For the greater good

For the greater good

It is in the interest of each nation that every other nation can halt a potential disease outbreak in its tracks, but without bold and practical steps to strengthen multilateralism in global health security, the world will remain at risk

As we make our way through a third year of the worst pandemic in living memory, our greatest challenge is complacency.

We are far from the finish line on Covid-19. New variants of the virus are a virtual certainty, with the chance that they will be more lethal than omicron and its recent sub-variants. Much of the developing world’s populations have not been vaccinated, let alone boosted. And evidence now suggests that herd immunity will be elusive, as new variants have been found to reinfect those infected with a previous variant.

Yet in too many countries, the politics of the day have moved on. Efforts to prepare for the next pandemic remain timid. And other ongoing global health challenges, particularly those that inflict continuing cost to lives in developing regions, still receive limited global attention.

While the war in Ukraine, crises in food and energy security, and inflation are understandably foremost in the public mind, it will be shortsighted to divert resources from global health security, and risk repeating the catastrophe experienced in the current pandemic.

There is no way to avoid such large-scale failure in public health without much stronger multilateral collaboration. It is in the interests of each nation that every other nation is able to halt an infectious disease outbreak in its tracks and to respond forcefully to the next pandemic. Pandemic prevention, preparedness and response are a global public good.

It requires, first, a properly resourced World Health Organization, given the central role it plays in strengthening global surveillance and national health system preparedness. We must also invest at higher levels in prevention, preparedness and response, collectively and over a sustained period, to insure against future outbreaks. Further, we must adequately fund the international financial institutions such as the International Monetary Fund, World Bank and other multilateral development banks, and repurpose them to meet the new and interconnected challenges of the global commons. And we must repair a siloed global health security ecosystem, to ensure that multilateral, regional and national stakeholders work together in much tighter concert.

Taking steps forward

There have been encouraging moves that we must build on. Credit must go to Indonesia and Italy, co-chairs of the G20 Joint Finance and Health Taskforce, for ably marshalling support for a new, overarching fund for pandemic prevention, preparedness and response (structured as a Financial Intermediary Fund hosted by the World Bank), following the recommendations of the G20 High Level Independent Panel on Pandemic Preparedness and Response. More than $1.3 billion had been committed by 15 sovereign donors and three non-governmental organisations by the end of August 2022.

This is a very good start, in a difficult year. But it is well short of the $10 billion that is the minimum additional sum that the world must invest through the FIF each year to strengthen our resilience against another Covid-19–scale pandemic. This sum is critically needed to enable early detection of new disease outbreaks anywhere and rapid development of vaccines, drugs and testing instruments. It will also help catalyse the public-private partnerships needed for investments in a globally distributed manufacturing network, so as to enable these key medical countermeasures to be produced at scale and reach low- and lower-middle income countries, much earlier in a pandemic.

This minimum funding size is beyond what we have been collectively willing to invest in the past. But with fair contributions by all, it is entirely affordable at about 0.02% of each nation’s gross domestic product – or several hundred times smaller than the costs to be avoided in another pandemic. To keep postponing such investments is financially reckless, besides being morally untenable.

We must take these bold and practical steps to strengthen multilateralism in global health security. We need to move with greater urgency, not wait for repeated reviews, and be willing to improve and innovate as we move forward. Waiting for the perfect has rarely been such a large enemy of the good.