SDSN Networks work together to respond to COVID-19 and achieve the SDGs

COVID-19 Researcher at ISGlobal

2020 has been a challenging year for humanity. Climate change continues to threaten human and natural systems, with 2019 the second hottest year on record. Many African countries fought swarms of desert locusts, jeopardizing food security and the livelihoods of millions of small-scale farmers. Australia has seen a record-setting fire season. And all of this has been completely eclipsed by the global COVID-19 pandemic, the biggest global peril to human well-being since World War II.

It is hard to exaggerate the devastation wrought by the new coronavirus. At the time of writing, over 27 million people have been confirmed to have been infected, and over 800,000 have died. Health systems and health workers have been put in extreme situations, as have the many millions of people who found themselves at home juggling childcare and remote work commitments, or the millions of others left unemployed. It is impossible to predict the many lasting and deep ways this crisis will transform our society, but we remain hopeful.

This pandemic is a multidimensional health and humanitarian crisis, and solving it requires contributions from all areas of science. Saving lives is the immediate objective, but in the long term, addressing this crisis requires the strengthening of health systems, ensuring universal access to care, developing therapeutics in record time, and ensuring no one is left behind with regards to a vaccine. Networks like the SDSN are critical in the response; they facilitate the formation of research collectives, share best practices across scientific disciplines and political borders, and are efficient at distributing accurate and timely information. The key challenges of 2020 are all collective; exacerbated by global climate change and accelerated by a globalized economy and society, the only paths to effective solutions are collaborative, and depend on networks such as SDSN.

In the last century, the world has suffered from and in turn solved many public health problems; the number of people affected by smallpox, measles, polio, and yellow fever has fallen dramatically. Solving these challenges was a result of major investments in the sciences, and the advancements made have had many additional benefits for human well-being. Development has always raised environmental and social issues, including the emergence of disease. Public health institutions respond by making scientific breakthroughs. Today, science and technology institutions and public policy makers face a great challenge, but also an opportunity to strengthen health systems with strong foundations in primary care and expand access. We also have an opportunity, as we improve care, to reduce historical inequalities in the health system. Now more than ever, networks of scientists and public health practitioners like the UN SDSN are building on a powerful tradition of strong responses during crises.

At present, there is a global mobilization of national investments in health for development, innovation, and production. The World Health Organization (WHO) is making an important effort to ensure access to new vaccines and medicines. However, there remain fierce disputes and several countries have blocked exports of medical equipment and supplies, seriously limiting other countries’ ability to procure essential goods. Just ten countries account for 90% of patents, showing great disparities in innovation, which make universal access to health globally unfeasible. This situation needs to be addressed, local production and innovation must be scaled up globally, and the existing social contract between governments and patent owners reconsidered in order to protect human well-being. Innovative forms of global health governance – such as the ACT-Accelerator for the development and distribution of diagnostics, treatments and vaccines – pay testimony to this rapidly changing landscape.

The social sciences are also vital in health emergencies, particularly in understanding the circulation of a virus and its impacts on society. The social sciences also make important contributions to understanding how we perceive risk and in designing effective public policies. Social scientists are needed to look at what measures and communication tools can change behavior and reduce inequalities. There is a very important social dimension to disease; everyone can catch the disease, but at the same time, there are different risk factors that align to unequal social relationships and power structures. If historian Eric Hobsbawn were alive today, he might say that the pandemic marks the socio-cultural beginning of the 21st century, as it calls into check the movement of people and goods from the so-called globalized world.

This emergency has brought out the worst in some of us, but it has brought out the best in the vast majority. We have seen the strength of our social fabric in the myriad creative ways people have found to help others while protecting themselves, from delivering groceries to the doorsteps of elderly neighbors, to the mass sewing of homemade masks, to the stirring rounds of nightly applause to celebrate essential workers. SDSN’s World Happiness Report identifies both generosity and social support as essential ingredients to well-being, and one of the positive results of the global pandemic is the many ways it has bolstered our sense of community, despite the many tragedies it has also caused.

The global scientific community has also come together in solidarity, with many efforts launched for joint research on effective prevention, treatment, and vaccines. Countries have facilitated better data sharing, and the WHO has done a herculean job of coordinating the response. WHO’s Global research and innovation forum: towards a research roadmap is a critical input, and WHO is also leading an international clinical trial on treatments, with input from a number of top-tier institutions.

The SDSN’s Health for All network has been a key player in this, hosting several webinars on COVID-19, as have many of SDSN’s other networks, organizing local efforts to address their distinct regional or national contexts. Our respective institutions, which together co-host the Health for All network, are also global leaders in the response. The Fundação Oswaldo Cruz (Fiocruz) has led a number of initiatives, including a collaboration lab to train countries across Latin America on COVID-19, and a COVID-19 Observatory to track the spread of the disease and coordinating the WHO Solidarity Clinical Trial in Brazil. The Laboratory for Respiratory Viruses and Measles of the Oswaldo Cruz Institute has been nominated Reference Laboratory of the World Health Organization for COVID-19 in the Americas and participates in the WHO network of laboratory specialists for COVID-19. In addition, it is leading the Latin American and Lusophone African countries’ networks of national public health institutes, establishing joint research projects, training staff, and supporting laboratories in partner countries. Fiocruz is also supporting the Brazilian Unified System of Health (SUS) in their response, and manufacturing and distributing more than 1 million diagnostic kits for testing, clinical attention, social support projects, and epidemiological information.

Srinath Reddy of the Public Health Foundation of India (PHFI) was appointed to India’s National Technical Taskforce on COVID-19 and has been supporting the response there at both the state and national level. PHFI’s health technologies division developed a digital solution to help community health workers identify people at increased risk of contracting COVID-19 based on travel history, comorbidities, and symptoms, and also led the way on training health workers to recognize the symptoms of COVID-19, offer diagnoses, and treat cases.

With Spain critically affected by COVID-19, the Barcelona Institute for Global Health (ISGlobal) is providing critical support locally in Barcelona, to the Spanish government at the national level, and also to European collaborators. Critical contributions include a number of white papers on strategies for progressively loosening COVID-19 containment measures, and ISGlobal’s partnership with over 70 institutions in the COVID-19 Clinical Research Coalition. The institute is also leading important prophylactic and serological studies in various locations, while co-leading major policy transformation efforts at the national level through the ad-hoc coalition ‘The Day After’, which brings together private, public and social sectors around the implementation of SDGs.

In China, Dr. Gordon Liu was the only economist selected to serve on the China National Expert Panel for COVID-19. He has been advocating globally for increasing resources and access to mass testing, especially antibody testing, which can be more cost effective than diagnosing infections and contact tracing. Antibody testing would allow us to identify the healthy and return them to work so that the economy can function while preventing future waves. An alternative to this would be to target high risk groups for testing, tracing, and isolation, letting the majority of the population at low risk to continue normal social and economic activities.

While the COVID-19 crisis has shown, in dramatic fashion, the many weaknesses of our global health system, even in well-resourced countries, it has also demonstrated clearly the interlinkages between health and many other social, economic, and environmental issues. Academia has long recognized these connections, but the pandemic has brought this to the forefront for both policymakers and the public.

We have seen how marginalized people, always the most vulnerable in a crisis, have been disproportionately affected. Social isolation and lockdowns have affected poor people, particularly people in low-wage jobs with little benefits and those working in the informal sector, more than the wealthy. The economic impacts of this outbreak severely threaten gains at reducing poverty (SDG 1), with global poverty increasing for the first time since the 1990s. There are stark examples of inequality as well in communities of color in the United States, where statistics on both incidence and mortality show dramatic disparities. It is important to consider SDG 10, Reduced Inequalities, in tailoring our response, from both a health and economic perspective, to ensure no one is left behind.

Disruption to global trade and supply chains has yet to be fully understood, but already we are seeing effects on certain commodities, particularly in the food and agriculture sector.

In recent years a number of issues have caused an increase in the number of undernourished people globally, and the current crisis threatens to pull us further backward. However, this is an opportunity, for as we recover, we can re-define value chains to be more sustainable, and to help small-scale farmers gain access to markets and higher incomes (SDG 2, No Hunger).

We have seen dramatic impacts to the education sector as well, at all levels, from early childhood through tertiary. However, this crisis has led to a lot of innovation in this space and some great advances have been made in virtual learning. Several cities and individual schools have been successful at adapting to online classrooms, while continuing to provide services like school meals and healthcare to students. However, these gains have been unequal and most students who are out of school, particularly in low-income countries, have not been given meaningful opportunities to continue learning. Achieving SDG 4 means that all students, at all levels, receive a quality education. But realizing this goal means success stories must be scaled up rapidly, and interventions undertaken to ensure the most vulnerable students, without access to the internet, do not fall behind.

Inequalities in access to infrastructure have also made it difficult to respond to COVID-19, emphasizing the importance of SDG 6, Clean Water and Sanitation, and SDG 7, Affordable and Clean Energy. Much of the advice we receive to prevent the trans- mission of COVID-19, such as washing hands for 20 seconds with soap and water, or placing clothing in a dryer to kill germs, assumes that all people have access to safe water and reliable electricity. However, two out of every five people in the world do not have access to basic handwashing facilities. The lives of these people are at stake, today from COVID-19, but also from diarrheal disease and other pathogens. Responding to today’s crisis is an opportunity to bring lasting improvements and resiliency for the long term.

This global pandemic has educated many about the links between deforestation, human encroachment on natural systems, and the emergence of zoonotic diseases. The academic literature has drawn these linkages for years, and today their findings are receiving much attention. This strengthens arguments for preserving natural lands, particularly tropical and temperate forests, and reaffirms the importance of SDG 15, Life on Land. As we think through policies to prevent future pandemics, we must consider the preservation of biodiversity and ecosystem services.

While these have been truly devastating times for humanity, they also represent an opportunity to accelerate the transition away from business as usual towards the achievement of the SDGs. But working together to share what we have learned and develop a common vision for a better future, we can ‘build back better’ and create a more resilient global community. Now more than ever, it is clear that achieving the goals will bring lasting resiliency and prosperity for both people and the planet. Despite the current challenge, let us all remain committed to our mission to value human and non-human life, and work together through organizations like the SDSN for a more inclusive, vibrant, and sustainable world.

COVID-19 Response

This article was written by Lauren Barredo (SDSN Secretariat), with Paulo Buss, Gonzalo Fanjul, Luiz Galvão, Gordon Liu, Antoni Plasencia, and Nisia Trindade Lima (SDSN Health for All thematic network).