The COVID-19 pandemic has changed our world in ways we could never have imagined when it started just over a year ago. More than 110 million cases have now been reported to WHO, and almost 2.5 million people have lost their lives.

The pandemic has severely disrupted health systems, including emergency care, primary health care, routine immunization and many other essential services. The impacts of the pandemic go far beyond the effects of the virus itself. Millions of livelihoods have been lost, schools have been closed, and the global economy has been thrown into turmoil.

The pandemic has held a mirror up to our world. It has shown humanity at its best and worst. It has exposed and exploited the fault lines, inequalities, injustices and contradictions of our world, within and between countries. 

But there are some signs of hope. Globally, the number of weekly reported cases has now declined for 6 consecutive weeks, and the number of deaths has also fallen for three straight weeks. Meanwhile, the development and approval of safe and effective vaccines is giving all of us hope that we can bring this pandemic under control. 

Since April last year, WHO and our partners have been working through the Access to COVID-19 Tools Accelerator for the equitable distribution of vaccines as global public goods. As you know, so far around 200 million doses of vaccine have been administered, most of them in the world’s richest countries.

I want to assure you that vaccine equity is our highest priority, and we will not stop until we get it. At the beginning of the year, I issued a challenge to all countries to work together to ensure that vaccination of health workers and older people is underway in all countries within the first 100 days of the year. There are 47 days left. We have a lot of work left to do, but we are making good progress.

Three vaccines have now received WHO emergency use listing, giving the green light for these vaccines to be rolled out through COVAX. And at their meeting on Friday, G7 leaders committed 4.3 billion U.S. dollars to fund the equitable distribution of vaccines, diagnostics and treatments.

WHO’s Regional Offices, under the leadership of Dr Moeti from the African Region and Dr Al-Mandhari from the Eastern Mediterranean Region, are providing technical assistance for countries to prepare for vaccine rollout. I commend the African Union and Africa CDC for its ongoing vaccine readiness work through the African Vaccine Acquisition Task Team.

Even as we work together to respond to the pandemic, we must also learn the lessons it is teaching us. We have all learned many painful lessons over the past year, but today I would like to focus on just three. 

First, preparedness. It’s clear that despite many warnings about pandemics, when COVID-19 hit, the world was badly underprepared. Country and community-level preparedness investments were inadequate, and the international system was not well coordinated to support these efforts. Even some of the wealthiest and most powerful countries were caught off-guard and were surprised. We must work together to address these weaknesses in the global ability to prepare for, prevent, detect and respond to pandemics.   

One idea proposed by the Central African Republic and Benin, representing the Africa group, is a system in which countries agree to a regular and transparent process of peer review, similar to the system of universal periodic review used by the Human Rights Council. WHO accepts it. We’re calling it the Universal Health and Preparedness Review. Its purpose is to build mutual trust and accountability for preparedness, by exchanging best practices, identifying new and emerging threats, promoting accountability and targeting investments more efficiently.

Another suggestion proposed by Charles Michel, the President of the European Council, is an international treaty for pandemic preparedness and response, which would give force to the International Health Regulations.WHO is actively developing both ideas, and I encourage all least-developed countries to support and participate in both of these initiatives.

The second major lesson is that the pandemic has demonstrated that the health of humans, animals and the planet that sustains us are intimately linked. Approximately 70% of all emerging and re-emerging pathogens are zoonotic, and we don’t know when the next threat – the next disease X – will emerge. 

We can only prevent future pandemics with an integrated One Health approach that addresses the impact of human activities that disrupt ecosystems, encroach on habitats, and further drive climate change. These activities include pollution, large-scale deforestation and extraction, the intensification of agriculture and livestock production, the overuse and misuse of antibiotics, and the way we produce, consume, and trade food.

That means that protecting and promoting human health cannot be a matter for ministries of health alone. Indeed, many of the reasons people get sick and die lie outside the health sector, in the food we eat, the water we drink, the air we breathe, and the conditions in which we live and work. Addressing these determinants of health will require policy action in agriculture, commerce, education, energy, planning, trade, transport, and more. It takes a whole-of-government, whole-of-society approach.

And that leads me to the third major lesson, which is that health is not a luxury item or a reward for development; it is the foundation of social, economic and political stability. When health is at risk, everything is at risk. But when health is protected and promoted, individuals, families, communities, economies and nations can flourish. Health is central.

At the UN General Assembly in September 2019, all UN Member States converged to endorse the political declaration on universal health coverage, just before the COVID-19 pandemic started. Member States embraced a vision for a world in which all people have access to essential health services, without facing financial hardship. The pandemic has only underlined why universal health coverage is so important.

Building strong health systems for universal health coverage requires investments in primary health care, which is the eyes and ears of every health system, and the first line of defense against health emergencies of all kinds, from the personal crisis of a heart attack to an outbreak of a new and deadly virus.

We know that many African countries have low levels of coverage of health services and a low number of health workers. By contrast, the Region of the Americas has almost ten times more nurses.

Africa has long grappled with migration of health workers. To draw attention to these issues, WHO has declared 2021 the International Year of the Health and Care Worker, with the theme of protect, invest, together. 

Another key dimension of strong health systems is a reliable supply of safe, effective and high-quality medicines. To that end, WHO is working with the African Union to establish the African Medicines Agency, and I call on all African countries to ratify the treaty so that AMA can enter into force. This will be a very important institution.

The COVID-19 pandemic has struck at a time of rapid transformation for Africa, with ageing populations and the double burden of communicable and noncommunicable diseases, all of which result in greater demands, and greater costs, for health systems. But we cannot and must not see health as a cost to be contained. Quite the opposite: health is an investment to be nurtured – an investment in productive populations, and in sustainable and inclusive development.

History will not judge us solely by how we ended the COVID-19 pandemic, but what we learned, what we changed, and the future we left our children.With improved preparedness, a One Health approach and universal health coverage as our goal, we can build the healthier, safer, fairer and more sustainable Africa we all want.

By Dr Tedros Adhanom Ghebreyesus

WHO Director-General.