Strengthening local and regional production, connecting existing health capacities and addressing inequalities in access are essential to building stronger preparedness for future health emergencies, Global Coalition Special Advisor Paula Reges said during a high-level discussion at Columbia University.
The event, “How Do We Prevent Future Health Emergencies and Pandemics?”, brought together senior political and global health leaders, including Helen Clark, former Prime Minister of New Zealand and Co-chair of the Independent Panel for Pandemic Preparedness and Response; Joe Phaahla, Deputy Minister of Health of South Africa; and Mauricio Cárdenas, former Minister of Finance of Colombia.
The panel also included Wafaa El-Sadr, Executive Vice President of Columbia Global and Director of ICAP; Michel Kazatchkine, member of the Independent Panel for Pandemic Preparedness and Response; and Peter Maybarduk, Director of Access to Medicines at Public Citizen. The discussion was moderated by Apoorva Mandavilli, science correspondent at The New York Times.
Organized by Columbia University’s Institute of Global Politics, ICAP Global Health and the Independent Panel for Pandemic Preparedness and Response, the event examined lessons from COVID-19, persistent gaps in preparedness and ways to strengthen multilateral cooperation amid declining global health financing, unresolved inequities and challenges to international cooperation.
It took place during the week of the United Nations General Assembly, when world leaders were gathering in New York to discuss global challenges, including pandemic threats.
Photo: Columbia University
Reges, who also serves as Advisor for International Affairs at Fiocruz, highlighted Brazil’s experience during the COVID-19 pandemic.
She noted that the country entered the crisis with important assets, including its universal public health system, SUS, a longstanding national immunization programme, production and development capacities, and strong public institutions.
Yet the pandemic also exposed difficulties in connecting those capacities effectively, particularly through coordination, information systems and equitable access across the country.
Production capacity as part of health preparedness
Reges stressed that health as a constitutional right in Brazil requires more than the provision of healthcare or the purchase of health products. It also requires the capacity to produce and deliver the technologies needed by the population.
She pointed to Brazil’s efforts to strengthen its Health Economic-Industrial Complex, linking health policy with industrial, economic and social development.
With a universal health system serving more than 200 million people, she said, public health demand can also provide a strategic basis for investment in local production.
At the same time, Reges emphasized that local production should not mean attempting to manufacture every health product in every country.
“We are not arguing that every country needs to become self-sufficient. We are arguing for strategic interdependence rather than structural dependency,” she said.
Instead, countries and regions should be able to assess their own needs and capacities, strengthen procurement and production pathways, and reduce excessive dependence on vulnerable supply chains while remaining connected to global markets and partnerships.
From national capacity to global cooperation
Reges linked this approach to the Global Coalition for Local and Regional Production, Innovation and Equitable Access, launched during Brazil’s G20 Presidency in 2024.
The initiative seeks to strengthen local and regional capacities while recognizing the interdependence required to ensure sustainable and equitable access to health technologies.
The Columbia University discussion took place as world leaders gathered in New York for the United Nations high-level week, placing pandemic preparedness, financing, international cooperation and equitable access once again at the centre of the global health debate.
