It’s the question on everyone’s lips: How do we end the COVID-19 pandemic? Or, despite the availability of vaccines, is it even possible?

Globally, cases are starting to fall. The World Health Organization (WHO) has reported that infections declined by 16% last week to 2.7 million, while deaths fell by 10% to 81,000. But there’s still a long way to go until we can all get back to life, and many believe that the world will never truly be the same again.

There are some key questions that need to be answered.

For example, what might the world need to do to effectively end the pandemic? Could various mutations of the virus, like the British variant currently detected in 94 countries, stand in our way? And how far will unequal distribution of vaccines and what’s known as vaccine nationalism slow the whole process down?

To shed some light on these questions and more, Global Citizen spoke with Dr. Bruce Aylward, senior adviser on organizational change to Dr. Tedros Adhanom Ghebreyesus, the director-general of the WHO.

The World Health Organization, along with the European Commission and Italian Prime Minister Mario Draghi, is supporting Global Citizen’s year-long campaign to get the world back on track — the Recovery Plan for the World. You can find out all about the campaign, and how you can join us in taking action to end COVID-19 for all, end the hunger crisis, resume learning everywhere, protect the planet, and advance equity for all, here. 

With decades of experience managing public health crises, Aylward has previously led the WHO mission to China to learn more about COVID-19 and directed the WHO’s response to the Ebola outbreak in West Africa. Basically, he knows his stuff.

Here’s what he had to say.

Is it even possible to completely eradicate the coronavirus?

It’s too early to know at this point but it is at least possible that the virus will continue to circulate in pockets of the global population for years to come.

If the world was to work toward making COVID-19 go the way of smallpox, what would countries need to do?

Safe and effective vaccines will be a gamechanger, but for the foreseeable future we must continue wearing masks, physically distance, and avoid crowds.

Being vaccinated doesn't mean that we can throw caution to the wind and put ourselves and others at risk, particularly because it is still not clear the degree to which the vaccines can protect not only against disease but also against infection and transmission.

Producing sufficient doses of the vaccines depends on international cooperation: If the world comes together through investments in research, manufacturing capacity, procurement, technology transfers, sharing intellectual property, plus investment in delivery, unprecedented speed can be achieved.

Safe and effective vaccines alone cannot solve the pandemic. Rapid diagnostics and life-saving therapeutics are also vital to end the pandemic and accelerate global recovery. These life-saving tools will only be effective if they are available for the most vulnerable equitably and simultaneously in all countries, and if strong health systems and services are in place to deliver them.

Significant political and financial commitments are needed urgently from governments too. Without them, COVAX [a facility that aims to purchase 2 billion vaccine doses by the end of 2021 to provide to low-income countries] cannot deliver the vaccines to everyone, everywhere, needed to end this pandemic.

If the world has to learn to live with the virus on some level, what would the “new normal” look like? 

It is impossible to speculate on this really, we just don’t know at the moment. This is a new virus and we are learning all the time. There is a possibility that we will need regular vaccinations, but it is too early to tell.

How far do mutations of the virus hamper our chances of going back to something resembling normality?

WHO is working with scientists and is in close contact with health officials in the UK, Brazil, and South Africa and around the world to understand how these changes affect the virus’ behavior, including on whether it could cause more severe disease, or have an impact on vaccines or diagnostic tests. 

The more we allow the virus to spread, the more opportunity the virus has to change. Viruses change as they circulate, and these changes can lead to changes in characteristics of the virus. It still remains key to stop spread at its source: maintain hand hygiene, physical distancing, masking, and all other measures to reduce transmission. The more people get vaccinated, the more virus circulation will be reduced and the potential for new mutations and variants will decrease.

The new variants highlight the need for better genomic surveillance and sequencing across the world, the need for sharing data, reinforcing collaboration among public health partners, and strengthening national data platforms to document clinical and epidemiological data and sequencing capacities across the world.

While at present, WHO is not recommending the application of widespread travel restrictions, we understand that some countries introduce such restrictions as a time-limited, precautionary measure, and with consideration of their domestic situation. WHO recommends taking a risk based approach to reduce travel-associated exportation, importation, and onward transmission of SARS-CoV-2 while avoiding unnecessary interference with international traffic. Essential travel should always be prioritized and facilitated.

Why is equitable vaccine distribution one of the most crucial components to ending the pandemic?

COVID-19 cannot be beaten one country at a time. The epidemiology shows that no country will be safe from the fallout of the pandemic until all countries are protected. The fact that numerous countries have had measles outbreaks and even lost their measles elimination status in the recent past, despite having extremely high vaccination rates, shows that national coverage is not enough – it has to be achieved in every community and every family.

A study by Northeastern [University's] MOBS lab, in partnership with the Bill and Melinda Gates Foundation, recently estimated that if the first 2 billion doses of an 80% effective vaccine are distributed equitably worldwide, 6 out of 10 deaths could be prevented. But if 50 countries were to monopolize COVID-19 vaccine supplies, only about half as many deaths would be averted.

What is vaccine nationalism, and how does it stand in the way of this goal?

Vaccine nationalism is the mentality that vaccines are a national rather than global resource, putting countries in competition with each other to vaccinate their populations first.

We recognize that countries are responsible to their populations and are working in their interest, however, in a supply-limited environment, which it will be for 2021, a global approach, which can distribute vaccines fairly and equitably is the best approach. 

The COVAX Facility is the only such global mechanism to deliver this and WHO is fully supporting the facility and is a co-convener of it. Bilateral agreements by wealthier nations are in some cases making fair and equitable allocation of vaccines a challenge. We know that protecting high-income countries alone will not end the pandemic. We must ensure that COVID-19 vaccines are affordable and accessible to all countries. 

Only by allowing all countries equal access to vaccines, tests, and treatments, can we end the pandemic and its devastating impacts for everyone.

How much more investment is needed to stop COVID-19?

To achieve its ambitious goal, COVAX is seeking to raise at least $7.7 billion in 2021: $1.3 billion for research and development, at least $4.6 billion for vaccine procurement, and $1.8 million for in-country delivery support for lower-income countries.

Let’s say we eventually get to 70% vaccine coverage globally, effectively ending the pandemic. On the current trajectory of the world, how long will it take for us to get there?

It is too early to speculate on this really as the virus is new and we are learning about it every day.

This clearly depends on a number of factors including regulatory approval and the success of the candidates. Also, increases in manufacturing volume and, for COVAX, dose sharing and donor commitments.

You can read more here about how Global Citizen’s Recovery Plan for the World campaign will work to tackle COVID-19, bringing together world leaders and governments, artists and entertainers, philanthropists, the private sector, and more, to help the pandemic for everyone, everywhere. You can join the campaign and start taking action with us right now, here.