Now or Never

Why this moment brings a once-in-a-century opportunity to strengthen global health.

One year ago today, based on analysis by experts from around the world at Resolve to Save Lives, we and others wrote, sadly, that a Covid pandemic was inevitable.

1. Science as a verb.

In “The Martian,” Matt Damon plays a botanist stranded on Mars. He realizes that to get back home, he’s going to have to “science the s — — out of” the problem. Resolve’s team of epidemiologists and public health specialists have been learning every day. As the evidence has changed, our approach has not — always base our recommendations on the best available science.

  • Using an adaptive response to the pandemic, which we released more than a year ago and updated regularly as more information became available. The concept, and most of the details on phased reopening guidance, were adopted by the White House, although unfortunately the strategy wasn’t followed.
  • Best practice reports on the impact of public health and social measures led to wider adoption of these measures.
  • Boxing in the virus to prevent explosive spread and reopen society as soon and as safely as possible.
  • Establishing alert level systems to provide a framework to support clear decision-making, improve accountability, and better communicate with the public. Many states and countries adopt this tool, and we partnered with the New York Times to make a consistent system across the U.S. available to all.
  • Reopening schools while prioritizing the safety of students and their families, teachers and staff, and the entire community.
  • Communicating the importance of wearing masks and implementing mask mandates to prevent viral transmission and slow community spread.
  • Measuring and reporting essential Covid indicators.
  • Implementing, along with our Vital Strategies colleagues, rapid mortality surveillance to better track the pandemic.

2. Funding to stop outbreaks — provided quickly.

Before and during the Covid pandemic, Resolve provided rapid response funds to more than two dozen countries in Africa and elsewhere. A systematic analysis in Nigeria found that time to outbreak response decreased from six to two days after the fund was implemented. Stopping an outbreak in a few days can cost a tiny fraction of what it would cost if allowed to spread for weeks or months. In Nigeria and other countries, these funds are now replenished by government funds.

A health worker stands in a testing booth while another sanitizes his gloves.
A health worker stands in a testing booth while another sanitizes his gloves.
COVID-19 test preparations in Ogun, Nigeria. Rapid Response Teams in Nigeria were supported by Resolve to Save Lives.

3. Working alongside partners to build capacity

Collaboration is essential to protect health sustainably. In 2019, our training course, Program Management for Epidemic Preparedness, graduated 25 mid-level managers representing seven countries in Africa. This investment paid off during the Covid pandemic as these individuals and their teams were able to rapidly improve detection and response. Our second training program, planned before and conducted during the pandemic, was held in the Democratic Republic of Congo and helped to align ministry officials and World Bank staff to enable the timely and effective use of $150 million in World Bank funds for epidemic preparedness.

4. Stopping Covid in the U.S. — especially among vulnerable populations.

We started work in the U.S., creating a US Covid Response team. Our staff worked with public health departments across the country to strengthen prevention strategies, testing, isolation and quarantine, contact tracing, vaccination, and community engagement, all with a focus on equity. We also joined with other national public health organizations to advocate for improved funding and policies to address this pandemic and prevent the next.

5. Honoring our health care heroes by protecting them.

As soon as the pandemic hit, we established on-the-ground health care worker training focused on infection prevention and control. Our training was used by more than two dozen partners to train more than 35,000 staff in 7,000 facilities throughout Africa, facilitating safe screening of more than 4 million patients. Learning from this experience, in January 2021, we led a coalition of 17 organizations to publish a report that highlights the risks health care workers face every day and provides recommendations to protect them — and their patients — by making health facilities safer.

6. Basing action on evidence.

We spearheaded development of the Partnership for Evidence-Based Response to Covid, a public-private partnership that supports evidence-based measures to reduce the impact of the pandemic on African Union Member States. The partnership collected and analyzed social, economic, epidemiological, population movement, and security data from 20 countries to help determine the impact of public health and social measures.

7. Primary care is primary.

A key lesson from the Covid pandemic is the need for primary care to be at the center of health systems. Non-communicable diseases continue to be the leading global causes of death, and we must continue life-saving preventive care and treatment during the pandemic; in addition to saving lives today, this will promote individual and community resilience against Covid and future health threats.

  • Delivering medications directly to patients.
  • Increasing use of telemedicine and other virtual technologies including phone, email, and text messaging.
  • Treating and monitoring at convenient locations in the community.

8. Using policy to save lives.

We continued to advance policy actions to address cardiovascular disease. Global momentum to eliminate trans fat is growing, including an earlier win in Thailand and recent bold action by India to eliminate trans fat by 2022, a stunning victory for healthy nutrition. Turkey and Paraguay also acted to eliminate trans fat, and Nigeria, Bangladesh and the Philippines are now poised to do so. We partnered with the World Health Organization to launch the second annual progress report for the REPLACE initiative to eliminate artificial trans fat. Although 58 countries have introduced laws that will protect 3.2 billion people from trans fat by the end of 2021, more than 100 countries still need to take action to remove this toxic substance from their food supply.

9. Spread truth.

The Covid pandemic was accompanied by an epidemic of competing and often inaccurate information spreading rapidly throughout the world. Our communications team filled a need for real-time, credible public health information by producing high-quality, evidence-based communications materials for diverse audiences.

This moment brings a once-in-a-century opportunity. It’s now or never.

Working together, we will take a giant step toward being able to find, stop, and prevent health threats faster in every country through public health systems that are understood, supported, and celebrated. This starts with expanding equitable access to vaccines to end the Covid pandemic. It’s both ethically unacceptable and epidemiologically perilous that so much of the world is so far from having vaccine access. Uncontrolled spread anywhere threatens to prolong the pandemic everywhere, and we must scale up not only vaccine access but also vaccine manufacturing capacity in low- and middle-income countries. Beyond Covid, we need a public health renaissance so health threats are detected rapidly by accurate and sensitive tracking systems and laboratory networks, stopped quickly by trained epidemiologists and rapid response teams, and prevented wherever possible, including through ongoing vaccination programs and action to make our environment safer.

President and CEO, Resolve to Save Lives | Former CDC Director and NYC Health Commissioner | Focused on saving lives. twitter.com/drtomfrieden

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