Chapter 3 - Time for transformative policies at all levels


Policy responses to the COVID-19 pandemic and resulting economic crisis to date have exacerbated rather than reduced global inequalities. The fact that since the outbreak of the pandemic, on the one hand, the wealth of billionaires have risen to record levels, and on the other hand, the number of people living in extreme poverty and hunger has also increased massively, shows that something is fundamentally wrong in the world.

In response to the disastrous effects of the crisis, especially in the poorest countries, there was much talk of solidarity with regard to health support, including access to vaccines. But the brutal competition for vaccines shows that solidarity is used by many politicians merely as a rhetorical phrase. By the end of August 2021, more than 60 percent of the people in high-income countries had received at least one dose of COVID-19 vaccine, but less than 2 percent have done so in low-income countries. In view of this dramatic disparity, the slogan "leave no one behind" of the 2030 Agenda for Sustainable Development remains purely lip service.

In fact, vested economic interests continue to dominate political decision-making. Deepening inequalities are a result of self-serving and hypocritical policies and governance failures at national and international level. Thus, given the urgency of the COVID-19 crisis and the other unresolved global problems, most notably the climate crisis, it is high time for transformative policies, strategies and structural changes (as we have described them in the Spotlight Reports since 2016).

As an immediate response to the global health crisis, the People’s Vaccine Alliance—comprised of health and humanitarian organizations, health experts, economists, faith-based groups and world leaders, past and present-- has formulated "5 steps to end ‘vaccine apartheid’" (see Box 3.1). These are in line with the demands derived from the analyses in this Spotlight Report. But beyond responding to the health crisis, far more fundamental transformational steps are needed in order to bring about a more equal and just world. Such steps are needed to enable a comprehensive response to all global crises, now and in the future – starting with the climate emergency. Examples of such steps, both nationally and globally, are described in the following contributions.

An essential aspect of an agenda for change is the shift toward a rights-based economy and a concept of human rights that forms the basis of our vision of economic justice (see contribution by Kate Donald, Center for Economic and Social Rights).

To implement this concept, the trend of privatizing, outsourcing and downsizing of public services must be reversed. The aim must be to reclaim and invest in public goods and services and to ensure that they benefit all people (see contribution by Daria Cibrario, Public Services International).

A basic precondition for the adequate provision of public goods and services is that States have sufficient resources to fulfill their human rights obligations (including their extraterritorial obligations). To prevent the COVID-19 pandemic being followed by a global debt and austerity pandemic, governments must be enabled to expand their fiscal space and to implement alternatives to neoliberal austerity policies (see contribution by Isabel Ortiz, Global Social Justice, and Matthew Cummins, consultant).

Only if the world collectively embarks on this path toward transformational policies is there a chance to reduce global inequalities, protect our shared planet and make the proclaimed solidarity a political and institutional reality.

Box 3.1

5 steps to end ‘vaccine apartheid’

Demands of the People’s Vaccine Alliance[1]

Raise the ambition to vaccinate 60% of the planet. We are not going to end this pandemic by vaccinating fewer than 30% of the world’s population in the next six months. World leaders must aim higher and create a clear roadmap of how to get there. Make sure to base this roadmap on a solid manufacturing and distribution plan for all COVID-19 products and technologies. This process should be funded with fair share financing from rich nations, and fair allocation of doses.

Break the shackles of intellectual property on vaccines and COVID-19 knowledge. This will allow every nation to produce or buy vaccine doses at affordable rates. All Government leaders must support the WTO proposal by India and South Africa to temporarily waive intellectual property on Covid-19 vaccines, treatments and related technologies. They must also force pharmaceutical companies to share their COVID-19-related technology and know-how through the World Health Organization’s COVID-19 Technology Access Pool.

Make an immediate and large investment of public money into manufacturing more vaccine doses around the world. We need to see a clear plan to fund the huge increase in manufacturing of vaccines that is needed. We need to build a global distributed network to deliver these doses as global public goods to all nations. We have seen a clear failure of the market alone in ensuring enough vaccines. Therefore, governments should keep sufficient ownership of these new facilities, and work with the WHO to make sure they serve public interests first.

Provide COVID-19 vaccines, treatments and tests free of charge. To everyone, everywhere, allocated according to need. Prioritize frontline workers, people at higher risk, and resource-poor countries least able to save the lives of those infected with the virus. Marginalized groups should be part of these programmes. This includes refugees, prisoners, people with disabilities, and indigenous populations.

Scale up global financial support for upgrading and expanding public health systems. We can use the experience of the pandemic to create resilient, universal and equitable health systems around the world. These services should be free at the point of use, with all user fees eliminated. Universal Health Coverage is the global public good needed to respond not only to emergencies but also to protect and save lives every day.