Can global health heal a world polarised by war?

If we all remember the impact of the coronavirus pandemic on us as individuals, it seems that the world of diplomacy and politics is doing its best to block out its legacy. One reason for this is the way in which the West fell dangerously out of sync with the rest during the scramble for resources, particularly vaccines, to fight Covid-19. The global rush to buy protective equipment was one thing, but the vaccine monopolisation by the rich countries was a real break with the developing world. Stockpiles in North America and Europe were as much as seven times the demand in those regions. These vaccines then expired while a number of less wealthy countries had little to offer their citizens. Attempts to open up the intellectual property rules to allow fair access to vaccines came to nothing. Meanwhile the lockdowns in the West were amply underwritten by its treasuries for the domestic population, but there was nothing left over for poor or medium-income countries to do the same. The popularity of the phrase Global South was turbocharged in that era, when a schism in geopolitics was cleaved out by the stark nature of the emergency. For many there was little left in the tank when the Ukraine war erupted , and the focus turned to the disruption of global energy and food supplies. Goodwill that has first been broken and then tested to breaking point again is very much the driver of the relationships between the traditional rich and the countries that strive but fail to prosper. The biggest test of how to overcome this divide is likely to play out in global health, even if the contested world of war and polarisation is not going away any time soon. For a measure of the rich-poor gap, it useful to consider what’s on offer from the top table of science, medical research and health care. Last week, former UK finance minister Sajid Javid led the launch of a report on the soft-power importance of health. He spoke of his time as health minister during Covid-19 and his pride that the UK “pharmaceutical defences” had held in the face of constantly evolving variants. Looking to the future, he wants the scientific and technological advances at the heart of the UK’s offer to the world to properly register with all countries. Launching the report from the UK’s Coalition for Global Prosperity, Mr Javid’s case was not just built on the record in vaccine research but genomics and exploitation of technology biobanks. A test is set to come next month, when the World Health Assembly meets to discuss the post-Covid-19 global pandemic treaty . The question in May will be if wealthy countries are ready to accept the same constraints from the rest of the world to thwart the next viral outbreak. Many are concerned that the promise has fallen apart, with 23 former presidents, 22 ex-prime ministers, a former UN secretary general and three Nobel laureates all calling for an urgent agreement from international negotiators on the Pandemic Accord . At the frontier of progress, the UK has attracted some of the biggest names in developing world philanthropy. The Gate Foundation is rightly proud that the effort to eradicate polio has almost reached its endpoint. Its incidence has dropped 99.9 per cent, with just four cases so far in 2024. It is now setting its sights on a malaria vaccine with a coalition of drug firms. The tools to take on these endemic diseases are originating in the research sector and then rolled out with the backing of charitable organisations and donor countries such as the UAE . The pharmaceutical life-sciences industry has, in fact, lined up several breakthroughs with seven vaccines in the pipeline. The promise of a tuberculosis vaccine would update a technology that was developed in the middle of the last century and could again transform lives in the developing world. One reason that poorer countries don’t take an unalloyed view of this remarkable progress is that they see the West as pursuing scientific progress but only giving limited glimpses of it to the less wealthy world. The second is that the debt explosion around the world is a trap for nations that face the daunting issues of climate change. These threats are all converging and are all seen as the product of an unequal world that the developed countries created. If you like, their pursuit of excellence and the cutting edge of progress has been achieved on the back of the disadvantage of others. Pushing initiatives to open up medicines and healthcare advances is obviously welcome. But it doesn’t help, for instance, when a country such as the UK cuts its overseas aid budget from 0.7 per cent of its gross domestic product to 0.5 per cent. As Mr Javid was reminded by former Australian prime minister Julia Gillard, representing the philanthropic Wellcome Trust, the resulting disruption from the UK’s cuts saw real hardship in the most deprived places. Creating a level playing field in pandemic preparedness or climate-related debt relief cannot be separated from the good that is coming from vaccine progress or new data-led healthcare drives. That being said, it is, at least, something to help overcome the dangerously fragmenting world around us.