Who will fund countries’ pandemic responses: the Pandemic Fund, the WHO, or a new entity?

Many practical questions about how to implement the Pandemic Agreement, such as how to fund countries’ pandemic prevention, preparedness and response (PPPR), are likely to be left to the Conference of the Parties (COP).

According to the latest draft Pandemic Agreement, a “coordination fiscal mechanism” will support the implementation of the Pandemic Agreement and the International Health Regulations (IHR) (see Article 20).

“Within the negotiations, there is an important debate on Article 20, about whether the coordination mechanism should be hosted by states. pandemic fundthe World Health Organization (WHO) or a new organization,” Professor Garrett Wallace-Brown, head of the School of Global Health Policy at the University of Leeds, said at the Geneva Global Health Hub (G2H2) media briefing on Tuesday. .

“There appears to be little appetite for new institutions and a strong case is being made for a pandemic fund to reduce fragmentation,” said the director of the new WHO Collaborating Center for Health Systems and Health Security. added Wallace Brown.

Priya Basu of the Pandemic Fund is pushing for her organization to become this mechanism. tell devex This week he argued that new funds to support the PPPR would represent “duplication”.

But Wallace-Brown said: “The final decision on the details of the coordination mechanism will be left to the Conference of the Parties (COP), which I think is a wise decision given the circumstances.”

“With only nine days left in the negotiation period, there are many details to be ironed out. But we are confident that the COP will be representative, comprehensive, proportionate to risk, deliberative and a departure from business as usual.” I think that’s prudent if it means that.”

In a conversation with representatives on the Intergovernmental Bargaining Body (INB) seeking to scrap the pandemic agreement, Wallace-Brown said: “What they want to do is commit to a coordination mechanism and funding. “The key is to make sure the wording is strong enough to show that there is,” he said. Them”.

Furthermore, they added that “there is some clarity as to what type of funding and what mechanisms will be put in place under that, but it is difficult to understand exactly what that will look like. “We plan to offshore those details for 12 months (although I’m proposing 24 months).” end”.

Domestic fund?

According to the draft proposal, the funding mechanism would include pooled funds for the PPPR and could include “donations received as part of the operations of the PPPR.” [Pathogen Access and Benefit-Sharing System]voluntary funds from both State and non-State actors, and other contributions as agreed by the Conference of the Parties.

However, G2H2 co-chair Nicoletta Dentico warned that poor countries were falling into debt and that debt cancellation should be considered to help these countries.

“54 low-income countries with serious debt problems had to spend more on debt servicing in 2020 than they did on COVID-19,” said the Society for International Development (SID) Global Health Research Institute. said Dentico, who heads the justice program.

“Contrary to the WHO Framework Convention on Tobacco Control, [pandemic agreement] “The document released for final negotiations stubbornly ignores repeated calls for legal protections essential to the implementation of the treaty and immunity from financing from vested corporate interests,” Dentico said. added.

“Domestic funding for pandemic prevention preparedness and response must not be at the expense of other domestic public health priorities,” warned Mariska Moors of the Dutch health NGO WEMOS.

“The draft Pandemic Treaty alarmingly includes “innovative financing mechanisms,” which in many cases direct public funds away from health and instead attract for-profit private investors. Instead, the Pandemic Treaty adopts the most obvious and fairest means of financing pandemic prevention, preparedness and response: global tax justice and debt cancellation. You should.”

“But to the detriment of other domestic public health priorities is exactly what we have seen happening under COVID-19. We have seen the changes and how funding for basic health care is reduced,” Moors warned.

“This document before us now neither acknowledges nor seeks to redress this.”

“The draft Pandemic Treaty alarmingly includes “innovative financing mechanisms,” which in many cases direct public funds away from health and instead attract for-profit private investors. Instead, a pandemic treaty should include the most obvious and fairest means of financing pandemic prevention, preparedness and response: global tax justice and debt cancellation. ,” Moors said.

Pandemic Fund “Black Box”

Wallace-Brown said she supported the pandemic financing mechanism in place at the WHO because she believes low- and middle-income countries are “more representative” than the Pandemic Fund.

However, donors “are less enthusiastic about it because they see it as a system where they lose control over how their funds are spent.”

However, for the Pandemic Fund to become a PPPR mechanism, it would require “fundamental changes” rather than “minor adjustments as currently being said.”

Some of the fund’s issues are that it focuses on just three elements of the PPPR, which “creates vertical silos” and that the fund’s governance framework “involves either the fund process or the fundraising process.” There is no clear guidance on how equity will be addressed. According to Wallace-Brown, this takes into account the priorities of the program’s beneficiaries.

Additionally, the first round of funding was over eight times oversubscribed, but the selection process was “not clear”.

“Applications that met the Scorecard funding criteria had to be rejected, but it remains unclear exactly how the board made its final decision,” he added.

Wallace-Brown described his personal views on the future direction as “agnostic” and said he had been studying the pandemic fund for some time but “I think it’s a bit of a black box.”

However, capacity building will be needed for WHO to become that mechanism.

“They handle money, and they have reserve funds for emergencies. They can give money to people, and they have processes to do that, but they’re not on the same scale as the World Bank.” he said.

“Or there could even be a third entity. So at this point I’m agnostic. It takes better analysis and better evidence to determine what works and what doesn’t.” “I think we need it” – and these kinds of details “won’t be decided in nine days”.

Image credit: Prachatai/Flickr.