Institute of Global Health and Human Ecology, The American University in Cairo, P.O. Box 74, New Cairo, 11835, Egypt.
Global Health. 2023 Mar 31;19(1):24. doi: 10.1186/s12992-023-00921-0.
Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics were sources of continuous debate on GHG leadership and structure resulting in its current structure. However, Covid-19 proved the presence of many deficits in the current GHG. The response to the Covid-19 pandemic is a cumulative result of all policies and actions of different governments and agencies active in global health. Assessing how Covid-19 is being handled globally provides lessons for ensuring better performance in facing upcoming outbreaks. This study has three main objectives: first, to evaluate the performance of GHG during Covid-19 in general and in relation to Covid-19 vaccine equity in particular. Second, to identify the reasons behind this performance; and third, to propose prospective changes in GHG for better performance.
A cross-sectional research design using the Delphi method was applied. A panel of experts participated in the three-round Delphi surveys. Their scores were used to perform consensus, performance and correlation analysis.
GHG performance limited the achievement of Covid-19 vaccines' global equity. GHG performance is a product of the existing GHG system, its actors and legal framework. It is a collective result of individual GHG actors' performance. The most influential actors in decision-making regarding Covid-19 vaccine are the vaccine manufacturers and governments. While the most invoked power to influence decision are economic and political powers. Covid-19 decisions underlying value, although had human right to health at the base, overlooked the concept of health as a global public good and was skewed towards market-oriented values. GHG mal-performance along with its underlying factors calls for four main changes in GHG structure: assigning a clear steward for GHG, enhanced accountability, centralized authority, more equitable representation of actors, and better legal framework.
GHG structure, actors' representation, accountability system, and underlying priorities and value require future modification for GHG to achieve better future performance and higher health equity levels.
Covid-19 并不是第一个对温室气体排放造成挑战的大流行病。先前的疫情和传染病一直是温室气体排放领导层和结构的持续争论的根源，从而导致了其目前的结构。然而，Covid-19 证明了当前温室气体排放存在许多缺陷。对 Covid-19 大流行的反应是不同政府和全球卫生机构采取的所有政策和行动的累积结果。评估全球如何应对 Covid-19 为确保在应对即将到来的疫情时更好地发挥作用提供了经验教训。本研究有三个主要目标：首先，评估温室气体排放在一般情况下，特别是在 Covid-19 疫苗公平方面的表现。其次，找出造成这种表现的原因；第三，为了更好地表现，提出温室气体排放的前瞻性变化。
使用德尔菲法进行了一项横断面研究设计。一个专家组参与了三轮德尔菲调查。他们的分数用于进行一致性、绩效和相关性分析。
温室气体排放的表现限制了实现 Covid-19 疫苗的全球公平性。温室气体排放的表现是现有温室气体排放系统、其行为体和法律框架的产物。这是个别温室气体排放行为体表现的集体结果。在决策中最有影响力的行为体是疫苗制造商和政府。虽然最有影响力的决策是经济和政治权力。尽管以健康权为基础，但影响 Covid-19 决策的价值观却忽略了健康作为全球公共利益的概念，并偏向于以市场为导向的价值观。温室气体排放表现不佳及其潜在因素要求对温室气体排放结构进行四项主要变革：为温室气体排放指定一个明确的管理者、加强问责制、集中权力、更公平地代表行为体、以及更好的法律框架。
温室气体排放结构、行为体的代表性、问责制系统以及潜在的优先事项和价值观都需要在未来进行修改，以提高温室气体排放的未来表现和更高的健康公平水平。
