The Lancet COVID-19 Commission.

The COVID-19 pandemic confronts the world with urgent and unsolved challenges. The pandemic marks the third deadly outbreak due to a coronavirus after severe acute respiratory syndrome in 2003 and Middle East respiratory syndrome in 2012.1, 2 In the absence of effective testing and contact tracing systems in many countries, COVID-19 has claimed more than 500 000 lives and disrupted the entire world, sparing no region.

In April, 2020, more than half of the world's population resided in countries enforcing a lockdown, resulting in hugely disruptive impacts on individuals, businesses, and entire sectors of society, such as global tourism and travel. Even countries that have suppressed the pandemic are experiencing harsh economic spillover effects from the rest of the world. The International Monetary Fund (IMF) downgraded the decline in global gross domestic product from –3% in April, 2020, to –4·9% in June, 2020. Although everyone has been impacted by the COVID-19 pandemic, poor and vulnerable populations, including low-skilled workers and refugees, are suffering far more than the rich in terms of lost lives, vulnerability to infection, declining incomes, and unemployment. Effective COVID-19 treatments and vaccines are still many months away at the minimum.3, 7, 8

The Lancet COVID-19 Commission has been created to help speed up global, equitable, and lasting solutions to the pandemic. The Commissioners join this effort in the shared belief that effective solutions can be found on the basis of global cooperation, social justice, sustainable development, and good governance that builds on public trust.

Globally, many creative solutions to the pandemic have already been implemented. Several countries have largely suppressed the virus, although they must remain vigilant to contain new outbreaks when they occur. A key aim of this Commission is to speed up the awareness and adoption worldwide of successful strategies to suppress transmission. Another key aim is to ensure that any new COVID-19 vaccines and other key technologies are equitably accessible across the world. So far in this pandemic there has not been equitable access to testing equipment, hospital facilities, especially intensive care units, and protective personal equipment for front-line workers.

There are four core challenges that must be faced cooperatively worldwide. The first and over-riding challenge is to suppress the pandemic as rapidly and decisively as possible. The second is to meet the dire and pressing needs of vulnerable groups such as the poor, minorities, and elderly. The third is to prevent the public health emergency from turning into a fulminant financial crisis for governments, businesses, and households. The fourth challenge is to build the world back better, with resilient health systems, global institutions, and economies that are being transformed on the basis of sustainable and inclusive development.

The Commission recognises that multilateral institutions face profound challenges in undertaking their crucial missions. WHO, the IMF, the World Bank, the Food and Agricultural Organization of the UN, the UN World Food Programme, the UN Educational, Scientific and Cultural Organization, the Organisation for Economic Co-operation and Development, and many others are on the front lines in coordinating the global response to the pandemic in the areas of public health, finance, food security and supply chains, schooling, and governance. Yet these institutions find themselves caught up in the middle of big-power geopolitics. The Lancet COVID-19 Commission will aim to make recommendations to strengthen the efficacy of these critical institutions and to promote their adequate financing. The Commission will also reach out to regional groupings, including the African Union, the Association of Southeast Asian Nations (ASEAN), the Southern Common Market (MERCOSUR), and others, to liaise with, hear evidence from, and support, when possible, the efforts of these bodies in fighting the pandemic.

The Lancet COVID-19 Commission will include Commissioners who are leaders of health science and delivery, business, politics, and finance from across the world. They volunteer to serve in their individual capacities, not as formal representatives of their home institutions, and will work together towards a shared and comprehensive outlook on how to stop the pandemic and how best to promote an equitable and sustainable recovery. The Commission and its task forces are committed to excellence and diversity across gender, geography, and sectors of society to ensure a comprehensive and inclusive approach in all aspects of the Commission's work.

Alongside the Commission, we aim to set up task forces that will focus on specific dimensions of the pandemic. Task force topics include: the nature, origin, and prevention of zoonotic diseases; public health systems for surveillance, testing, tracing, and isolating COVID-19 cases; the development and distribution of COVID-19 vaccines and medicines; the protection of vulnerable groups; wellbeing and mental health in the context of pandemic control; equitable and efficient financing of pandemic control; and building back better in the post-COVID-19 economy to achieve the global goals of sustainable development. There will also be working groups for various subregions, drawing on global and local experts.

The Commission will report periodically throughout the pandemic to provide timely public updates, assessments, and recommendations. The Commission had its first meeting on June 23, 2020, and will issue a first public statement in September, 2020, at the time of the UN General Assembly. We aim for the first interim report of the Commission to be in January, 2021. The Commission will present its planned second interim report in July, 2021, and a comprehensive report in January, 2022. During the next 18 months, the Commission will hold periodic regional and global webinars, which will be open to the general public and expert practitioners, to discuss the work of the Commission and to generate inputs and feedback. The Lancet COVID-19 Commission's website will post ongoing and up-to-date information on the Commission's work, offer policy briefs and background studies, and provide a venue for the public to submit questions, data, reports, and insights to support and learn about the Commission's activities.

The Lancet COVID-19 Commission is confident that this pandemic can be controlled decisively and justly through innovative, equitable, and globally cooperative strategies that are undertaken jointly by all nations and with the firm commitment to leave no one behind.