People Stepping up During the Pandemic with Breathtaking Innovations

  • Bill & Melinda Gates Foundation today launched its fifth annual Goalkeepers Report, featuring an updated global dataset illustrating the pandemic’s adverse impact on progress toward the United Nations Sustainable Development Goals (Global Goals). 
  • This year’s report, co-authored by Bill Gates and Melinda French Gates, co-chairs of the Bill & Melinda Gates Foundation, shows that disparities caused by COVID-19 remain stark, and those who have been hardest hit by the pandemic will be the slowest to recover.
  • Because of COVID-19, an additional 31 million people were pushed into extreme poverty in 2020 compared to 2019. And while 90% of advanced economies will regain pre-pandemic per capita income levels by next year, only a third of low- and middle-income economies are expected to do so. 

Fortunately, amidst this devastation, the world stepped up to avert some of the worst-case scenarios. In last year’s Goalkeepers Report, the Institute for Health Metrics and Evaluation (IHME) predicted a drop of 14 percentage points in global vaccine coverage—effectively erasing 25 years of progress in 25 weeks. New analysis from IHME demonstrates that the decline, while still unacceptable, was only half of what was anticipated. 

In the report, the co-chairs highlight the “breathtaking innovation” that was only possible because of global collaboration, commitment, and investments over decades. They acknowledge that averting the worst-case scenarios is commendable, yet they note it’s not enough. To ensure a truly equitable recovery from the pandemic, they call for long-term investments in health and economies—like the ones that led to the rapid development of the COVID-19 vaccine—to propel recovery efforts and get the world back on track to meet the Global Goals. 

“[The past year] has reinforced our belief that progress is possible but not inevitable,” write the co-chairs. “If we can expand upon the best of what we’ve seen these past 18 months, we can finally put the pandemic behind us and once again accelerate progress in addressing fundamental issues like health, hunger, and climate change.”

The report highlights the disproportionate economic impact that the pandemic has had on women globally. In high- and low-income countries alike, women have been harder hit than men by the global recession that was triggered by the pandemic. 

“Women face structural barriers in every corner of the world, leaving them more vulnerable to the impacts of the pandemic,” said Melinda French Gates. “By investing in women now and addressing these inequities, governments can spur a more equitable recovery while strengthening their economies against future crises. It’s not just the right thing to do—but a smart policy that will benefit everyone.”

The report also illustrates how the so-called “miracle” of COVID-19 vaccines was the result of decades of investment, policies, and partnerships that established the infrastructure, talent, and ecosystems necessary to deploy them quickly. However, the systems that allowed for the unprecedented development and deployment of the COVID-19 vaccine exist primarily in wealthy countries, and as a result, the world has not benefited equally. 

“The lack of equitable access to COVID-19 vaccines is a public health tragedy,” said Bill Gates. “We face the very real risk that in the future, wealthy countries and communities will begin treating COVID-19 as yet another disease of poverty. We can’t put the pandemic behind us until everyone, regardless of where they live, has access to vaccines.”

More than 80% of all COVID-19 vaccines have been administered in high- and upper-middle-income countries to date, with some securing two to three times the number needed so they can cover boosters; less than 1% of doses have been administered in low-income countries. Further, COVID-19 vaccine access has been strongly correlated with the locations where there is vaccine R&D and manufacturing capability. Though Africa is home to 17% of the world’s population, for example, it has less than 1% of the world’s vaccine manufacturing capabilities. 

Ultimately, the report calls for the world to invest in R&D, infrastructure, and innovation in places closer to the people who stand to benefit.

“We must invest in local partners to strengthen the capacity of researchers and manufacturers in lower-income countries to create the vaccines and medicines they need,” said Gates Foundation CEO Mark Suzman. “The only way we will solve our greatest health challenges is by drawing on the innovation and talent of people all over the world.

In so many ways, the pandemic has tested our optimism. But it hasn’t destroyed it.

Under the most difficult circumstances imaginable, we’ve witnessed breathtaking innovation.

We’ve seen how quickly we can change our behavior, as individuals and as societies, when circumstances require it.

And today, we can also report that people in every part of the world have been stepping up to protect the development progress we’ve made over decades—when it comes to the SDGs, at least, the impact of the ongoing COVID-19 pandemic could have been far worse.

It has been a year that has reinforced our belief that progress is possible but not inevitable. The effort we put in matters a great deal. And, as impatient optimists, we believe we can begin to learn from the successes and failures of the pandemic so far. If we can expand upon the best of what we’ve seen these past 18 months, we can finally put the pandemic behind us and once again accelerate progress in addressing fundamental issues like health, hunger, and climate change.

What are some solutions that help in the race to end the pandemic? Watch Bill Gates and three Goalkeepers highlight tools being used to fighting COVID.

Read the report:

Over the past year, it has been impossible to ignore stark disparities not only in who has gotten sick and who has died—but also in who had to go to work, who could work from home, and who lost their jobs entirely. Health inequities are as old as the health systems themselves, but it took a global pandemic to forcefully remind the world of their consequences.

Millions More in Extreme Poverty

For many, the economic impacts of the pandemic continue to be severe and enduring. We know we may seem like unlikely messengers on this topic—we’re two of the most fortunate people on the planet. And the pandemic has made that even more clear. People like us have weathered the pandemic in good shape, while those who are most vulnerable have been hit the hardest and will likely be the slowest to recover. An additional 31 million people around the world have been pushed into extreme poverty as a result of COVID-19. Although men are 70% more likely to die from COVID-19, women continue to be disproportionately affected by the economic and social impacts of the pandemic: This year, women’s employment globally is expected to remain 13 million jobs below the 2019 level—while men’s employment is largely expected to recover to pre-pandemic rates.

Although variants threaten to undermine the progress we’ve made, some economies are beginning to recover, bringing with them business reopenings and job creation. But recovery is uneven between—and even within—countries. By next year, for example, 90% of advanced economies are expected to regain pre-pandemic per capita income levels, while only a third of low- and middle-income economies are expected to do the same. Poverty reduction efforts are stagnating—and that means nearly 700 million people, the vast majority in low- and middle-income countries, are projected to remain mired in extreme poverty in 2030.

Growing Gaps in Education

We’re seeing a similar story when it comes to education. Before the pandemic, nine out of 10 children in low-income countries were already unable to read and understand a basic text, compared to one in 10 children in high-income countries.

Early evidence suggests that learning losses will be greatest among marginalized groups. Growing educational disparities were found in wealthy countries, too. In the United States, for example, learning loss among Black and Latino third grade students was, on average, double that of white and Asian American students. And learning loss among third graders from high-poverty schools was triple those of their peers in low-poverty schools.

More Children Missing Vaccines

Meanwhile, global routine childhood vaccination rates fell to levels last seen in 2005. Between the start of the pandemic and when health services began to recover in the second half of 2020, more than 30 million children around the world missed their vaccinations—that’s 10 million more because of the pandemic. It’s possible that many of these children will never catch up on doses.

But here, the data surprised us: A year ago, we had reported that the Institute for Health Metrics and Evaluation was estimating that vaccine coverage would drop 14 percentage points globally in 2020, which would have amounted to 25 years of progress down the drain. But based on more recent data, it looks like the actual drop in vaccine coverage—devastating though it was—was only half that.ShareLegend:2020 Report2021 Report

People Stepping Up

As we continued to sift through the data, it became evident that this was not a fluke: On many key development indicators, the world stepped up over the past year to avert some of the worst-case scenarios.

Take malaria, for example, which has long been one of the world’s most deeply inequitable diseases: 90% of malaria cases are found in Africa. Last year, the World Health Organization forecasted severe disruptions to essential malaria prevention efforts that could have set progress back 10 years—and result in an additional 200,000 deaths from a preventable disease. That projection spurred many countries to action to ensure that bed nets were distributed and testing and antimalarial drugs remained available. Benin, where malaria is the leading cause of death, even found a way to innovate in the midst of the pandemic: They created a new, digitized distribution system for insecticide-treated bed nets, getting 7.6 million nets into homes across the country in just 20 days.

Agent Jean Kinhouande distributes mosquito nets in the Agla district of Cotonou, Benin, to fight malaria despite the COVID-19 pandemic disruption. (Photo by Yanick Folly/AFP via Getty Images, April 28, 2020)
Cotonou, BeninPhoto courtesy of Yanick Folly/AFP via Getty Images

They deserve the world’s gratitude.

Of course, the full extent of the pandemic’s impact on the SDGs will take years to fully understand, as more and better data becomes available. And this data doesn’t diminish the very real suffering the pandemic has caused for people everywhere—far from it. But the fact that we can point to positive signs amid a once-in-a-generation global pandemic is extraordinary. With one hand tied behind their backs, countless individuals, organizations, and countries went above and beyond to innovate, adapt, and build resilient systems, and for that, they deserve the world’s gratitude.

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