Stopping epidemics when and where they occur

Throughout the COVID-19 pandemic, vaccines and other health tools have reached lower-income countries out-of-step with need and demand. Yet lessons from this pandemic to address such inequities are not catalysing the fundamental changes required. Similarly, despite the well known risk of Ebola virus disease outbreaks, it took months before candidate vaccines were made available for testing during an outbreak in Uganda in late 2022. And although there have been cases of mpox (formerly known as monkeypox) in Nigeria, the Democratic Republic of the Congo, and Central African Republic for many years, it was only when the virus spread globally during 2022 that high-income countries focused on the disease, with people in wealthy countries getting access to mpox vaccines and therapies.

Governments and the global community must urgently tackle difficult questions about why, how, where, and when diagnostics, treatments, and vaccines are produced, and about who is in control of their availability and distribution. Epidemics present unique and complex scientific, health, socioeconomic, and international cooperation challenges that require a fit-for-purpose response. Current market forces cannot provide the tools to stop disease outbreaks. We propose a new framework that is designed in the public interest and rooted in equity from start to finish to create a sustainable ecosystem for medical countermeasures to outbreaks, based on the sharing of knowledge and technology and governed and financed through a global commons approach (panel).