Institute for Justice and Democracy in Haiti

Call for a Coordinated, Equitable, and Human Rights-Based Global Response to COVID-19

Over 100 organizations and global health leaders unite in calling for G20 countries to meet their responsibilities during COVID-19 pandemic: funding, debt relief, equitable distribution, protecting vulnerable populations, April 14, 2020

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Dear heads of state and government of G20 countries,

We, the undersigned 99 organizations and 40 individuals, call upon you to ensure a robust, coordinated global response to the coronavirus disease 2019 (COVID-19) pandemic that is humane, equitable, based in the universality of human rights, and meets the needs of countries and people who are most vulnerable and have the fewest resources.

We recognize that we are in an unprecedented situation of a colossal need for sharing and solidarity even as many of world’s wealthiest and best-resourced nations are experiencing their own severe public health emergencies. And we applaud governments that, even with domestic health emergencies, have offered support to other countries.

Yet these actions are far from commensurate with the scale of the pandemic and global need, especially of the most vulnerable people and people in the most vulnerable countries. We fear a looming catastrophe, especially in countries where even before COVID-19, health systems were overstretched, and for populations who were already highly vulnerable to health risks, including people living in poverty, people with disabilities, the elderly, and refugees, internally displaced persons, and migrants.

Accordingly, we issue this urgent call for coordinated global action, undertaken through the leadership of your governments, and working closely with civil society organizations, the public health community, and international organizations to:

Provide countries with the financial and expert resources required for a response that is maximally effective and protective of vulnerable populations

Many lower-income countries will require significant external support to effectively contain, respond to, and recover from COVID-19, and to mitigate its social and economic cost.

We therefore call upon your governments to:

Immediately fully fund COVID-19 humanitarian appeals, including:

The UN emergency appeal for $2.01 billion – less than 0.1% of what wealthy countries are spending on emergency domestic COVID-19 responses – and any future such appeals. This should not reduce support for other humanitarian appeals, which also require full funding.

WHO’s COVID-19 appeal, and any future such appeals.

National COVID-19 response plans and any other national funding requests.

Provide the necessary funding to meet the urgent needs of health, social, and economic systems in lower-income countries, as called for by the 6 April 2020 letter sent to you by Gordon Brown and 164 other global leaders[1]

Provide significant new resources to international, national, and community-based civil society organizations responding to COVID-19

Ensure full transparency of contributions and their use

Make available technical expertise to support international and national need

Suspend debts of lower-income countries and increase debt relief

Countries need all available domestic resources to respond to COVID-19, and will need significant funding for their longer-term recovery.

We therefore call upon your governments to:

Immediately suspend debt payments of countries eligible for International Development Association financing, as called for by the World Bank and IMF; all African countries, as requested by African ministers of finance; and other countries experiencing extraordinary circumstances

Provide significant, sustained additional debt relief to countries eligible for the Heavily Indebted Poor Countries (HIPC) initiative

Maximize supply and share health resources globally, equitably and based on need

Higher-income countries have insufficient necessary medical supplies and equipment, yet shortfalls in lower-income countries are far greater still, with a lack of personal protective equipment putting large numbers of health workers at preventable risk, and causing countless avoidable COVID-19 patient deaths.

We therefore call upon your governments to:

Use the full authorities under your law to demand the utmost efforts of manufacturers to maximize the supply of critically needed medical supplies and equipment

Support WHO in developing a global pool of intellectual property rights for technologies for preventing, detecting, controlling, and treating the COVID-19 pandemic, to make the intellectual property needed to manufacture these technologies and secure their regulator approval freely accessible or available through licensing at reasonable and affordable terms, as proposed by the government of Costa Rica

Implement your 26 March 2020 commitment to ensure medical supplies are widely available at affordable prices, on an equitable basis, where most needed, and as quickly as possible, through all necessary actions, which may include:

Supporting WHO in developing guidelines to determine where supplies and equipment should be distributed based on these principles; supporting WHO in developing a platform to facilitate needs-based, equitable distribution; and adhering to WHO guidelines

Agreeing to donate a significant proportion of any procurements of these supplies and equipment available to WHO, for it to distribute equitably, based on need

Regularly, publicly report on how you are meeting your 26 March 2020 commitment

For countries past the peak of their epidemics, or with sufficient levels of supplies and equipment, share not presently needed supplies and equipment based on the same principles of need and equity

Distribute therapies and vaccines equitably, based on need

Once developed, COVID-19 therapies and vaccines for COVID-19 must also be distributed equitably, based on need, and not on where they are manufactured or what country can pay the most.

We therefore call upon your governments to:

Work with WHO to develop a plan for manufacturing and distributing any COVID-19 vaccines globally, equitably, based on need, and free at the point of use; and commit to following this plan

Immediately provide the Coalition for Epidemic Preparedness Innovations the $2 billion it requires to support developing a vaccine

Require any vaccines developed with public funding to be available to governments and international organizations at affordable prices

Remove export controls, reform sanctions, and revise travel restrictions that hinder the global COVID-19 response

Dozens of countries have imposed export controls on medical supplies and equipment, preventing them from being distributed equitably, based on need. Sanction regimes on several countries, notably Cuba, Iran, North Korea, Venezuela, and Zimbabwe are impeding their ability to respond to COVID-19. And travel restrictions may prevent health and humanitarian workers from traveling to countries to assist in the COVID-19 response or meet other humanitarian needs.

We therefore call upon your governments to:

Remove export controls, at least to the extent they prevent needs-based, equitable distribution

Reform sanctions that may hinder national COVID-19 responses, at a minimum to ensure prompt, flexible authorization for medicines, medical supplies and equipment, and other humanitarian needs

Exempt health and humanitarian workers from travel restrictions

Protect people who lack protection from own governments

Refugees, internally displaced persons, asylum seekers, stateless people, and other migrants living in camps or other situations highly conducive to the spread of COVID-19 and with limited access to health care require extra support.

We therefore call upon your governments to:

Fully and rapidly meet all UN humanitarian appeals

Prioritize these populations for distribution of medical supplies and equipment and COVID-19 related health technologies, including vaccines and therapies when available, due to their heightened vulnerability

Ensure that all migrants, regardless of status, and stateless people have equal access to all COVID-19-related health services and social supports as their own citizens

Lastly, we implore you to take all possible measures to protect members of your own countries who are homeless, living with a disability, elderly, children, living with HIV, low-income, in confined settings (including prisons, nursing homes, detention centers, psychiatric or social care institutions or institutions for people with disabilities, and orphanages), or in any other way marginalized and extra vulnerable, ensuring robust health and social support, protections from discrimination, and any special measures that may be needed to protect their health and well-being. And we call for you to support other countries in doing the same to protect their own marginalized and vulnerable populations.

The only way to protect the health of people in all countries will be to protect the health of people in each country – all the people. A response to this pandemic based in social and global solidarity, that equally values poor and rich, and is grounded in the equal rights of all people will most quickly get us through this crisis with the least possible human devastation. The global coordination of such a response could launch a new era of global collaboration to move us nearer a world that fully respects each person’s dignity.

Sincerely,
Organisations
Action for Humane Hospitals
Cameroon
AIDS and Rights Alliance for Southern Africa (ARASA)
Namibia
Aidsfonds
Netherlands
AIDS Foundation South Africa
South Africa
African Youth and Adolescent Network
Lesotho
Alianza Colombiana por la Salud Alimentaria/Colombian Alliance for Food Health
Colombia
Alianza Latinoamericana de Salud Global (ALASAG)/Latin American Alliance of Global Health
Costa Rica
Alianza Libre de Humo Argentina/Alliance of Smoke Free Tobacco Argentina
Argentina
Alliance for Surgery and Anesthesia Presence (ASAP)
USA
American Heart Association
USA
Asociación Argentina de Salud Pública (AASAP)
Argentina
Bangladesh Legal Aid and Services Trust
Bangladesh
Canadian HIV/AIDS Legal Network | Réseau juridique canadien VIH/sida
Canada
Cancer Alliance
South Africa
Centre for Applied Legal Studies
South Africa
Centre for Environmental Rights
South Africa
Centre for Health and Resource Management
India
Centre for Law and Policy Research
India
Centre on Law & Social Transformation
Norway
Centro de Estudios para la Equidad y Gobernanza en los Sistemas de Salud (CEGSS)/Center for the Study of Equity and Governance in Health Systems
Guatemala
CHESTRAD Global
Global
Children’s HeartLink
USA
Communication for Development Centre
Nigeria
Disability Rights International
USA
Division of Social Accountability, University of Saskatchewan
Canada
Educar Consumidores/Educate Consumers
Colombia
Equal Education Law Centre (EELC)
South Africa
Every Girl in School Alliance
Malawi
Framework Convention on Global Health Alliance
Switzerland/Global
Frontline AIDS
UK
Fundación Interamericana del Corazón Argentina/Inter-American Heart Foundation – Argentina (FIC Argentina)
Argentina
 
Fundación para el Desarrollo de Políticas Sustentables / Foundation for the Development of Sustainable Policies
Argentina
Fundación Salud Ambiente y Desarrollo (FUNSAD)/ Environment, Health and Development Foundation
Ecuador
Global Health South
Nigeria/Global
Health Economics and HIV and AIDS Research Division
South Africa
Health-e News Service
South Africa
HealthGap
USA
Healthy Living Alliance (HEALA)
South Africa
IFHHRO | Medical Human Rights Network
Netherlands
Imamia Medics International (IMI)
USA
Institute of Analysis & Advocacy
Ukraine
Institute for Economic Justice (IEJ)
South Africa
Institute for Justice & Democracy in Haiti
USA
International Alliance of Patients’ Organisations
United Kingdom/Global
International Council of AIDS Service Organizations (ICASO)
Canada/Global
International-Lawyers.Org (INTLawyers)
Switzerland/Global
International Rescue Committee
USA
 
International Treatment Preparedness Coalition
South Africa
Joep Lange Institute
Netherlands
Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN)
Kenya
Light of Hope
Ukraine
Living Goods
USA
MADRE
United States
Management Sciences for Health
USA
medica mondiale
Germany
Médecins Sans Frontièrs South Africa
South Africa
Mesa Colombiana por las Enfermedades Crónicas/Colombian Board for Chronic Disease
Colombia
Ndifuna Ukwazi
South Africa
Operation Smile
USA
Oxfam South Africa
South Africa
Partners In Health
USA
People’s Health Movement
Global
PharmAccess Group Netherlands
Netherlands
PharmAccess Group Nigeria
Nigeria
PharmAcess Group Tanzania
Tanzania
Policies for Equitable Access to Health
Italy
POSITIVE-GENERATION
Cameroon
Positive Vibes
Namibia/South Africa
Prayas
India
Probono.org
South Africa
Public Affairs Research Institute
South Africa
Public Health Foundation of India
India
Public Service Accountability Monitor
South Africa
Rare Diseases South Africa
South Africa
ReSurge International
USA
Rural Health Advocacy Project
South Africa
Sala de Derecho a la Salud de la Universidad Blas Pascal/Right to Health Room, Blas Pascal University
Argentina
Salud y Fármacos (EE.UU)
USA
Saluteglobale.it Associazione di Promozione Sociale
Italy
Save the Children South Africa
South Africa
Schweizer Partnerschaft Hôpital Albert Schweitzer Haiti (SPHASH)
Switzerland
SECTION27
South Africa
Seed Global Health
USA
She Decides
South Africa
Siasa Place
Kenya
Smile Train
USA
Sonke Gender Justice
South Africa
South African Non Communicable Diseases Alliance
South Africa
STOPAIDS
UK
Sustainable Resource Foundation
Pakistan
TB Proof
South Africa
The Center for Law, Justice and Society – Dejusticia
Colombia
Treatment Action Campaign (TAC)
South Africa
Viva Salud
Belgium
Wemos
Netherlands
What To Expect Project
USA
White Ribbon Alliance
Kenya
World Federation of Public Health Associations
Switzerland/Global
World Heart Federation
Global
Youth Wave
Malawi
Individuals
Anand Grover
Executive Director, Lawyers Collective
Former UN Special Rapporteur on the right to health
India
Anele Yawa
General Secretary, Treatment Action Campaign (TAC)
South Africa
Bernard Kadasia
President, Alliance for Health Promotion
Former Deputy Executive Director and Director of Policy and Advocacy, Research
Promotion and Communication, International HIV/AIDS Alliance
Kenya
Brook K. Baker,
Senior Policy Analyst
Health GAP (Global Access Project)
USA
Claire Brolan
Centre for Policy Futures
The University of Queensland
Australia
Dainius Puras
UN Special Rapporteur on the right to health
Professor and the Head of the Centre for Child Psychiatry Social Paediatrics, Vilnius
University
Lithuania
Debrework Zewdie
Distinguished Scholar, CUNY School of Public Health and Public Policy
Former Director, Global AIDS Program, World Bank
Former Deputy Executive Director and Deputy General Manager of the Global Fund to
Fight AIDS, Tuberculosis and Malaria
USA
Devi Sridhar
Professor and Chair of Global Health, University of Edinburgh
Founding Director, Global Health Governance Programme, University of Edinburgh
Medical School
United Kingdom 
Donald Berwick
President Emeritus and Senior Fellow, Institute for Healthcare Improvement
Lecturer of Health Care Policy, Harvard Medical School
Former Administrator, Centers for Medicare and Medicaid Services
USA
Eric A. Friedman
Global Health Justice Scholar
O’Neill Institute for National and Global Health Law
USA
Francine Mestrum
Founder and chairperson
Global Social Justice
Belgium
Garance Fannie Upham
President
AMR Think-Do-Tank, Geneva international
Switzerland
Gorik Ooms
Honorary Professor of Global Health Law and Governance, London School of Hygiene and Tropical Medicine
Former Executive Director, Protection International
Former Executive Director, Médecins Sans Frontières Belgium
United Kingdom/Belgium
Gregg Gonsalves
Co-Director, Global Health Justice Partnership, Yale University
Assistant Professor of Epidemiology and Associate Professor of Law, Yale University
MacArthur Fellowship Recipient (2018)
Co-Founder, International Treatment Preparedness Coalition
Co-Founder, Treatment Action Group
USA
Henry B. Perry
Senior Scientist, Health Systems Program
Department of International Health
Johns Hopkins Bloomberg School of Public Health
USA
James G. Hodge
Director, Center for Public Health Law and Policy
Arizona State University
USA
Joe Amon
Director of Global Health
Drexel University Dornsife School of Public Health
USA
Srinath Reddy
President, Public Health Foundation of India
Adjunct Professor of Epidemiology, Harvard University
Honorary Professor of Medicine at the University of Sydney
Former President, World Heart Federation.
India
Lance Gable
Associate Professor of Law
Wayne State University Law School
USA
Lawrence O. Gostin
University Professor
Founding O’Neill Chair in Global Health Law
Faculty Director, O’Neill Institute for National and Global Health Law
Director, World Health Organization Collaborating Center on National & Global Health
Law
Georgetown University Law Center
USA
Malebona Precious Matsoso
Director of Health Regulatory Science Platform, Wits Health Consortium, University of Witwatersrand
Former Director General of Health, South Africa
Former Chair of the Executive Board at World Health Organization, 2015-2016
South Africa
Mark Dybul
Co-Director, Center for Global Health Practice and Impact, Georgetown University Medical Center
Professor, Georgetown University Medical Center
Former Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria
Former Coordinator of the U.S. President’s Emergency Plan for AID Relief (PEPFAR)
USA
Mark Rosenberg
Visiting Professor, Rollins School of Public Health, Emory University
Former President and CEO, Task Force for Child Survival and Development/Task Force for Global Health
Former Director, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention
Former Assistant Surgeon General
USA
Martín Hevia
Dean and Associate Professor
School of Law, Universidad Torcuato Di Tella
Argentina
Matthew M. Kavanagh
Director, Global Health Policy & Politics Initiative
O’Neill Institute for National and Global Health Law
Visiting Professor of Law and Assistant Professor of Global Health
Georgetown University Law Center
USA
Meg Davis
Special Advisor
Global Health Centre, Graduate Institute
Switzerland
Michael Krawinkel
Institute of Nutritional Sciences
Justus-Liebig-University Giessen
Germany
Michele Barry
Drs. Ben and A. Jess Shenson Professor of Medicine and Tropical Diseases, Stanford University
Director of the Center for Innovation in Global Health, Stanford University
Senior Associate Dean for Global Health, Stanford UniversityFounder, WomenLift Health
USA
Miriam Were
Member, The Champions for an AIDS-Free Generation
Former Chancellor, Moi University
Former Chair, AMREF
Former Chair, National AIDS Control Council, Kenya
Co-Founder, UZIMA Foundation
Kenya
Mirta Roses Periago
WHO Special Envoy on COVID-19 for Latin America and the Caribbean
National Academy of Medicine of Buenos Aires
Argentina
Mushtaque Chowdhury
Formerly Vice Chair of BRAC and Founding Dean and Adviser, James P. Grant School of Public Health, BRAC University
Bangladesh
Paul Farmer
Chief Strategist and Co-Founder, Partners In Health
Kolokotrones University Professor and chair of the Department of Global Health and Social Medicine, Harvard Medical School
Chief of the Division of Global Health Equity, Brigham and Women’s Hospital in Boston
USA
Paulo M. Buss
Emeritus Professor
The Oswaldo Cruz Foundation (Fiocruz)
Full Member, Nacional (Brazilian) Academy of Medicine
Brazil
Peter Hill
Honorary Associate Professor
School of Public Health, University of Queensland
Australia
Peter Laugharn
President and CEO
Conrad N. Hilton Foundation
USA
Petru Botnaru
Freelance journalist
Executive Director NGO “Terra-1530”; Editor publication “Adevarul” (Truth)
Republic of Moldova
Professor Pankaj G. Jani
Department of Surgery, University of Nairobi
Vice Chair, G4A P.C.
Past President, COSECSA
Kenya
Réginald Moreels
Humanitarian surgeon
Former Minister
International Cooperation Belgium
Belgium
Richard Skolnik
Former Director, Health, Nutrition and Population, South Asia, the World Bank
Former Lecturer, George Washington University and Yale University
USA
Roger Magnusson
Professor of Law
Sydney Law School, The University of Sydney
Australia


[1] The funding called for in the 6 April 2020 letter (https://www.project-syndicate.org/commentary/a-letter-to-g20-governments-by-erik-berglof-et-al-2020-04) includes:

  • An immediate COVID-19 response package of $100 billion, including new financing and debt relief, plus $50 billion for 2021, as requested by African finance ministers
  • $35 billion that WHO estimates is required to support countries with weak health systems
  • $8 billion that the Global Preparedness Monitoring Board estimates is required for vaccines, therapies, and WHO
  • $7.4 billion that Gavi, the Vaccine Alliance, requires for its next replenishment

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