As of May 31, 2022, there were 6·9 million reported deaths and 17·2 million estimated deaths from COVID-19, as reported by the Institute for Health Metrics and Evaluation (IHME; throughout the report, we rely on IHME estimates of infections and deaths; note that the IHME gives an estimated range, and we refer to the mean estimate). This staggering death toll is both a profound tragedy and a massive global failure at multiple levels. Too many governments have failed to adhere to basic norms of institutional rationality and transparency, too many people—often influenced by misinformation—have disrespected and protested against basic public health precautions, and the world's major powers have failed to collaborate to control the pandemic.

The multiple failures of international cooperation include (1) the lack of timely notification of the initial outbreak of COVID-19; (2) costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2, the virus that causes COVID-19, and in implementing appropriate measures at national and global levels to slow the spread of the virus; (3) the lack of coordination among countries regarding suppression strategies; (4) the failure of governments to examine evidence and adopt best practices for controlling the pandemic and managing economic and social spillovers from other countries; (5) the shortfall of global funding for low-income and middle-income countries (LMICs), as classified by the World Bank; (6) the failure to ensure adequate global supplies and equitable distribution of key commodities—including protective gear, diagnostics, medicines, medical devices, and vaccines—especially for LMICs; (7) the lack of timely, accurate, and systematic data on infections, deaths, viral variants, health system responses, and indirect health consequences; (8) the poor enforcement of appropriate levels of biosafety regulations in the lead-up to the pandemic, raising the possibility of a laboratory-related outbreak; (9) the failure to combat systematic disinformation; and (10) the lack of global and national safety nets to protect populations experiencing vulnerability.