More than one year ago, I wrote here:

I still think it will take time to write down the whole COVID-19 story. There are too many interests to protect. Yet, the analysis is going on, and more and more voices claim for a deeper one and the need to see behind the curtain to understand.

The Lancet COVID-19 Commission, published on Sept 15, offers us a glimpse behind that curtain.

As of May 31, 2022, there were 6·9 million reported deaths and 17·2 million estimated deaths from COVID-19, as reported by the Institute for Health Metrics and Evaluation (…) This staggering death toll is both a profound tragedy and a massive global failure at multiple levels. Too many governments have failed to adhere to basic norms of institutional rationality and transparency, too many people—often influenced by misinformation—have disrespected and protested against basic public health precautions, and the world’s major powers have failed to collaborate to control the pandemic.

The multiple failures of international cooperation include:

1. the lack of timely notification of the initial outbreak of COVID-19;
2. costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2, and in implementing appropriate measures at national and global levels to slow the spread of the virus
3. the lack of coordination among countries regarding suppression strategies;
4. the failure of governments to examine evidence and adopt best practices for controlling the pandemic and managing economic and social spillovers from other countries;
5. the shortfall of global funding for low-income and middle-income countries (LMIC)
6. the failure to ensure adequate global supplies and equitable distribution of key commodities—including protective gear, diagnostics, medicines, medical devices, and vaccines—especially for LMICs;
7. the lack of timely, accurate, and systematic data on infections, deaths, viral variants, health system responses, and indirect health consequences;
8. the poor enforcement of appropriate levels of biosafety regulations in the lead-up to the pandemic, raising the possibility of a laboratory-related outbreak;
9. the failure to combat systematic disinformation
10. the lack of global and national safety nets to protect populations experiencing vulnerability.

The message is overwhelming, but at the same time a bright spark of hope.

The Lancet Commission on lessons for the future from the COVID-19 pandemic lays bare what has been nothing less than a massive global failure—a failure of rationality, transparency, norms of public health practice, operational coordination, and international solidarity. The Commission shows that national governments were too slow and too cautious in their response to the outbreak of SARS-CoV-2. They paid too little attention to the most vulnerable groups in society. Their responses were hampered by low public trust and an epidemic of misinformation and disinformation. The result was millions of preventable deaths and a reversal in progress towards sustainable development for many countries. A multilateral system developed after the World War 2 did not hold up to a modern pandemic. Global collaboration and solidarity were good in business and science but poor in politics and international relations.

The Commission proposes five pillars that are essential in fighting emerging infectious diseases: prevention, containment, health services, equity, and global innovation and diffusion.

The Commission gives recommendations in three main areas.

1. practical steps to finally control and understand the COVID-19 pandemic, such as a vaccination strategy that is sustainable and not just reactive, with the goal of protecting populations.
2. realistic, feasible, and necessary investments to improve the first line of defense in countries by strengthening health systems and widening universal health coverage.
3. ambitious proposals to ignite a renaissance in multilateralism, integrating the global response to the risk of future pandemics with actions to address the climate crisis and reversals in sustainable development.

In this way, the Commission boldly sets out a vision of a different future, defined by a properly financed and better-prepared global architecture that is driven by cooperation and shared responsibility rather than globalised profit-seeking.

Once again: We know reasonably well what we need to do to be prepared for the (un)expected and stop talking nonsense as an informed excuse. Will we be able to do it?

I am pessimistically full of hope.