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Memorias del Instituto de Investigaciones en Ciencias de la Salud

versão On-line ISSN 1812-9528

Mem. Inst. Investig. Cienc. Salud vol.20 no.3 Asunción dez. 2022 


Assessing the pandemic. The global successes and failures according to the Lancet Commission

1Ministerio de Salud Pública y Bienestar Social, Dirección General de Vigilancia de la Salud. Asunción, Paraguay

The Lancet Commission set itself the goal of evaluating "independently" what was done in the management of the pandemic. It began its work in July 2020 and after two years, 28 of the main experts in public policy, international governance, epidemiology, vaccination, economics, international finance, sustainability and mental health, and consultations with more than 100 collaborators in its 12 global working groups, recently launched in September the report with their claims1. Led by Jeffrey Sachs, a professor at Columbia University, who at the launch of the report said: "The staggering human cost of the first two years of the pandemic is a profound tragedy and massive social failure on multiple levels." He also indicated: “We must face hard truths: too many governments have not adhered to the basic norms of institutional rationality and transparency; too many people have protested against basic public health precautions, often influenced by misinformation; and too many nations have failed to promote global collaboration to control the pandemic.”

The published work has 3 well-differentiated sections:

Section 1 provides a conceptual framework for understanding pandemics: the pillars of success in fighting an emerging infectious disease (prevention, containment, health services, equity, and innovation and development; trust and social solidarity compacted in a concept that they call "prosociality"; as well as how were the quick responses of the governments; and the different strategies deployed by countries and regions against COVID19.

Section 2 provides a chronological description of the pandemic and the most relevant facts. Starting with the molecular description of SARS-Cov2 and its "weak points" for mutation promoters, addressing the probabilities of possible origins of the virus. Discussing in depth also the limits of genetic manipulation. However, this report recommends intensifying the exploration of the origins of the pandemic.

Section 3 presents policy recommendations, particularly around WHO-focused multilateral cooperation to address global health crises. The approach to investments in preparing for future pandemics through stronger health systems is highlighted, the well-cited resilience of systems and international financial and technological cooperation are discussed, mainly with and between regions with lower incomes2.

The report cites some positive examples of international cooperation, including public-private partnerships to develop vaccines in record time. But it highlights the inequalities generated or rather deepened by the pandemic between rich and poor countries, also within countries and cities. The world already had a trend of increasing inequalities, but the pandemic deepens them, adding political and ideological polarization in an ocean of fake news, infodemics and massive “infoxication”. Inequalities in vaccination rates are extreme, with three in four people fully vaccinated in high-income countries, but only one in seven in low-income countries. Our country reproduces this internally, with better coverage at the urban level or in areas with higher incomes, but very poor coverage in the poorest districts.

Among the commission's key recommendations are:

- The effort that must be made to strengthen national health systems, the adoption of national pandemic preparedness plans, and broader universal health coverage; and

-Develop a strengthened multilateralism that focuses on a reformed and reinforced WHO, that integrates the global response to the risks of a future pandemic with actions to address the climate crisis and the setbacks that will occur or will occur for sustainable development3.

Continuing with Sachs's statements: "Now is the time to take collective action that promotes Public Health and sustainable development to end the pandemic, address global health inequalities, protect the world against future pandemics, identify origins of this pandemic and build the coping capacity and resistance [resilience] of communities around the world.”

After the publication of the report, the WHO has not remained silent and has responded to criticism from The Lancet with a small report or a few lines through its Twitter profile that said: "The WHO welcomes the general recommendations of the report from The Lancet Commission on lessons learned from the Covid-19 pandemic. The recommendations align with our commitment to enhanced global, regional and national pandemic preparedness, prevention and response" but it also criticized saying: "At the same time, there are several key omissions and misinterpretations in the report, especially with regard to the public health emergency of international concern and the speed of scope of the WHO's actions"4).

The evaluations of the management of the pandemic come after more than two years of its beginning and still not seeing its end. The Commission's report draws attention to the lack of criticism of the management of the pandemic, from its very beginnings to how the government of Continental China continues to manage it today. Fortunately, it is not the only group of "experts" that is trying to order in narrative terms what this great crisis of humanity was.

And how are we doing at home?

Dr. Guillermo Sequera, General Director Direction of Health Surveillance, MSPyBS.


1. Sachs JD, Karim SSA, Aknin L, Alen J, Borbol K, Colombo F, et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet. 2022 Oct 8; 400(10359):1224-1280. Epub 2022 Sep 14. PMID: 36115368; PMCID: PMC9539542. [ Links ]

2. Haldane V, De Foo C, Abdalla SM, Jung AS, Tan M, Woo S, et al. Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nat Med 27, 964-980 (2021). ]

3. Griffin S. Covid-19: Commission describes "massive global failures" of pandemic response. BMJ. 2022 Sep 14; 378: o2237. doi: PMID: 36104067. [ Links ]

4. WHO. WHO responds to The Lancet COVID-19 Commission. Disponible en: ]

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