The Political Lens for a Global Coronavirus Response

The need for a political lens on COVID-19 is a continuing theme of my commentaries these days. In this commentary, the political lens is applied to three aspects of recent efforts to mobilize a global response to the pandemic. The commentary starts first with an assessment of  the progress that is being made on the continuing challenge to get all the key actors together. This is followed, secondly, with an analysis of the unusual approach that is being taken to avoid forming any new entity to administer the global coordination. And third, it concludes with some reflections on the transformative implications of the unusual mix of different stakeholders that are actually getting together. My conclusion is that good things are happening on this issue. There is room for optimism that a collaborative approach will prevail against the “unilateralist” tendencies of the US (and even a few others). Perhaps it will even be transformative. 

Uniting resources to collaborate on a global search for a vaccine and/or other treatments against COVID-19 is indeed taking shape. The attention has mostly been on the G-20 as an avenue for resource mobilization, instead of the UN or any other global entity. This is at least tentatively OK for now even if the G-20 has its flaws. As announced by the WHO on 24 April, the launch of the “Access to Coronavirus Tools (ACT)- Accelerator” did pull together a core set of global partners with a G-20 link. In my last commentary, I wondered about the credibility of such a link, given the relatively small proportion of G-20 members who were identified as partners of this new venture. But I was eager to see what the next steps would be.

On 4 May 2020, to move this initiative along, the European Union hosted a virtual pledging summit for the ACT-Accelerator. It was good to see that this summit did identify a broadened set of global partners, including a few more of the G-20’s members.  Of course, these events are unfolding without the participation of the US and, up to now, with merely a token involvement of China. The G-20 “hook”, nonetheless, is being facilitated by the open and generous cooperation of the current G-20 president Saudi Arabia – in its capacity as the G-20 president – and the increasing number of other G-20 members in the mix. So this is my first point. Progress is being made on mobilizing a global effort at collaboration.

Second, ignoring the absence of the US, the G-20 might still serve as a channel for global coronavirus mobilization in the context of a loose institutional framework without a distinct framework of its own. The G-20 has never had an institutional framework – no bureaucracy or structure, just a passing of the baton from the preceding host head of state or government to the next one. So why not use this loose form of collaboration as a model? Might this looseness cause the mobilization to fizzle? Or is it indeed the better way to attract concerned parties to come together?

My third point, however, is a more positive one. This “Coronavirus Global Response” or this “ACT-Accelerator” or whatever it is that you might choose to call it, is actually a phenomenally expanding multi-stakeholder initiative. The collaboration is potentially bringing together an impressive diversity of stakeholders – foundations, public/private partnerships, business associations, academic institutions, advocacy groups and other NGOs. A post-pandemic world will need to find new organizing principles to move beyond the classic inter- governmental nature of international organizations today. And this is a good beginning.

Absence of Full G-20 Collaboration

In fact, it is the multi-stakeholder nature of this Coronavirus Global Response (we’ll stick with this name for the time being) that makes the first two observations less concerning. We know, of course, that the current US President is not a globalist – and is actually working against existing global institutions like the UN and the WHO. One might argue that China is also a non-participant in the effort, even though the Chinese Ambassador to the EU did ultimately appear at the 4 May pledging summit (and made a smallish $20 million pledge). But the key concern has been the absence of American leadership and the looming possibility of US unilateral action to the detriment of the rest of the world.

Working against this concern is the high visibility of Americans other than the US president in the global effort. For example, we take note that the trigger for the launching of this Coronavirus Global Response was a report from the Global Preparedness Monitoring Board. This Board was established in 2018 as an independent monitoring and advocacy body to prepare for and mitigate the effects of global health emergencies. And it is this body that urged for the rapid mobilization of $8 billion for a global response to the spread of COVID-19. Ursula von der Leyen, the European Commission President and host of the pledging conference on 4 May, even introduced the chair of the GPMB as the one who was responsible for specifically requesting this pledging event to happen.

And who is this chair? None other than an American, Dr. Victor Dzau, President of the US National Academy of Medicine! And three other members of this Board are also Americans: Dr. Chris Elias (President of the Global Development Program at the Bill and Melinda Gates Foundation), Henrietta Fore (Executive Director of UNICEF, appointed during the Trump Presidency to this position) and, more surprisingly in the current political context, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases! While this doesn’t mean that these Board members are themselves acting to override the US president’s isolationism, it is significant that four of the Board’s fifteen members are US-based Americans.

And this is without even highlighting the leading role of the Bill and Melinda Gates Foundation in promoting and supporting the Coronavirus Global Response. This is especially relevant to the cross-cutting nature of American participation in this initiative. But it is also highly significant that the American pharmaceutical industry is  represented in this initiative, albeit indirectly, through its membership in the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).  The IFPMA is indeed a committed partner in the ACT-Accelerator initiative, and it is indeed another American, Dave Ricks, the CEO of Eli Lilly, who, as the IFPMA’s President, is visibly representing the association in these events. One could cite many other researchers and research institutions in the US that are already engaging in collaborative work beyond US borders, even if they are not themselves listed as partners. Thus, it is clear that the cold shoulder from Trump is not stopping Americans outside of official governmental channels to pursue collaboration.

The informal American links to the effort, however, are also just that – informal. The frictions between the US and China may well operate to keep both of these countries from truly integrating their official efforts into the Coronavirus Global Response initiative. It is, of course, the absence of US participation that is the most concerning here, but one can’t really move on without noting that the link to the G-20 itself is in need of more participants to be a credible forum for establishing and implementing the initiative.

Yes, the 4 May event confirmed that G-20 members Australia, Japan, Korea, Mexico and Turkey were on board, along with the 24 April listing of the EU, France, Germany, Italy, the UK, Saudi Arabia, South Africa and Canada. But where are the others?  We are still missing Argentina, Brazil, India, Indonesia and Russia. In fact, the 4 May program was brimming with European Union speakers, including both Norway and Spain as core partners, even though they are not G-20 members. There was also a smattering of speakers from the Middle East. Some would say that the willingness of over 30 heads of state to appear on the summit’s program was itself a sign of its success.

Again, the absence of the US is the key concern, but the absence of any South American participation should be a warning signal, too, relating in all likelihood to a lack of resources (especially Argentina) or of interest (Brazil) but also perhaps an anxiety about a pro-European bias.  And finally on this point, one should also be aware that India, Indonesia and Russia may have their own unilateralist-style interests, extending even to high-volume accelerated manufacturing of likely vaccines even before their effectiveness has been confirmed in the phased sequencing of trials. So the G-20 nature of this initiative is not as comprehensive as one would like to see, but at least the effort is making progress.

No New Institutional Framework

On the second point, the Coronavirus Global Response is a framework for mobilizing global resources for COVID-19 – without a framework! That is to say, no new institutional framework is being proposed for overseeing the $8 billion that was pledged on 4 May. One could argue that the European Union is the de facto institutional framework, but here is the proposed “organigram” that the EU itself has put together:

It has a strange mixture of descriptors – a “facilitation group” that will “oversee and report progress, mobilise resources and engage with stakeholders”. One would think that this would actually be the G-20, but no, it features the country flags of only 7 of the G20, plus Spain and Norway, the WHO, the Bill and Melinda Gates Foundation, the World Economic Forum and the Wellcome Trust. Then there is a “coordination hub” at the WHO, but with three different partnerships on vaccines, therapeutics and diagnostics. Fair enough. We do understand that donors are being offered the choice of earmarking their contributions for any one or more of these partnerships – or for a more “transversal work stream” that will be directing resources to the building of health system capacity, along with overall knowledge and data sharing.

Although the chart does show WHO again at the middle of the page in what appears to be a coordinating role on “product allocation”, it is not entirely clear that this is the same thing as the “transversal work stream”. In any case, each of the three partnerships has two other co-convenors. These entities are supposedly the repositories or conduits for their respective partnerships – CEPI and GAVI, the Vaccine Alliance on vaccines, a new “Therapeutic Accelerator” and UNITAID on therapeutics, and FIND and the Global Fund on diagnostics. But note, too, that the chart has another set of boxes to illustrate the intended “whole-value-chain” approach on R&D, manufacturing, procurement and deployment. The implication seems to be that the first co-convenor in each partnership is at the early end of that value chain, and the second co-convenor is at the later end.

This is just one proposal for a graphic illustration of the Coronavirus Global Response, but it is revealing of the determination not to create a new structure.  It is also interesting that it does not for now have a specific link to the G-20. This may change once the initiative gets going, and we will certainly monitor the G-20 heads of state summit, which happens to be scheduled in November after the US elections. And one can fully appreciate the fact that both this Coronavirus Global Response and the G-20 are “non-institutionalized” phenomena.

The key observation for me to make here is that the avoidance of any new institutional framework is indicative of what I see to be a reluctance to move towards any type of global governance reform, even where there is obvious dissatisfaction with existing governance frameworks, whether the UN or the Bretton Woods institutions. So even this tenuous link to the G-20 “non-institutional” façade suits the current state of play for pulling concerned parties together for a global effort. Will the “facilitation group” be replaced eventually by a more specifically G-20 arrangement? Or will it morph into something else, what with the large number of non-G-20 member states in the mix? And non-state actors, too? I’m not suggesting that it should get a more formal oversight body at this stage.

The G-20 itself has seemed to operate very non-bureaucratically and has therefore been dependent on the particular and expanding interests of the host country. One sees more and more non-G-20 members welcomed to their summits and a growing array of G-20 Engagement Groups (for business, civil society, labour, youth, women, think tanks, science, urban).   The loose but inclusive approach of the G-20 might actually be a pretty good model for this exercise.

The Expanding Multi-Stakeholder Network

The third point, on the phenomenally expanding multi-stakeholder nature of the Coronavirus Global Response, is a counter-point to the distress signals of my first two points here –  that is to say, of the “non-involvement” of the US and China or the “non-institutionalizing” of the latest effort at global resource mobilization for COVID-19.  The appearance of foundations, business associations and even individual businesses as global partners in this loosely non-institutional initiative is clearly evident in the press releases and programs associated with the initiative. The multi-stakeholder character of this initiative is marvelous to see.

The involvement of several non-state entities in this initiative has already been mentioned in this commentary because of their American origins or connections  – the Bill and Melinda Gates Foundation, members of the Global Monitoring Preparedness Board, and the presence of the American CEO of Eli Lilly as President of the IFPMA. Here I bring them up again because of their role as non-state partners in this initiative.  I was struck by the equal billing given to a number of non-state entities – and not only the Bill and Melinda Gates Foundation or the IFPMA. (Clarification: The IFPMA is a partner in the ACT-Accelerator initiative that was launched at the WHO on 24 April and participated in the 4 June pledging summit but is not listed as a partner of this broader initiative.) One also finds both the Wellcome Trust (a British philanthropic foundation) and the World Economic Forum on the tally of partners of both the ACT-Accelerator and this more loosely labelled Global Coronavirus Response.

This visibility of the World Economic Forum really caught my eye. Its members are global businesses, in contrast to the other global business groups like the International Chamber of Commerce or the International Organization of Employers. (These are made up of national business associations.) But here it is, a full-fledged partner of the Global Coronavirus Response, with governments, international organizations, global health partnerships like GAVI, the Vaccine Alliance and the Global Fund, and foundations and industry-specific associations.

I believe that the inclusion of these private-sector and other non-state entities as full-fledged partners is enabled in large part because the initiative does not have a formal structure. I’m not sure it would make much difference if the US or China were more involved, but one can only surmise that these two would be less inclined to treat any non-state actors as their partners. And without them, the main governmental or intergovernmental instigators of this initiative are definitely in the multilateral camp, if not as obviously in the multi-stakeholder camp. But there is another noticeable missing part.

This is the absence of civil society. Again, the argument can credibly be made that both the 24 April launch of the ACT-Accelerator initiative and the broader pledging summit on 4 May were entirely devoted to mobilizing financial resources for a coordinated effort. The Federation of Red Cross and Red Crescent Societies is, to be sure, a supporter of this initiative, but its members are mostly quasi-public national organizations. Most other civil society groups are unlikely to pledge substantial resources to a collective effort and are more likely to be implementing partners. Civil society representatives of this sort (e.g. Save the Children) have praised the formation of this initiative. And many other organized representatives of civil society  are active in many of the health-related coalitions like GAVI, the Vaccine Alliance and the Global Fund that are the co-convenors for targeted partnerships. So fine and good.

What was quite stunning with regard to a civil society role (or its absence so far) was what Ursula von der Leyen, the President of the European Commission, had to say in her closing remarks. She understandably reaffirmed that the success of the pledging summit, reaching the $8 billion targeted for the event (thanks to a favorable exchange rate for the Euro), was only the beginning. Much more would be needed to provide everyone in the world with whatever tools will be found and developed against COVID-19. And the next event, she reaffirmed, was the GAVI replenishment summit, scheduled for London on 4 June. (We have been aware of this event, scheduled prior to the COVID-19 crisis, as a pledging event for GAVI’s ongoing and other vaccine access initiatives, to which COVID-19 has now been added.)  And, by the way, she said, this 4 June summit will serve as the opportunity to bring civil society, such as the group known as Global Citizen and others, into the global effort! Huh?

I must admit that I went scurrying back to my search engine. Yes, I had come across this group Global Citizen already – active as it seems to have been around UN events in New York in recent years.  An Australian group originally? Yes, I even recall some “post-2015 Development Agenda” gatherings of civil society groups. Its mission comes out of that “post-2015” momentum – dedicated to “working together towards a world free of extreme poverty by 2030”.

This one, though, has a uniquely millennial flavor to it – mostly youthful Americans on its leadership team along with the two Australian co-founders. And it has a definite alignment with the private sector – working with its “core partners” Johnson&Johnson, P&G, Cisco, Verizon, Delta, Citi and WW (i.e. WW International or WeightWatchers Reimagined, not World Wildlife International). Other partners are also listed: Analog Devices, Coca Cola, gsk, IBM, Pepsi, State Farm, Teneo and Vodafone.  What this tells me is that this NGO, Global Citizen, is emphatically linked to the private sector in ways that many other NGOs are not. Perhaps the most revealing part of the search, though, is that Global Citizen played the organizing role for the Live-Aid-style event with Lady Gaga on One World: Together at Home.

Does this mean that there is a new array of global civil society actors out there? A millenial generation? Happy to work with the business world? Even if one hopes to see many of the more established civil society organizations drawn into this COVID-19 effort, one can only praise this kind of linkage of youthful exuberance with socially responsible business partners. So why not? We have been used to working with groups like Save the Children or Médecins sans Frontières or Oxfam. And we hope they, too, will be drawn into the collaborative effort. It is still not clear, however, how civil society will play its part in an initiative that has no institutional framework. But maybe the G-20 experience with G-20 Engagement Groups will eventually be the model. So this is another opportunity to look forward to the next steps!

Conclusions

The Coronavirus Global Response or ACT-Accelerator initiative is a welcome development to bring together all concerned actors, even without the US or China or Brazil or India or Indonesia or Russia. It did reach the goal of $8 billion in pledges, although there was also an announced €7.5 billion goal that was not met. At least it was close (almost €7.4 billion), and the favorable exchange rate pushed it over $8 billion. Some critics will say this included resources that had already been committed, but even there one can argue that anything committed after the announcement on 31 January of COVID-19 as global health emergency is definitely part of resource mobilization for the pandemic. On the other hand, we also know that this $8 billion is only the beginning of this multi-billion dollar challenge. What is important for now is to see how this first “go” of $8 billion filters into real action in the coming months.

The absence of an institutional framework does make it difficult to monitor, even with a designated “facilitation group” to oversee and report progress, mobilize resources and engage with stakeholders. This group has ten “flag” entities (EU, Canada, France, Germany, Italy, Japan, Norway, Saudi Arabia, Spain and the UK, plus the WHO, the Bill and Melinda Gates Foundation, the World Economic Forum and the Wellcome Trust. But no structure. It does look, though, that the WHO will have both a coordination role for the work on vaccines, therapeutics and diagnostics and a leading role on product allocation. And we do know that the WHO has solid support for these roles among the other facilitation group members. They are also emphatically committed to making sure that the WHO budget is not weakened by the US “suspension” of its contributions. I think this is fine for now, and I am especially interested in how the three non-state actors in the facilitation group will operate. The question remains whether this informal arrangement will have any noticeable links with the G-20 – in the foreseeable future beyond the November elections and G-20 heads of state summit, if not in the coming months.

The multi-stakeholder nature of the loose coordination is a step forward in opening up collaborative arrangements of states with non-state actors in new and different settings. The G-20 may still be the “official” conduit for the Global Coronavirus Response, but it, too, was established as a relatively unstructured subunit of the international system to meet a need that the UN system could not deliver.  The looseness of its “soft governance” makes it a good conduit for what is happening here. And here is yet another step.

There have been numerous public-private partnerships in the health arena, and even a number of multi-stakeholder partnerships. Thus, the collaborative nature of the Coronavirus Global Response is not necessarily a new thing. It is just a more definitive reflection of the transnational interests that are less and less dependent on being channeled through national governments and their inter-national organizations. Although most initiatives still depend on these national channels, the global implications of a pandemic that affects every nation-state in ways that ultimately require a global collaboration appear to include the opening up of partnering possibilities through different channels and with different actors. This, to me, is the most promising avenue for ensuring that the search is accelerated through broad collaboration and that the resulting vaccines and other tools are made universally available and affordable.

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