Reviewing Supranational Costs of Health Security Preparedness for WHO and G20 Evidence-base
Lead Research Organisation:
University of Leeds
Department Name: Politics and International Studies
Abstract
This work will deliver a review of cost estimates for the regional / global (supranational) activities needed to improve health security preparedness and protect the world from health emergencies like epidemics and pandemics. Working in collaboration with the World Health Organization (WHO) and academic partners at Duke University, this project will deliver evidence to inform new WHO guidance and policy recommendations, Government of Twenty (G20) negotiations, and related policy negotiations prior to the 75th World Health Assembly and beyond. The COVID-19 pandemic has highlighted the need for such work, with experiences over the past two years showing the importance of health security preparedness across country, regional and supranational levels. This work will complement ongoing WHO efforts to detail cost estimates for country-level resource needs for such preparedness activities. In doing so, this research will address five key issues related to determining cost estimates for pandemic preparedness and response reform: 1) Locating current and future budget / costing requirements at supranational and regional levels; 2) Detailing 'supranational' from 'regional' and 'national' activities; 3) Address the key knowledge gap around efficiency and effectiveness at the interface between national, regional and supranational levels; 4) Locate activities contributing to 'global common goods for health', and; 5) model subsystem investment prioritization strategies that can best realize these common goods for health in pandemic preparedness and response.
People |
ORCID iD |
| Garrett Brown (Principal Investigator) | |
| Gavin Yamey (Co-Investigator) |
Publications
Brown G
(2023)
Challenges in international health financing and implications for the new pandemic fund
in Globalization and Health
Brown G
(2023)
The Dynamics of Power Flow From the Global Health Financing Comment on "Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process"
in International Journal of Health Policy and Management
| Description | In collaboration with the WHO our research provided cost estimates for pandemic preparedness and response. These directly informed the WHO and G20. Moreover, our research examined the feasibility and potential mechanisms available to finance these costs. We found that it was not feasible, even under best case, to fund the estimated costs and recommended new financing options. We found that the current Pandemic Fund was not suitable for pandemic funding needs and identified eight problems with the Pandemic Fund that new reform. We also provided findings suggesting that Innovative Financing, as historically used, was not sufficient to make up estimated shortfalls in pandemic financing. We recommended how it might be possible to compliment this funding with other instruments, such as debt relief for surge events. |
| Exploitation Route | They are currently informing ongoing policy debates about pandemic preparedness. |
| Sectors | Communities and Social Services/Policy Healthcare Government Democracy and Justice Security and Diplomacy |
| Description | The global and regional pandemic preparedness and response (PPR) cost estimates generated by our scoping review in collaboration with the World Health Organisation (WHO) were used to help calculate the USD 31.1 billion per annum PPR cost estimate being used by the WHO, G20 and World Bank. The PPR financing feasibility findings were used in a PPR report by Save the Children and were reported by the Brookings Institute / World Bank. The findings led to commissioned research by Transparency International, who wanted the research parameters expanded to include the examination of anti-corruption measures in the new World Bank Pandemic Fund. Ongoing engagements continue with the WHO, STOP/AIDS, and UNICEF, who are particularly interesting in our findings on governance challenges and underrepresentation of stakeholders. The findings have also now informed debates and evidence used within the Pandemic Treaty negotiations by Member States and NGOs. In particular, the Co-Chair for the International Negotiating Body (INB) for the Treaty has relied upon me and my expertise associated with the research for policy insights related to Articles 12, and Article 20. The findings have also been used in four workshops for Article 20 involving over 60 Member State delegates. The research has been used within debates and discussion about how best to finance and deliver the Treaty. |
| First Year Of Impact | 2023 |
| Sector | Healthcare,Government, Democracy and Justice,Security and Diplomacy |
| Impact Types | Policy & public services |
| Description | Changed opinions and policy views of NGOs regarding the Pandemic Treaty |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Implementation circular/rapid advice/letter to e.g. Ministry of Health |
| Description | Influenced decision about how to create a return on investment case for the new International pathogen Surveillance Network |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Contribution to new or improved professional practice |
| Impact | Convinced the team handling the RoI work to also focus on routine health benefits from the network and not just pandemic returns. |
| Description | Ongoing technical advisor for Article 20 Subcommittee (financing) for the Pandemic Treaty |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Description | Ongoing technical advisory work with the co-chair of the International Negotiating Body for the Pandemic Treaty |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Description | Pandemic Preparedness and Response estimated costings |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | The estimates generated from the research have been used in policy debates and have changed the types of policy solutions available for debate within various national and global institutions. The final estimates were provided by the WHO, suggesting evidence of their use. |
| Description | Provided expert input into the World Health Organisation's new health emergency surveillance guidelines (STAG-HI) |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Citation in other policy documents |
| Impact | Provides WHO guidelines on surveillance for epidemic and pandemic diseases. This policy document will inform all future policies from the WHO. |
| URL | https://www.who.int/publications/i/item/9789240080959 |
| Description | Technical advisor to Co-facilitator to Article 20 of the Pandemic Treaty (Canada) providing policy insights |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Description | Commissioned Research on global pandemic preparedness financing accountability and anti-corruption mechanisms |
| Amount | £10,000 (GBP) |
| Organisation | Transparency International UK |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 06/2022 |
| End | 08/2022 |
| Description | Pandemic Preparedness and Response Financing |
| Organisation | Duke University |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | As PI I oversaw the management of the project with all partners and the three research associates from the University of Leeds team. The Leeds team, in collaboration with the WHO, provided data for pandemic preparedness and response (PPR) cost estimates. These informed the WHO / World Bank report on PPR for the G20 Summit in November 2022. The University of Leeds team conducted all research on Work Package One, Two and Three of the PPR financing research. This included mapping of the PPR governance and financing architecture (WP1), a scoping review of existing global health financing challenges and World Bank FIFs (WP2), and the potential for innovative financing mechanisms to meet PPR funding shortfalls (WS3). The University of Leeds team was involved with all other work packages including the meta analysis (WP 6). |
| Collaborator Contribution | The partners were responsible for work package 5 to design a series of scenario models to text the feasibility of meeting the cost estimates at national and global levels. |
| Impact | This collaboration is multidisciplinary including: political science, health economics, public health, global health governance and international relations. The collaboration generated a series of reports for the WHO for each of the work packages, two visual summary policy briefs, and a article for the Brookings Institute / World Bank (see other outputs). The collaboration has also generated three drafts for academic articles based on the reports, one of which is under review with the British Medical Journal. |
| Start Year | 2022 |
| Description | Pandemic Preparedness and Response Governance and Financing Challenges |
| Organisation | Transparency International UK |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | The University of Leeds team was commissioned to conduct research and generate a report and policy brief on transparency, anti-corruption and accountability measures associated with the new World Bank Pandemic Fund. |
| Collaborator Contribution | Transparency International helped design the research protocol, write the report, and design the policy brief. |
| Impact | A report on governance challenges and a visual policy brief. The results of this project directly informed Transparency International's official policy on the new World Bank Pandemic Fund and was disseminated to all partners within their network. The report will also influence their policy advocacy efforts. |
| Start Year | 2022 |
| Description | WHO costing estimates |
| Organisation | Transparency International UK |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | We provided cost estimates for global and regional pandemic preparedness and response to the World Health Organisation to inform their report for the World Bank and G20. |
| Collaborator Contribution | Provided pandemic preparedness and response financing feasibility models. |
| Impact | Pandemic Preparedness and Response cost estimates that informed a World Bank / WHO report for G20 health and finance ministers. |
| Start Year | 2020 |
| Description | Collaboration with Transparency International (NGO) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Debriefed Transparency International on the findings of our collaborative research on pandemic preparedness and response governance and anti-corruption measures within the new World Bank Pandemic Fund. These findings were adopted by Transparency International and used in their policy outreach activities. This was in the form of a report written for the organisation as well as a policy brief that was released via their communication network. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://ti-health.org/content/overcoming-governance-challenges-in-international-health-financing/ |
| Description | Commissioned by World Bank to write blog on findings |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Wrote blog for the Brookings Institute / World Bank relating key findings on resource shifting as a result of new pandemic preparedness and response policies and its impact on Sustainable Development Goal 3.8. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.brookings.edu/blog/future-development/2022/12/07/global-health-financing-after-covid-19-... |
| Description | Consultancy with the new International Pathogen Surveillance Network |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Was asked for methodology advise about how to calculate return-on-investment for the new International Pathogen Surveillance Network. This took place over three online meetings with SEEK (a consultancy firm helping to create an investment case) and the World Health Organization, who will oversee the new network (based in Berlin). I convinced them that it will not be easily possible to create a reliable return on investment case for pandemics since the zoonosis spillover risk is low as well as associated disease burdens (COVID is an outlier). I convinced them that they should also focus on 'routine' health benefits for the network and how these can generate 'everyday returns'. They adopted this approach. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Interview for international news agency |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | 45 minute sit down interview with Epoch Times discussing pandemic preparedness and response costs, financing and governance shortcomings. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Media Article and Interview |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | Wrote media article on Disease X, the World Economic Forum and the Pandemic Treaty |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.internationalhealthpolicies.org/featured-article/the-world-economic-forum-and-the-deus-e... |
| Description | Member of WHO commission on pandemic preparedness and emergency response |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Was invited to sit on a World Health Organisation commission workshop on pandemic preparedness and emergency response. Findings from this commission were used as insights for ongoing WHO policy discussions associated with the revised International Health Regulations and with health system readiness. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Presentation to Article 20 Sub-committee members regarding financing options for the Pandemic Treaty |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Along with the NGO Public Interest presented a 20 minute lecture to Article 20 delegates on financing pandemic preparedness and response. There was then a 1.5 question and answer session. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Press conference on Article 20 Negotiations and the Pandemic Fund |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Media (as a channel to the public) |
| Results and Impact | Gave a one hour press conference on the current state of Article 20 negotiations in the Pandemic Treaty and the suitability of coordinating pandemic financing through the World Bank. This press conference was in conjunction with NGOs WEMOs (Dutch) and Society for International Development (Italy). |
| Year(s) Of Engagement Activity | 2024 |
| Description | Technical Advice for Pandemic Treaty International Negotiating Body Co-Chair |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | I have been 'on call' for technical support to the Co-Chair (South African delegate) of the International Negotiating Body for the Pandemic Treaty. We have had 5 online and telephone conversations covering zoonosis spillover risk assessments, pandemic preparedness estimated costings, and financing. The Co-Chair has adopted most of the evidence I have provided and used it as insights during the negotiations. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Technical Expert for Article 20 Subcommittee for financing the Pandemic Treaty |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Fielded questions from Member State delegates regarding Article 20 financing, in particular whether to host the Treaty's financing component in the World Health Organization, the World Bank, or to create a new institution as a FIF. They audience have committed to a Coordination Mechanism for financing, yet debates continue as to where it should be hosted. I gave evidence and opinion about the pros and cons of each based on my research findings. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Technical Expert for Article 20 Subcommittee for financing the Pandemic Treaty |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Was invited by the Canadian Embassy in Geneva to relate technical financial evidence regarding pandemic preparedness to 50 UN Member State delegates. This was a two hour meeting where I fielded questions from member states. Key countries involved included the US, UK, Germany, Canada, the Africa Group (Ethiopia as Chair of that group), Japan, Malaysia, South Africa and Brazil. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Technical expertise given to Article 20 Subcommittee Chair for the Pandemic Treaty (Ambassador to Brazil). |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Met with the Ambassador to Brazil in Geneva to discuss Article 20 (pandemic financing) and to provide requested evidence on cost estimates, financing options and cost-benefit based on zoonosis risk assessments. It was a one hour conversation with him and his aids at the World Health Organization HQ. |
| Year(s) Of Engagement Activity | 2024 |