What’s needed now

Not only are funding and research essential for halting future health crises, but echoing the finance sector’s post-2008 playbook could also
reap benefits

In the spirit of never letting a crisis go to waste, what a fortunate coincidence for Prime Minister Boris Johnson and his colleagues, having to demonstrate their genuine belief in Global Britain, as well as the United Kingdom being one of the G7 members that suffered so badly due to COVID-19. The need for the UK to show leadership could not be clearer.

When I led the independent Review into Antimicrobial Resistance for the UK prime minister from 2014 to 2016, who might have dreamt that within five years the world economy would be so devastated by a pandemic? That review became known for its central proposition that, if AMR was not tackled by 2050, the world could face 10 million deaths every year, and an accumulative economic loss in the vicinity of $100 trillion. This doesn’t look quite so outlandish now.

Our review recommended 29 separate interventions across 10 different areas that required around $42 billion in finance over a decade to help diminish such worrying numbers from ever happening. Some of these recommendations are equally relevant to trying to halt the risk of future pandemics, either a variant of COVID-19 or something entirely different, as well as stopping AMR.

At the core of these ideas are steps that need to stop health being just the preserve of health experts, and embed key aspects of it into the centre of finance. As with everything else, without money, not much will happen.

THE NEXT MOVES

First of all, as recommended in the interim report of the so-called Monti Commission, on which I sit as a member, the G20 needs to take a copy out of the 2008 playbook, mimic the establishment of the Financial Stability Board and set up a ‘Global Health Board’ under the G20’s leadership. Its job would require finance ministers to rely on experts in the global health structure to provide technical expertise and advice on probable and rising global health threats, allowing the finance ministers to trigger whatever financial flows are necessary to stop those threats from becoming real. Just as the central bankers play the crucial role in the operations of the FSB, the G20’s chief medical officers could play the same role here.

The UK, as G7 host, should embrace this idea, recommend it – not least because this year’s G20 host, Italy, is a G7 member.

Alongside this, there needs to be permanently funding – not occasionally given monies from official development assistance finances once a crisis hits. It needs all the key requirements to minimise the risk of global health crises, and, when they do break through, to rapidly minimise them. There needs to be a regular ongoing pipeline of necessary research and development for all the surveillance, diagnostics, therapeutics and vaccines. This could be funded along the same lines that International Monetary Fund quotas are agreed, with the relative size of the economy playing an important role, so a pro-rata system would be fair.

Crucially, such instruments should not be regarded as part of normal health department budgets. Rather, they are genuine economy-wide investments to support economic growth, as this crisis has shown. They could either sit in divisions of defence departments, in the spirit of comparing battling COVID-19 with fighting a war. It might even be the case that, due to the escalated levels of government debt, that the time has come for a true golden rule in which all government spending is split into current, consumption spending and investment spending.

The IMF itself has a major role to play, which the UK should also encourage through its G7 leadership. Through its massive economic brainpower, the IMF needs to lead modern accepted convention into a new, better way of thinking of government accounts, especially as it relates to preventing health diseases. And in parallel to this, the IMF now has no excuse but to also volunteer that it will introduce monitoring health preventiveness as part of its influential Article IV process.
Much of the initiative for all this needs to come from the G7 leaders, and it is a great opportunity for the UK as its 2021 host.