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An Effective Pandemic Response Must Be Truly Global

The world needs a global pandemic preparedness and response strategy that is built on equitable and representative decision-making. But developing one will require the G20 and the World Bank to abandon their current "health for some" approach.

LONDON/NEW DELHI – At their recent meeting in Bali on July 15-16, G20 finance ministers reaffirmed their commitment to coordinated action to get the COVID-19 pandemic under control and better prepare for the next global health emergency. A central topic was the creation of a new financial intermediary fund (FIF) to address pandemic preparedness and response (PPR), under the trusteeship of the World Bank and with the World Health Organization playing a central technical and coordinating role. The goal is to close some of the annual PPR financing gap of $10.5 billion and help strengthen capacities that are critical to protecting global health, including genomic sequencing and drug manufacturing.

Over the next month, the G20, World Bank, and the WHO will finalize the FIF design, under heavy external pressure to develop an equitable and inclusive governance structure. The Indonesian G20 Presidency has enabled some preliminary agreements that move in the right direction. For example, there is an emerging consensus that the FIF’s governance must include low- and middle-income countries, non-G20 partners, and civil society. Moreover, G20 countries acknowledge that the FIF must build on the existing global health framework for PPR, with a central role for the WHO. This is a positive departure from the World Bank’s May 2022 White Paper which proposed a deeply retrograde, insular design whereby (mainly rich country) donors would make all the decisions and consult others (or not) as they chose.

The next step is for the G20 to recognize more explicitly that an effective PPR mechanism, as a global common good, requires a FIF model based on universal contributions (according to capacity) and representation, and universal access to benefits. The world desperately needs a FIF governance structure that can help fill critical gaps quickly and effectively. This requires a decision-making body that is agile, but also widely viewed as legitimate and therefore able to make hard decisions without months of consensus-building diplomacy.