Covid-19: a disaster five years in the making

The covid-19 pandemic is not a one-off extraordinary event but the culmination of a five year unravelling of progress in global health, writes Peter Hotez. We live in extraordinary times in global health. Through two decades of the United Nations’ millennium and sustainable development goals, the number of childhood deaths from measles and some other vaccine preventable infections has fallen by as much as 87%.1 The launch and support of global vaccination programmes through Gavi, the Vaccine Alliance, and mass treatment programmes for HIV-AIDS, malaria, tuberculosis, and neglected tropical diseases have produced enormous global health gains.1 We are also moving towards the elimination of neglected tropical diseases including onchocerciasis, lymphatic filariasis, scabies, yaws, and trachoma, with major falls in the incidence of AIDS in Africa and elsewhere. The benefits of these successes go beyond public health to reduced poverty through improvements in productivity, child development, and maternal-fetal outcomes. Global security has also been strengthened. Over the past 5-6 years, however, we have seen abrupt reversals in these developments leading to the emergence or re-emergence of both vaccine preventable diseases and neglected infections in multiple areas of the world. And that’s before the onset of covid-19. Humanity is able to make tremendous gains against global disease like never before—but we have allowed those gains to unravel. The novel coronavirus has shown us the consequences of this.