Via The Lancet Global Health: Opportunities to finance pandemic preparedness. Excerpt:
In the past 2 years, the World Bank has taken a series of steps to become more actively engaged in pandemic preparedness and response. The World Bank took a leading role in the response to the 2014–16 Ebola outbreak in west Africa, has provided leadership within the Global Health Security Agenda, and created the Pandemic Emergency Financing Facility (PEF) to provide funds during outbreaks of specific infectious diseases.
Although these activities are important and should be supported, the World Bank has a window of opportunity to do much more in bringing attention to, and concrete funding for, pandemic preparedness.
Every 3 years, the World Bank undergoes a process to replenish the International Development Association (IDA), with the current effort known as IDA18. IDA is a part of the World Bank Group, and is designed to help the 77 poorest countries of the world by providing loans on soft terms as well as grants.
These funds are not earmarked; governments determine their priorities on the basis of a set of investment areas that are agreed on during the replenishment dialogue that involves low-income countries, donors, and the World Bank itself. These IDA funds are made available in predetermined amounts to individual low-income countries.
There are also amounts reserved for regional integration projects and programmes, using the same set of agreed investment areas, which are over and above the amounts specified for individual countries. The IDA18 negotiation process, which must be concluded by the end of 2016, is at a crucial phase, with 50 donor countries asked to increase their contributions from 3 years ago of US$52·1 billion to as much as $90 billion.
IDA is one of the best, if not the very best, significant multilateral funding mechanism to address critical pandemic challenges on a sustained basis in low-income countries, and could do so by funding fundamental public health infrastructure.
Public health priorities often receive limited funding in low-income countries because (i) health budgets are often driven primarily by immediate health needs and vertical programmes, with readily defined metrics for success, and (ii) finance ministries are often less inclined to support resource commitments for longer-term payoffs.
This remains true despite the fact that all countries are obligated to build public health capacity to prevent, detect, and respond to potential public health emergencies of international concern under the International Health Regulations (IHR), and despite disastrous recent public health events, including the west Africa Ebola outbreak and the spread of Zika virus.