In 1948, the Declaration of Geneva 1 was passed as one of the first official acts of the World Medical Association. The Declaration updated the ancient Hippocratic oath and defined ethical principles applicable to the medical profession worldwide. 2 Other health professions have similar pledges and oaths that guide their practice, generally based on the four bioethical principles of justice, autonomy, non-maleficence, and beneficence. Over time, these pledges have been updated to account for evolving societal norms, expectations, and challenges, 3 and many students and health education institutions use adaptations of the original oath. 4,5 A pledge for planetary health to unite health professionals in the Anthropocene national and international levels for predicting future disease outbreaks and pandemics, analogous to the US National Weather Service and the European Centre for Medium Range Weather Forecasts, which use extensive data from multiple sensors and supercomputing. So far during the COVID-19 pandemic in the USA, there has been inadequate central coordination and command in public health surveillance, response, and innovation. Although ACTIV and RADx have been established, it is unclear how such efforts work together. Further more, there are challenges for the coordinated implementation of innovations. A lack of coordination between US state and local public health departments, for example, led to difficulties in delivery of contact tracing programmes. 16 Globally, there is inadequate financing to sustain a coordinated strategy for COVID-19 innovations. The ACT-Accelerator, for example, brings together governments, health organisations, scientists, businesses, civil society, and foundations to accelerate development, ensure equitable allocation, and scale up delivery of new COVID-19 tools. But the ACT-Accelerator is principally dependent on funding from donor countries and foundations, which is an insufficient and unsustainable way to finance a global public good. The ACT-Accelerator will require long-term, predictable, and sustained financing based on global solidarity. Innovation to tackle COVID-19 must be centred within strategy, command, coordination, and sustainable financing. VJD served previously as a member of the Board of Medtronic Inc, ending in June, 2014, and received deferred compensation until 2018, unrelated to the topic of this Comment. CB declares no competing interests.
