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)
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
Brown GW
(2023)
Challenges in international health financing and implications for the new pandemic fund.
in Globalization and health
| Description | This project generated two sets of evidence for the World Health Organisation (WHO) regarding pandemic preparedness and response post COVID-19. First, the research team in collaboration with the WHO conducted a scoping review to estimate global level and regional level pandemic preparedness (PPR) costs to help inform WHO, World Bank and G20 deliberations on post COVID-19 financing policy. This exercise contributed to the USD $31.1 billion per annum global level estimate currently being used in G20, World Bank and WHO discussions. This number includes global, regional and national level cost estimates. Second, the research team was able to conduct five additional work packages to examine the feasibility of governing and financing the $31.1 billion annual costs at all levels. The findings are fivefold: 1. There is evidence that official overseas development aid for health has shifted existing resources to pandemic control and preparedness at the expense of other programmes for health, such as health system support and nutrition. This will threaten universal health coverage targets associated with the Sustainable Development Goals unless new sources of financing are found. 2. The emerging financial mechanisms for pandemic response and control are complex, competitive, overlapping and contested, making it difficult to track financial flows for transparency and accountability purposes as well as it leading to increased governance / policy fragmentation. This suggests that improvements in current governance structures is required to counter legacy failures associated with poor COVID-19 response. 3. Various projections for financing for pandemic preparedness and response suggest a low likelihood that PPR targets can be met over the next five years at either the national or global level. This is true even under our models projecting best-case financing scenarios. The implication is that unprecedented financing increases to PPR will be need and/or that cost-effective prioritisation of PPR activities will be required. 4. There is no evidence that alternative / existing innovative financing mechanisms for raising the extra funds would be effective to meet current PPR gaps. The mechanisms assessed included: Mechanisms assessed: advance purchase commitments; procurement guarantee and cost-sharing; the International Finance Facility for Immunisation (IFFIm); the Pandemic Emergency Financing Facility (PEF) and PEF 2.0. 5. A scoping and policy review identified that the new World Bank Pandemic Fund has not sufficiently addressed challenges associated with past health financing instruments. By not doing so, the new Pandemic Fund looks to be 'built to fail' already existing evidence of serious underfunding. The main takeaway from the research is that current PPR needs will not be sufficiently addressed without large scale governance and financing reforms within global health policy. |
| Exploitation Route | The findings have been in collaboration with the World Health Organisation. The original research objectives regarding pandemic preparedness and response cost estimates were fed directly into policy reports and costings being drafted by the Evidence and Analytics for Health Security Unit at the WHO. The findings on financial feasibility were published by the Brookings Institute / World Bank, and have feed into engagement activities with Save the Children, StopAIDS, UNICEF, and Transparency International. The findings will be of interest to governments, NGOs, CSOs, ministries of health and international organisations associated with pandemic preparedness. |
| Sectors | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice,Security and Diplomacy |
| URL | https://www.brookings.edu/blog/future-development/2022/12/07/global-health-financing-after-covid-19-and-the-new-pandemic-fund/ |
| 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. |
| First Year Of Impact | 2022 |
| Sector | Healthcare,Government, Democracy and Justice,Security and Diplomacy |
| Impact Types | Policy & public services |
| 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 | 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 | 07/2022 |
| 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 | 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 | 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 |