The World Health Organization’s emergency committee on Covid-19 says that “analysis of the present situation and forecasting models indicate that the pandemic is far from finished.”  To curtail it, a “coordinated international response” is needed, reports Co-host Claudia Romo Edelman.

“Where have I heard that before?” replied co-host Edie Lush. A coordinated response is exactly what the world has not had. Edie and Claudia explore the chaotic response with Dr. David Nabarro and other health experts at his regular briefing.

Rebecca Kanter, a nutrition expert based in Chile, described how travel had become a crazy patch work of rules that could only be met by taking extra doses of vaccine.

“I have a PhD and I can’t even figure out now what the new travel restrictions are,” she said.

“I have friends who say, ‘I don’t want to get 5 vaccines.’ But if the only way they can move around is to get five vaccines they’re in a weird ethical dilemma.”

John Atkinson, an expert on how systems work, and why sometimes they don’t, said: “systems like this are almost inevitably not designed to be that way. They’re the unintended consequences of really caring often and smart people trying to do the right thing. Each time layer upon layer upon layer. And the whole thing ends up in a complete mess. We have to surface these contradictions and make them visible. So people just see how crazy it is.”

David Nabarro, special envoy on Covid-19, said the tangled rules disadvantaged the poor and helped those who knew how to play the system. He also described how vaccination distribution remained wildly inequitable. Rich countries should pay for vaccine supply to go directly from manufacturers to COVAX, the global system for distributing vaccine, rather than donating surplus supplies they have been holding. These surpluses are often near their expiry date, he said, and giving them away was like donating stale bread to the hungry.

Featured guests

Irina Sinha
With 22 years of progressive experience in the development sector within the state of Bihar, Ms. Irina Sinha currently holds the position of Director – Strategic Insight & Systems in Project Concern International, India. Her substantive experience includes providing supervision and oversight to large scale government and donor supported programmes mainly related to Women’s Empowerment. This includes programme conceptualization, implementation and monitoring, and also effective programme team management and external donor relations. Her specific expertise lies in community mobilization, capacity building, livelihoods promotion and micro finance, besides management of programmes being implemented for social empowerment of women, primarily with a focus on running crisis intervention centres and other interventions aimed to extend institutional support to women in distress. She has been instrumental in the preparation of the Women Empowerment Policy for the state of Bihar. She has spent a large part of her career as the Project Director of Women Development Corporations, Department of Social Welfare, Govt. of Bihar, which is the nodal agency for implementing women related programmes. She has also worked closely with the Urban Development and Housing Department on urban reforms programme. She has also spearheaded the JEEViKA programme supported by the World Bank (now the Bihar State Rural Livelihoods Mission) in its initial formative years. Irina has considerable experience in policy advocacy and a nuanced understanding of working with the State Government of Bihar.
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Mahua Roy Choudhury

Program Co-ordinator- Governance and Knowledge Management JEEViKA, Bihar Rural Livelihoods Promotion Society, Government of Bihar, India.

A Development Professional with specialization in Knowledge Management, Program Management, Public Policy Management, Institution Building and Rural Livelihood Promotion, she focuses upon enhancing organization capacity in strategic planning to push projects forward. She has a work experience of over 20 years in the sector and has worked from various platforms of governmental and non-governmental agencies, such as Social Welfare Department, Government of Bihar, CAPART, UNDP, PRADAN and BASIX.

She has been a core team member in conceptualizing World Bank supported projects – Bihar Integrated Social Protection Strengthening Project (BISPS), Bihar Transformative Development Project(BTDP), and DFID supported Sector Wide Approach for Strengthening Health (SWASTH).

She has been instrumental in instilling professional youths in the development sector by strengthening the Young Professionals Program. She is a Chevening Clore Leadership Fellow and also a NUFFiC fellow.

Jane Carter

Jane Carter’s successful career in the music industry spans over 25 years, during which time she has held senior positions in Publishing, Recording and Broadcast companies, built an extensive and impressive track record, and supported the careers of both established and up and coming composers around the world.
During her illustrious career, Jane has held the role of General Manager for BBC Worldwide Music Publishing; Creative Director, BBC Music; and Head of Marketing for Warner Classics UK. She launched the BBC Late Junction record label, and set up her own live events production company. She is currently Managing Director UK for Universal Production Music & VP of Global Repertoire.
Jane was responsible for George Fenton’s partnership with BBC Worldwide, and was the brainchild behind the trilogy concert BBC’s ‘Earth in Concert’. The series premiered with ‘The Blue Planet in Concert’ at London’s Royal Festival Hall in October 2001, performed by the BBC Concert Orchestra, conducted by Fenton and narrated by Sir David Attenborough. The series also includes ‘Planet Earth in Concert’ and ‘Frozen Planet in Concert’, which toured worldwide with critically acclaimed international orchestras for 20 years. She has worked with film composers Michael Nyman, Craig Armstrong, Max Richter and Steven Price and was the creative powerhouse for two ground breaking BBC Proms; The War Horse Prom with the National Theatre, commemorating World War I and the first animated BBC Prom with Aardman Animations featuring Wallace and Gromit.


[00:00:01] David N: This situation is not yet stabilized. We’re still have got the virus being transmitted in many parts of the world. And it’s still this pattern of declining numbers and then picking up again with a rapid surge, and then declining and a rapid surge.

[00:00:20] Rebecca: I have a PhD and I can’t even figure out now what the new travel restrictions are.

The friends I have don’t want to get 5 vaccines but if the only way they can move around is to get five vaccines, they’re in a weird ethical dilemma.

[00:00:38] David N: There’s enormous disparity still in access to vaccines. 70% of the vaccines that have been administered to date have been administered in high-income countries. 2% have been administered in low income countries.

A donation of nearly expired vaccines is like a donation of stale bread.

[00:01:01] Claudia Romo Edelman: Welcome to the Global GoalsCast.

[00:01:09] Edie Lush: The podcast that shows how we can change the world. In this episode, Covid Chaos, chaos, chaos.

[00:01:18] Claudia Romo Edelman: The pandemic is far from over, and as it drags on, even the well-intented efforts to keep us safe are producing unintended and sometimes downright crazy outcomes.

[00:01:31] Edie Lush: And that includes travel rules that are prompting some people to get four and even five doses of different vaccines. That is crazy, and of course wasteful just when we need every dose we can to go to someone who is not yet vaccinated.

[00:01:47] Claudia Romo Edelman: And of course, vaccine distribution is a second example of the COVID chaos, chaos,

[00:01:53] Edie Lush: chaos.

[00:01:54] Claudia Romo Edelman: Despite all the promises and commitments, we still are not getting enough vaccine to where it’s needed most.

[00:02:01] Edie Lush: Which is why the emergency committee at the world health organization has just warned that this pandemic is far from over, and to end it we need to get our global act together. Where have we heard that before? We need much better coordination among countries and even within different groups and jurisdictions within countries.

[00:02:22] Claudia Romo Edelman: We will have much more on all that right after this message.



[00:02:29] Michelle: This episode of Global GoalsCast is brought to you by our listeners. That’s right, listeners like you who care about the future. Please spread the word, tell your friends about Global GoalsCast. Hit the like and subscribe and give us five stars. Thanks also to CBS News Digital and Universal Production Music.

[00:02:50] Claudia Romo Edelman: Welcome back. I’m Claudia Romo Edelman.

[00:02:58] Edie Lush: And I am Edie Lush. Claudia. I feel like this pandemic is like Groundhog Day. We seem stuck in an endless pandemic.

[00:03:07] Claudia Romo Edelman: And I understand why you and everybody can feel that way. The World Health Organization has this emergency committee to watch over how are we doing against COVID-19? And they met the other day and concluded, and I will quote what they said, analysis of the present situation and forecasting models indicate that the pandemic is far from finished.

[00:03:29] Edie Lush: That is so not awesome.

[00:03:31] Claudia Romo Edelman: There was a second big point Edie. They stressed that to end the pandemic requires a coordinated international response, which is what we have not had, right?

[00:03:45] Edie Lush: Right. And you can say that again. We got an earful from the health and medical professionals gathered on our regular call of our friend David Nabarro.

[00:03:54] Claudia Romo Edelman: These calls are so valuable. My old boss, Dr. David Nabarro is the special Envoy on COVID-19 for the World Health Organization. And he really brings together some amazing experts.

[00:04:08] Edie Lush: Who aren’t afraid to call out that COVID chaos, chaos, chaos.

[00:04:13] Claudia Romo Edelman: Chaos.

[00:04:15] Edie Lush: One big topic at the latest briefing was the crazy quilt of travel rules. You’ve heard Rebecca Cantor on Global GoalsCast before. She’s an expert on nutrition and she’s based in Chile. She tore back the curtain on how the disparity in travel rules around the world was causing some people to get vaccinated way more than they need in order just to comply.

[00:04:38] Rebecca: I have a PhD and I can’t even figure out now what the new travel restrictions are. 

[00:04:51] Rebecca: To leave the Chilean airport, I need my Chilean mobility pass, which is based on my two doses of Sinovac. But the UK does not accept Sinovac as being a full vaccination course. So the only way I can enter the UK is through my US CDC vaccination card, because when Chili’s borders finally opened up, I was able to travel back to the US for the first time in also many months and got two more rounds of vaccine, sort of as a, why not, but not realizing how important that would now be for potential travel. I know other people here in Chile also with four vaccine doses, and Chile now also saying that mobility pass active, if you’re over age 55, you have to get a booster. But what about my friends who are over 55 who have four vaccines, but two of them are from the US so then they’re not honored in the mobility pass. However, I know people who were able to get their mobility pass activated finally through antibody tests with their US CDC card. So it’s possible that for the booster addition, they’ll also honor some sort of additional antibody test.

[00:06:20] Edie Lush: If you’re struggling to keep up, join the club. It is a mess.

[00:06:26] Rebecca: The friends I have don’t want to get 5 vaccines, but if the only way they can move around is to get five vaccines they’re in a weird ethical dilemma.

I know one person who has two doses of Sinovac, one dose of Pfizer as a booster, and then needs to travel to the UK because she is from UK and her son’s getting married and had to get the AstraZeneca because the UK won’t honor one dose of Pfizer or two doses of Sinovac. So she just four, four as well.

 Of course me and the other people I know are privileged sort of ex-pat people, but I just see this playing out. And it’s a really weird travel game that I can’t even fathom how it came to but it’s come to this.

[00:07:22] Claudia Romo Edelman: David Nabarro summed up why this chaos was more than just confusing and inconvenient.

David – responds to travel chaos

[00:07:30] David N: So it’s discriminating massively against poorer people and it’s giving enormous advantage to people who can work out how to game the system. Some of whom, as you point out, will have five, six or more vaccines by the end of this year to try to enable them to travel, for work, for education or for family reasons.

Thank you, Rebecca, for just talking about it like it is, I have no solution, but it impels me to try to persuade the representatives of different governments to work together on this with greater urgency than is happening right now.

[00:08:16] Rebecca: Please do, because I see also to additional levels of discrimination. One is so many countries aren’t accepting Sinovac, but if the WHO accepts Sinovac, then why are we discriminating against that pharmaceutical company or vaccine? And then secondly, why aren’t other vaccine documents from other countries accepted? Like why isn’t the US CDC card accepted here in Chile? Do they really think that we forged the card? I mean, I agree. It’s, it’s better to be serious and, and to do the antibody test just to make sure. But at the end of the day, as this plays out with travel, the US didn’t accept my Chilean mobility pass to leave the US to fly back to Chile.

[00:09:06] David N: And there are many opportunities for rules to change at short notice, there’s lots of different interpretations just to say, Sinovac and Sinopharm are approved by WHO, they are on the WHO emergency use list. And it remains a little bit of a surprise that so many countries and blocks are not accepting certificates with Sinovac and Sinapharm.


[00:09:37] David N: Everybody I’d just like to turn to John Atkinson.

[00:09:41] Edie Lush: Atkinson is an expert on how systems work and don’t work, and he’s an advisor to Dr Nabarro.

John Atkins

[00:09:48] John Atkinson: Listening to Rebecca, crazy systems like this are almost inevitably not designed to be that way. They’re the unintended consequences of really caring often and smart people trying to do the right thing each time layer upon layer upon layer. And the whole thing ends up in a complete mess. So have to surface these contradictions and make them visible so people just see how crazy it is. Otherwise they just keep carrying on.

[00:10:14] Edie Lush: That’s really our theme episode. Chaos caused by good intentions.

[00:10:21] Claudia Romo Edelman: And we do love to blame people, particularly politicians, Donald Trump, Boris Johnson, Bolsonaro.

[00:10:26] Edie Lush: And they do deserve a lot of the blame they get to be sure. But just blaming them misses this larger point. Many things aren’t working despite everyone’s best intentions.

[00:10:38] Claudia Romo Edelman: Vaccine distribution is certainly another area in chaos despite plenty of good intentions as David Nabarro described.

[00:10:45] David N: There’s enormous disparity still in access to vaccines. 70% of the vaccines that have been administered to date have been administered in high-income countries. 2% have been administered in low income countries. Already now, three times more doses are being given as boosters in high-income countries than are being offered as primary vaccination in low income countries. We have this amazing scheme for moving vaccine to low-income countries which is negotiated deals with vaccine manufacturers at a good cost for vaccines to go everywhere where they’re needed.

It’s called Kovax. Kovax is not getting the supplies it needs in order to vaccinate the world’s health workers, in order to start moving vaccine into poor countries as well. And so a lot of effort now is going into trying to persuade the leaders of rich countries to agree to defer receiving vaccines from the manufacturers for say, two months in order that the new manufactured vaccines can go straight to Kovax and could go to poor countries.

We’d prefer that system rather than donations. The trouble with donations is they are often donations of stock that has already been in storage in wealthy countries for some time. The disadvantage then is that the vaccines may be close to their expiry date. A donation of nearly expired vaccines is like a donation of stale bread.

Yes, you might try to eat it, but it’s an incredibly difficult thing to cope with because you have to eat it straight away. And the same with these nearly expired vaccines, they have to be used straight away. And that can be a real problem, especially with some of the vaccines that need to be kept very cold, like Pfizer and also like Maderna.

 So there’s a serious effort to persuade wealthy nations yet again that they can afford to delay receiving vaccines. They can afford to go a bit slow on any program to vaccinate children. They can afford to go a bit slower on booster vaccinations for their adults, and they can instead allow some millions of doses to go to poor countries that they can just provide the very basic level of vaccination.

It’s still thought to be a political choice that’s too difficult for the leaders of many rich countries, but in discussions this week, it looks as though there’s the beginning of sort of some movement. And that is great.

[00:13:54] Edie Lush: The leaders of the G20, the club of major economies agreed that 70% of the world should be vaccinated by the middle of next year, which is to say poor countries should reach the level of vaccination rich countries have now. So the pandemic runs on, and Dr Nabarro used a graph to update us on the continuing fight.

[00:14:19] David N: The graph shows that there have been some definite periods when the numbers of cases have been higher, and then there’ve been periods when the numbers of cases have been lower, higher, and then lower. Now if you look at it overall, it’s not really presenting in distinct waves, but there is most definitely a variability in the numbers of cases. And it’s not exactly seasonal.

This situation is not yet stabilized. We’re still have got the virus being transmitted in many parts of the world. And it’s still this pattern of declining numbers and then picking up again with a rapid surge and then declining and a rapid surge. And the size of the surge will be diminished if there’s a high coverage of people with vaccination, but it’s not a guarantee.


[00:15:19] Edie Lush: Claudia it’s unsettling how much work the world still has to do to bring this pandemic under control.

[00:15:33] Claudia Romo Edelman: I think that sad thing is that both COVID and climate change are systemic and are here to stay. And we’re having evidence that we have an inavailability to get our act together, to organize that call for international coordination is not going to happen, is it.

[00:15:56] Edie Lush: And it feels like the response from COVID was everyone looked back into themselves worried about supply chains, worrying about getting their own countries together with their own populations, which is, we’ve discussed before, is entirely understandable, You want to look after your own people. The problem is we can’t roll back the globalization that we’ve already seen and you can’t solve a problem that crosses borders by working on your own.

[00:16:28] Claudia Romo Edelman: It’s even worse because even if we stop globalization, climate change is global, there’s no way that you can say like, okay, from the border, everything will be green here and the air will not be polluted, and the seas will not, you know, like it’s not possible to control it even with artificial borders.

Like the pandemic, it’s really tough. You can actually start considering that your vaccination distribution can protect your people, but if 2% of the poor countries of the world have received vaccination, it’s inevitable that this pandemic will continue. So this is very disheartening in a way that is happening, you know, what just happened with climate change, which means that COVID-19 is far from over.

[00:17:12] Edie Lush: I also do worry about that point that Rebecca mentioned about vaccine passports. It’s interesting when you remember that passports didn’t even exist before the first World War, and it took years to get the League of Nations involved, to get countries to introduce these kinds of passports. Now here we are a hundred years later and everyone gets what a passport is for. I think we’re seeing a real change in what people will have to do in order to travel.

[00:17:48] Claudia Romo Edelman: I have to tell you, I’m fine with that. Like, look in all these closure, I have three vaccines. I could go and get an a, a fourth one just to be on the safe side and so on, but I do want to make sure that, you know, like we just don’t go and go crazy on the travel again. I think it feels that everybody’s going back to everything that we said, and we’re not going to go back to, so I just don’t want to have five days full week in an office. And everybody traveling as much, I’m happy to have least some restrictions.

[00:18:18] Edie Lush: So one thing I wanted to ask, Claudia, was whether you had had any experience in the Global Fund about what it took to wake people up.

[00:18:26] Claudia Romo Edelman: So in the eighties, vaccines were taking from 20% of populations that were getting vaccines to eighties and the high eighties.

And that was because it was a coordinated effort by, under a number of agencies, like organizations like UNICEF and others with government saying we have to do it. And in some countries you do it by building trust through a religious leaders, in some others, through teachers, in some others through door to door, posters, whatever it takes.

And what is happening right now is that that also is a stagnating because the fear of COVID, it was so messy in the implementation for so many people, that chip that Bill Gates is putting in your soul that is going to spy on you and so on, those fears are taking the overall vaccination and not only through COVID, but others down, and that keeps on going.

I thought it was going to stop, but so we’re really need 80% right now in overall across the world. And in a place like Rwanda where you already have, like 93% of the population had access to vaccinations probably is affecting them too. So overall I think that with global fund, GAVI, the organization that is the like the Global Alliance for Vaccines, overall the suffering more than any other in trying to invest their money, not on aids, not in tuberculosis, not in malaria, but on education overall, going back to the basics.

 Tomorrow by the time we launch this podcast and make it available for the world, you are going to be in Glasgow, witnessing how COP 26 unfolds and how the decision-makers will have a chance of their life to take us out of this chaos and bring some order to the world.

So Edie, deliver a good message for those leaders.

[00:20:12] Edie Lush: Global GoalsCast will be there in Glasgow for COP 26.

[00:20:18] Claudia Romo Edelman: Edie, good luck in Glasgow. And everybody listen to Global GoalsCast, where we’re going to be bringing you the news from Glasgow. So subscribe, follow, rate us, give us thumbs up and everything you need because Edie lush will be in Glasgow, covering up for Global GoalsCast.

[00:20:38] Edie Lush: A special thank you to David Nabarro, Catherine Deland and Miriam Lele from 4 SD and all the contributors to this week’s briefing. Thanks to our audience for listening, and please subscribe, share and like wherever you find us, see you next time.

[00:20:55] Claudia Romo Edelman: Good luck in Glasgow.

[00:20:56] Edie Lush: Thank you.



[00:21:04] Michelle: Global GoalsCast was hosted by Edie lush and Claudia Romo Edelman. We are editorial gurued by Mike Oreskes, editing and sound production by Simon James. Our operations director is Michelle Cooperider. Music in this episode was courtesy of Universal Production Music, one of the world’s leading production music companies, creating and licensing music for film, television, advertising, broadcast, and other media, including podcasts. Original music by Neil Hale, Angelica Garcia, Simon James, Katie Crone and Andrew Phillips.

Thanks also to CBS News Digital.