Twenty months after the COVID-19 pandemic, there is broad agreement that more international and prudent funding is needed to respond to
the current pandemic and prepare for the next global health threat. Most
assessments of international funding need to boil down to an immediate $ 50
billion need to respond to and combat this pandemic and an $ 10 billion annual
need for ongoing preparedness. There is also a consensus that these needs
should be multilaterally funded for a collective or common good, and that
zero-sum trade-offs should be avoided when using aid for other broader
development priorities or global health of equal importance. The report of the
independent G20 group and this blog, among other things, highlight the
priorities for use and the required characteristics of funding, but now let's
move on to the next tricky question: how to raise the money?
What are other sources of income other than ODA that could
contribute to the proposed Global Fund against Health Threats?
The first premise is that most governments should finance
their own pandemic preparedness and response with their own domestic resources.
The G20 Independent Panel (HIP) has calculated that low- and middle-income
countries should aim to increase national health spending by 1 percent of GDP
over the next five years. According to the HLIP, high-income countries will
also need to increase their domestic investment by about $ 15 billion over the
next 5 years. Most of this spending has direct domestic benefits and is highly
profitable given the constraints and priorities of the national budget.
But the increase in domestic spending will not be enough to
counter the threat of a pandemic. There must also be adequate funding for
actions that benefit neighboring countries and the world, such as research and
development of medical countermeasures, always warm and distributed
countermeasures and storage, and global and regional pathogen and disease
surveillance efforts. International funding is also needed to support public
good elements in investment in low-income countries as they face intense
competitive demand amid very tight government budgets for the foreseeable
future.
As with all ambitious collective action, there will and
should be multiple sources of funding, including but ideally minimizing the use
of ODA, whose primary purpose is to meet national development priorities in
developing countries.
However, money is fungible - the budgetary source or
coding of money is ultimately an artificial design, and the money will come
from the country's governments, companies, charities, or the population in one form
or another. The aim is to guarantee that the benefits far outweigh the costs of
these necessary investments; In forthcoming work by Alessandra Löchen and her
colleagues at Imperial College London, pandemic preparedness rates in the four
countries studied are estimated at 2-25 percent of GDP, depending on the type
of pathogen controlled.
