19 and what are the worst-hit countries doing to guard against any re-run?
The impact of Covid-19
The International Monetary Fund estimates that Covid-19 cost the global economy nearly US$14 trillion, with losses made worse by a lack of preparedness.
From shattered economies to overwhelmed healthcare systems, the impacts of the pandemic continue to be felt.
The WHO estimates that nearly 15 million deaths were associated with Covid. About 400 million people have had long Covid, costing countries billions in lost productivity and increased health and social welfare costs.
According to the International Labour Organization, 114 million jobs were lost in 2020, the year a global pandemic was declared. The ILO estimates that US$3.7 trillion was lost in labour income.
What global measures have been taken since Covid?
The Pandemic Fund, hosted by the World Bank, was set up in September 2022 to finance pandemic prevention policies in low- and middle-income countries.
It is the first fund of its kind and has already raised more than US$2 billion from rich countries and charitable foundations.
However, in a 2023 report, the Global Pandemic Preparedness Monitoring Board said attempts to fund pandemic prevention were “woefully inadequate, inefficient, uncoordinated”.
The WHO’s 194 members have been in talks for two years to draw up a pact to boost collaboration before and in a pandemic.
A new treaty is meant to address some of the systemic inequalities faced by the Global South in accessing vaccines and help them improve their healthcare services.
The WHO has faced criticism over its Covid response, accused of failing to declare the initial outbreak in China an international emergency.
A report by The Lancet medical journal said the WHO had acted “too cautiously and (was) too slow” on several fronts, be it on face masks or travel bans.
The return of Donald Trump has further clouded the outlook, with the newly-sworn-in president signing an executive order to withdraw his nation, the WHO’s top funder, from the UN agency.
The order accuses the WHO of mishandling the pandemic and being unduly influenced by other nations, which the WHO denies.
Last December, WHO chief Tedros Adhanom Ghebreyesus said he was confident of securing a pandemic deal by May 2025 but some nations fear such an accord could undermine their sovereignty.
The pandemic treaty talks resume on Feb. 17.
Which countries suffered worst from Covid-19?
UNITED STATES – It registered the highest death toll with 1.2 million people dying from the virus, according to the Centers for Disease Control and Prevention.
In 2021, then-President Joe Biden established the American Pandemic Preparedness Plan to strengthen public health systems and bolster their links with local communities.
A year later, Congress established the Office of Pandemic Preparedness and Response Policy to advise the president.
Trump, who had threatened to shut the office during the presidential campaign, recently appointed Gerald Parker, a former health official, to run it.
BRAZIL - More than 700,000 people died between 2020-2023 as a result of Covid, the highest death toll in South America.
Then-president Jair Bolsonaro was criticised for downplaying the risk, opposing lockdown measures and promoting unproven treatments.
Last year, a major Brazilian vaccine manufacturer, Bio-Manguinhos/Fiocruz, joined the Coalition for Epidemic Preparedness Innovations’ (CEPI) - a network of vaccine manufacturers in the Global South.
The group wants faster, fairer responses to future threats.
CEPI has adopted the 100 Days Mission, aiming to develop safe and effective vaccines within 100 days of any pandemic threat being reported.
INDIA - India was particularly hard hit by a second wave of Covid in 2021 with hospitals scrabbling for beds and oxygen. The country logged more than half a million Covid deaths.
Some experts said India’s initial response was faster than its neighbours’, but that vaccine rollout was then slow and its healthcare systems were underfunded, meaning millions were struck in the second and third waves.
In early 2024, India established a National Pandemic Preparedness Plan for Respiratory Viruses.
The Serum Institute of India, the world’s largest vaccine manufacturer, joined CEPI last year.
RUSSIA - According to Russian data, more than 400,000 people died from Covid, although some estimates suggest the figure is closer to a million.
There is little public data on Moscow’s handling of Covid.
In 2022, Russia unveiled a project known as the “Sanitary Shield” to strengthen public health and “fend off infections”. Under the project, scientists and epidemiologists work on pandemic prevention and vaccine development.
MEXICO - Covid accounted for about 300,000 deaths in Mexico between 2020 and 2022, according to the John Hopkins Coronavirus Research Center.
The government was criticised for refusing to close its borders when the Omicron variant surfaced in 2021, accused of prioritising foreign tourism over domestic health.
Restrictions were only imposed later after Mexico came under US pressure due to the rising number of migrants crossing Mexico as they headed north for the US border.
Last October, Mexico, Canada and the United States unveiled the North American Preparedness for Animal and Human Pandemics Initiative, updating an old plan drawn up for influenza.
Under the pact, the three countries will collaborate on policy and health efforts in the event of a pandemic.
Mexico cut its health budget for 2025 by 12 per cent, raising concerns that pandemic preparations would suffer.
Which other countries were hard hit?
Peru, Bulgaria, Hungary and Bosnia and Herzegovina suffered some of the worst Covid death rates, averaging some 3,000 – 7,000 deaths per million people.
Eastern European and Balkan countries made up a majority of the countries with the highest rates, which experts put down to chronic under-investment in public health after the collapse of communism.
In 2024, North Macedonia adopted an action plan to deal with disease threats, leading the way in the Western Balkans.
Bulgaria, which had the highest death rate in Europe, is redistributing its healthcare funding after experts found rural areas fared worse under Covid than its big cites.
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