Monday 15 April

Dear heads of state and government of G20 countries,

CALL FOR A COORDINATED, EQUITABLE, AND HUMAN RIGHTS-BASED GLOBAL RESPONSE TO COVID-19

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:

  1. 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
  1. 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
  1. 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
  1. 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
  1. 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
  1. 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.

Call for global action plan on COVID-19 – 14 April 2020

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

For correspondence, please contact:

Umunyana Rugege (Executive Director, SECTION27) – rugege@section27.org.za

Sasha Stevenson (Head of Health Rights, SECTION27) – stevenson@section27.org.za

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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