World Leader 3 Year Letter

never again

11 March 2023

A PDF version of this letter is available in English, French, and Spanish.

Today marks three years since the World Health Organization (WHO) first characterised COVID-19 as a pandemic. In that time, we have seen extraordinary feats of scientific innovation and an enormous mobilisation of public resources to develop effective vaccines, tests, and treatments. But we have also seen a global response held back by profiteering and nationalism.

We are hopeful that an end to the acute stage of the COVID-19 pandemic may be in sight.1 Thus, the world is at a critical juncture. Decisions made now will determine how the world prepares for and responds to future global health crises. World leaders must reflect on mistakes made in responding to the COVID-19 pandemic so that they are never repeated.

There are decades of publicly funded research behind COVID-19 vaccines, treatments, and tests. Governments have poured taxpayer money by the billions into research, development, and advance orders, reducing the risks for pharmaceutical companies.2 These are the people’s vaccines, the people’s tests, and the people’s treatments.

Yet, a handful of pharmaceutical companies has been allowed to exploit these public goods to fuel extraordinary profits, increasing prices in the Global North while refusing to share technology and knowledge with capable researchers and producers in the Global South.

Instead of rolling out vaccines, tests, and treatments based on need, pharmaceutical companies maximized their profits by selling doses first to the richest countries with the deepest pockets. Billions of people in low and middle-income countries, including frontline workers and the clinically vulnerable, were sent to the back of the line.

Had governments listened to the science and shared vaccines equitably with the world, it is estimated that at least 1.3 million lives could have been saved in the first year of the vaccine rollout alone, or one preventable death every 24 seconds.3 That those lives were not saved is a scar on the world’s conscience.

Even today, as we enter the fourth year of the COVID-19 pandemic, many developing countries cannot access affordable treatments or tests. And, like so many other disasters, poor women, people of colour, and people in low- and middle-income countries carry the main burden of the impact of COVID-19. As UNCTAD has warned, COVID-19 could set back the fight for gender equality by four decades.4

The tragedy of this pandemic is made all the greater because this inequity was preventable and the scale of the impacts of COVID-19 could have been greatly reduced. We have been here before. At the height of the HIVAIDS pandemic, millions died as expensive, patented treatments were unaffordable for much of the world.

As the world pauses to remember the lives and livelihoods lost to three years of COVID-19, we ask world leaders to pledge – “never again.”

Never again will the lives of people in wealthy countries be prioritised over the lives of people in the Global South. Never again will publicly funded science be locked behind private monopolies. Never again will a company’s desire to make extraordinary profits come before the needs of humanity.

Yet we do have the tools needed to plan an equitable response to the next global health crisis; including by supporting low- and middle-income countries to host research and development hubs and to manufacture vaccines, tests, and treatments. Commitment from world leaders now can prevent a repetition of the pain and horror of the COVID-19 and HIV and AIDS pandemics.

We call on world leaders to take four urgent steps:

  1.  Support a Pandemic Accord at the WHO that embeds equity and human rights in
    pandemic preparedness and response. To do so, it must commit governments to
    waive relevant intellectual property rules automatically and ensure the sharing of medical technology and knowledge when a Public Health Emergency of International Concern is declared.
  2. Invest in scientific innovation and manufacturing capacity in the Global South through projects like the mRNA Technology Transfer Hub established by WHO and
    partners. Governments, companies, and international institutions should provide
    political, financial, and technical support to these initiatives to maximise production and supply for all.
  3. Invest in global common goods. Public funding delivered miracles in the COVID-19 pandemic. But publicly financed medical innovations should be used to maximise the public benefit, not private profits. They should not be locked behind patents. All governments should invest more in public research and development, and place strict requirements for publicly funded medical technologies developing from that investment to be affordable and accessible to everyone, everywhere.
  4. Remove the intellectual property barriers that prevent knowledge and technology sharing. Governments at the World Trade Organization (WTO) took too long and did too little to address this barrier for COVID-19 vaccines. WTO members should move to approve an intellectual property waiver for COVID-19-related vaccines and extend that decision to cover COVID-19 tests and treatments. That would dramatically improve access to all these lifesaving products. Developing countries should exercise their rights to use the full flexibilities of the TRIPS agreement to protect public health.

These actions should be a priority for the G20 and G7, at this historic moment for Global South leadership with the G20 Presidency passing from Indonesia to India, and then to Brazil and South Africa.

With these actions, world leaders can begin to fix the structural problems in global health that have held back the response to COVID-19, HIV and AIDS, and other diseases. It is time to embed justice, equity, and human rights in pandemic preparedness and response. Only then can we truly turn the page on this chapter of history and say, “never again.”


H.E. José Manuel Ramos-Horta – President of Timor Leste1
Quarraisha Abdool Karim – Associate Scientific Director, CAPRISA
Tahir Amin – Co-Founder and Co-Executive Director, I-MAK
María Elena Agüero – Secretary General, Club de Madrid
Rashid Alimov – Secretary General, Shanghai Cooperation Organization (2016-2019), Minister of Foreign Affairs of Tajikistan (1992-1994)2
Adbullaziz Altwaijri – Former Director-General of ISESCO2
Carlos Alvarado Quesada – President of Costa Rica (2018-2022)1
Kenneth Nana Amoateng – Executive Director, AbibiNsroma Foundation ANF / GCAP Ghana
Eduardo Arathoon – Country Ambassador for GAFFI
Elena Arengo – Co-Executive Director, PODER
John Arnold – Bishop of Salford and Chair of CAFOD
Rosalía Arteaga Serrano – President of Ecuador (1997)2
Haitham Muhammed Ibrahim Awadallah – Acting Federal Minister of Health of Republic of Sudan
Shaukat Aziz – Prime Minister of Pakistan (2004-2007)2
José María Aznar – President of the Government of Spain (1996-2004)1
Elia Badjo – Executive Director, COSAMED
Jan Peter Balkenende – Prime Minister of The Netherlands (2002-2010)1
Saeed Baloch – General Secretary, Pakistan Fisherfolk Forum
Clemente Bautista – International Network Officer, Advocates of Science and Technology for the People
Ban Ki-Moon – Eighth Secretary-General of the United Nations1
Joyce Banda – President of the Republic of Malawi (2012-2014)1
Linda-Gail Bekker – CEO of the Desmond Tutu Health Foundation
Carol Bellamy – Chair of the Board of the Global Community Engagement and Resilience Fund and Former Executive Director of the United Nations Children’s Fund (UNICEF)3
Mariëlle Bemelmans – Director, Wemos
Valdis Birkavs – Prime Minister of Latvia (1993-1994)1
Irina Bokova – Former Director-General of UNESCO, Former Minister of Foreign Affairs of Bulgaria. Co-Founder & Member of GWL Voices
Volkan Bozkir – 75th President of the UNGA2
Arlene D. Brosas – Assistant Minority Leader, House of Representatives, 19th Congress of the Philippines
John Bruton – Prime Minister of Ireland (1994-1997)1
Gabriela Bucher – Executive Director, Oxfam
Mahendranath Busgopaul – Secretary-General, Halley Movement
Winnie Byanyima – Executive Director of UNAIDS and UN Under-Secretary General
Kathy Calvin – Former President and Chief Executive Officer of the United Nations Foundation3
Chuckie Calsado – Chairperson, AGHAM Advocates of Science and Technology for the People
Kim Campbell – Prime Minister of Canada (1993)1
Fernando Henrique Cardoso – President of Brazil (1995-2003)1
Francisca L. Castro – Deputy Minority Leader, House of Representatives, 19th Congress of the Philippines
Sarah Champion, Chair of the UK’s International Development Committee and MP for Rotherham
Laura Chinchilla – President of Costa Rica (2010-2014) and Vice-President of Club de Madrid
Lois Chingandu – Acting Executive Director, Frontline AIDS
Sok Chamreun Choub – Executive Director, KHANA
Helen Clark – Prime Minister of New Zealand (1999-2008) and Co-Chair of the Independent
Panel for Pandemic Preparedness and Response1 2 3
Sean Cleary – Chairman, Strategic Concepts (Pty) Ltd4
Marie Louise Coleiro Preca – President of Malta (2014-2019)1
Rafael Hendrikus Da Costa – Chairman, Gaya Nusantara Foundation
Nick Dearden – Director, Global Justice Now
Rut Diamint, Professor – Universidad Torcuato di Tella4
Rajesh Didiya – Executive Director, Suruwat
Paul Divakar Namala – Convenor, Global Forum of Communities Discriminated on Work and Descent (GFoD)
Florita Durueke – Executive Director, New HIV Vaccine and Microbicide Advocacy Society
Alistair Dutton – Chief Executive of Caritas Scotland (SCIAF)
Charles Ebikeme – Visiting Fellow, London School of Economics and Political Science
María Natalia Echegoyemberry – Academic Coordinator, Investiga Más Estudios de Salud y Sociedad
Grzegorz Ekiert – Professor of Government at Harvard University, Director of Minda de Gunzburg Center for European Studies and Senior Scholar at the Harvard Academy for International and Area Studies4
Diane Elson – Emeritus Professor, University of Essex
Ngozi Erondu – Co-chair, O’Neill-Lancet Commission on Racism & Structural Discrimination and Global Health
María Fernanda Espinosa – 73rd President of the UN General Assembly, Former Minister of Foreign Affairs of Ecuador, Executive Director of GWL Voices2 4
Christiana Figueres – Former Exec Secretary of the UN Convention on Climate Change
Jan Fisher, Prime Minister of the Czech Republic (2009-2010)2
Vicente Fox – President of Mexico (2000-2006)1
Eduardo Frei Ruiz-Tagle – President of Chile (1994-2000)1
Sakiko Fukuda-Parr – Professor of International Affairs at The New School
Chiril Gaburici – Prime Minister of Moldova (2015)2
Cristina Gallach – Former Under Secretary General to the United Nations. Former Secretary of State for Foreign Affairs and for Ibero-America and the Caribbean of the Spanish government.3
Jayati Ghosh – Professor of Economics, University of Massachusetts Amherst USA, and Member of the WHO Council Economics of Health for All
Yvonne Gilleece – Chair of the British HIV Association
Githinji Gitahi – Global CEO, Amref Health Africa
Felipe González – President of the Government of Spain (1982-1996)1
Tinashe Goronga – Community Organiser, Equalhealth Global Campaign Against Racism
Paul Groenewegen – Founder, Rights Initiative
Dalia Grybauskaitė – President of Lithuania (2009-2019)1
Olga Gurgula – Senior Lecturer in Intellectual Property Law, Brunel Law School
Ángel Gurría – Secretary General of the OECD (2006-2021)1
Alfred Gusenbauer – Chancellor of Austria (2007-2008)1
Han Seung-soo – Prime Minister of the Republic of Korea (2008-2009) and Vice-President of Club de Madrid
Ameerah Haq – Chair of the Global Board of BRAC and Former UN Under-Secretary-General for Field Support3
Tirana Hassan – Executive Director, Human Rights Watch
Hilda Heine – President of the Marshall Islands (2016-2020)1
Andrew Hill – Department of Pharmacology and Therapeutics, University of Liverpool
Christy Hoffman – General Secretary, UNI Global Union
Jennifer Hurd – Wales Synod Cymru, The Methodist Church
Masaki Inaba – Co-Chair / Global Health Director, Africa Japan Forum
Mladen Ivanic – President of Bosnia and Herzegovina (2014-2018)2
Gjorge Ivanov – President of the North Macedonia (2009-2019)2
Jeremiah Johnson – Acting Executive Director, PrEP4All
Tian Johnson – Strategist, African Alliance
Anthony T. Jones – Vice-President and Executive Director of Gorbachev Foundation of North America (GFNA)1
Ivo Josipovic – President of Croatia (2010-2015)1 2
Martina Kabisama – National Coordinator, SAHRiNGON Tanzania Chapter
Onesmus Kalama – Technical Support Manager, EANNASO
Simekinala Kaluzi – Programmes Manager, Council for NGOs in Malawi – CONGOMA
Mats Karlsso – Vice-President of the World Bank (1999-2002)2
Rima Khalaf – Former Executive Secretary of the UN Economic and Social Commission for Western Asia (ESCWA), Former Deputy Prime Minister of Jordan3
Jadranka Kosor – Prime Minister of Croatia (2009-2011)2
Priti Krishtel – Co-ED of I-MAK, 2022 MacArthur Fellow
Jan Kubis – Minister of Foreign Affairs of Slovakia (2006-2009)2
Nomfundo Kwini – Community Arts Network
Ricardo Lagos – President of Chile (2000-2006)1
Zlatko Lagumdžija – Prime Minister of Bosnia and Herzegovina (2001-2002)1 2
Arthur Larok – Secretary General, ActionAid International
Yves Leterme – Prime Minister of Belgium (2008; 2009-2011)1
Benjamin Levenson – Deputy Director, Justice is Global
Alexander Likhotal – Professor, the Geneva School of Diplomacy and International Relations4
Vanessa López – Executive Director, Salud por Derecho
Lidice Lopez Tocon – Coordinator, Corresponsales Clave
Petru Lucinschi – President of Moldova (1997-2001)2
Igor Luksic – Prime Minister of Montenegro (2010-2012)2
Nora Lustig – Director, Commitment to Equity Institute at Tulane University
Graça Machel – Founder, The Graça Machel Trust and Foundation for Community Development
Wahid Majrooh – Former Minister of Public Health of Afghanistan
Thabo Cecil Makgoba – Archbishop of Cape Town
Susana Malcorra – Former Minister of Foreign Affairs & Worship of Argentina, President of GWL Voices.4
Mark Malloch-Brown – President of the Open Society Foundations
Purnima Mane – Former President and CEO of Pathfinder International, Former United Nations Assistant Secretary-General and Deputy Executive Director (Programme) at United Nations Population Fund (UNFPA)3
Raoul Danniel A. Manuel – Member, House of Representatives, 19th Congress of the Philippines
Moussa Mara – Prime Minister of Mali (2014-2015)1
Georgi Margvelashvili – President of Georgia (2013-2018)2
RD Marte – Executive Director, APCASO
Mariana Mazzucato – Professor in the Economics of Innovation and Public Value (University College London), Chair of the WHO Council on the Economics of Health For All
Luke McDonagh – Assistant Professor, London School of Economics
Diarmaid McDonald – Director, Just Treatment
Brian McGee – President of SCIAF – Caritas Scotland and Bishop of Argyll and The Isles
Peter Medgyessy – Prime Minister of Hungary (2002-2004)2
Rexhep Meidani – President of Albania (1997-2002)1 2
Carlos Mesa – President of Bolivia (2003-2005)1
Rossella Miccio – President, EMERGENCY
James Michel – President of Seychelles (2004-2016)1
Georgina Muñoz – Coordinacion, RENICC
Rovshan Muradov – Secretary General, Nizami Ganjavi International Center
Joseph Muscat – Prime Minister of Malta (2013-2020)2
Sarojini Nadimpally – Founder, Sama
Sophie Neuburg – Executive Director, Medact
Dennis Nyati – National Coordinator, Civil Society SDGs Campaign GCAP Zambia
Ernest Nyimai – Executive Director, National Association of Non-Governmental Organisations (Zimbabwe)
Eugene Nzabanterura -Executive Director, Tumukunde Initiative
Olusegun Obasanjo – President of the Federal Republic of Nigeria (1999-2007)1
Jane Odongo – Executive Director, Polycom Development Project
Ebere Okereke – CEO of Africa Public Health Foundation
Sharad Onta – Country Coordinator, People’s Health Movement Nepal
Djoomart Otorbayev – Prime Minister of Kyrgyzstan (2014-2015)2
Angélica Patiño – Director, Global Humanitarian Progress Corporation
PJ Patterson – Prime Minister of Jamaica (1992-2006)
Rosen Plevneliev – President of Bulgaria (2012-2017)
Mike Podmore – Director, STOPAIDS
Nicoletta Policek – Chair of UK-CAB
Álvaro Pop – Global Steering Group of International Decade of Indigenous Languages
Achal Prabhala – Coordinator, AccessIBSA project
Harry Prabowo – Programme Manager, Asia Pacific Network of People living with HIV (APN+)
Romano Prodi – Prime Minister of Italy (1996-1998; 2006-2008)1
Jorge ‘Tuto’ Quiroga – President of Bolivia (2001-2002)1
Fifa Rahman – Civil Society Representative, WHO Access to COVID-19 Tools Accelerator (ACT-Accelerator)
Ricardo Ramíres – Physician, Frente Nacional por la Salud de los Pueblos del Ecuador
Asad Rehman – Executive Director, War on Want
Ingo Ritz, Director – Global Call to Action Against Poverty (GCAP)
Richard John Roberts – Nobel Prize in Physiology or Medicine (1993)
José Luis Rodríguez Zapatero – President of the Government of Spain (2004-2011)1
Petre Roman – Prime Minister of Romania (1989-1991)1 2
Francisco Sagasti – President of Peru (2020-2021)1
Joshua San Pedro – Co-convenor, Coalition for People’s Right to Health
Nancy Sandoval – Chair of Organization for Women in Science for the Developing World in Guatemala
Ismail Serageldin – Vice-President of the World Bank (1992-2000), Co-Chair Nizami Ganjavi International Center
Fatiha Serour – Justice Impact Lab Co-founder, Former Deputy Special Representative and Assistant Secretary-General in Somalia (United Nations)3
Farha Shah – Vice president, INSAF Delhi
Sandeep Shakya – President, National TB network (Nepal)
Jenny Shipley – Prime Minister of New Zealand (1997-1999)1
Olive Shisana – South Africa
Alberto Sibrian – President, Laboratorio de Datos GT
Brianna da Silva Bhatia – COVID-19 Health and Policy Strategist, Physicians for Human Rights
Musa Ansumana Soko – CEO, WASH-Net Sierra Leone
Juan Somavía – Ninth Director of the International Labour Organization (1999-2012)1
Oumar Sow – Coordinator, GCAP Senegal
Craig Spencer – Associate Professor of the Practice Health Sciences, Policy, and Practice at Brown University School of Public Health
Samuel Spong – Advocacy and Public Affairs Lead, Health Poverty Action
Joseph E. Stiglitz – Nobel Laureate in Economics and University Professor at Columbia University
Petar Stoyanov – President of Bulgaria (1997-2002)2
Shahnaz Sumi – Director, Bangladesh Nari Progati Sangha
Judy M. Taguiwalo Ph.D. – Secretary of Social Welfare and Development, Philippines (2016-2017), Convenor, Citizens’ Urgent Response to End COVID-19 (CURE COVID)
Kang-San Tan – General Director, BMS World Mission
Veriano Terto – Vice-President, Brazilian Interdisciplinary AIDS Association (ABIA)
Jigmi Y. Thinley – Prime Minister of Bhutan (2008-2013)1
Eka Tkeshelashvili – Deputy Prime Minister of Georgia (2010-2012)2
Aminata Touré – Prime Minister of Senegal (2013-2014)1
Danilo Türk – President of Slovenia (2007-2012) and President of Club de Madrid
Baone Twala – Legal Researcher, SECTION27
Atta Ul Haq – CEO, Youth Association for Development (YAD) Pakistan
Cassam Uteem – President of Mauritius (1992-2002)1
Carina Vance Mafla – Minister for Public Health of Ecuador (2012-2014)
Roman Rafael Vega Romero – Global Coordinator, People´s Health Movement (PHM)
Raimonds Vejonis – President of Latvia (2015-2019)2
Irma Velásquez – Member of NHS Race and Health Observatory International Experts Group Francois Venter – Executive Director: Ezintsha, Faculty of Health Sciences at University of the Witwatersrand
Dominique de Villepin – Prime Minister of France (2005-2007)1
Vaira Vike-Freiberga – President of Latvia (1999-2007), Co-Chair Nizami Ganjavi International Center1
Filip Vujanovic – President of Montenegro (2003-2018)2
Darren Walker – 10th President of Ford Foundation
Margot Wallström – Former Minister for Foreign Affairs for Sweden and Former Vice- President of the European Commission3
Aditya Wardhana – Executive Director, Indonesia AIDS Coalition
Patrick Watt – CEO, Christian Aid
Mark Watts – Executive Director, C40 Cities
Stephen Wigley – Chair of Wales Synod Cymru of the Methodist Church
LaloMwelu William – Public Relations Manager, The Right Way
Hardi Yakubu – Movement Coordinator, Africans Rising
Kateryna Yushchenko – First Lady of Ukraine (2005-2010)2
Viktor Yushchenko – President of Ukraine (2005-2010)1 2
Valdis Zatlers – President of Latvia (2007-2011) 1 2

1 Member Club de Madrid
2 Member Nizami Ganjavi International Center
3 Member Group of Women Leaders (GWL) Voices for Change and Inclusion
4 Member Advisory Committee of Club de Madrid


1 Statement on the fourteenth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic, January 2023:
2 Oxfam, A shot at recovery, 2022:
Angelis A, Suarez Alonso C, Kyriopoulos I, Mossialos E. Funding Sources of Therapeutic and Vaccine Clinical Trials for COVID-19 vs Non–COVID-19 Indications, 2020-2021. JAMA Netw Open,
US National Institutes of Health, Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC), 2022,
3 According to a study published in Nature (Moore et al, 2022), an estimated 1.3 million fewer people would have died if COVID-19 vaccines were distributed equitably in 2021:
4 United Nations Conference on Trade and Development, 2021: