Delivering on the G20 Leaders’ commitment to establish a fair and effective Financial Intermediate Fund (FIF) for Pandemic Preparedness and Response (PPR) – Global


Recommendations to G20 Leaders, Ministers of Finance and Health from the WHO Economics Council for Health for All and the G20 Partnership for Health and Development.

“The Council on the Economics of Health for All was created on November 13, 2020 by the Director-General of WHO to rethink how the value of health and well-being is measured, produced and distributed across the world. whole economy. The Council aims to redefine health for all as a public policy goal and to ensure that national and global economies and finances are structured to achieve this ambitious goal. The Council will aim to create a body of work that views investment in local and global health systems as an investment in the future, not a short-term cost. (World Health Organization – November 13, 2020)

“We are establishing a joint G20 Finance-Health Task Force aimed at strengthening dialogue and global cooperation on issues related to pandemic PPR, promoting the exchange of experiences and best practices, developing coordination agreements between the Ministries of Finance and Health, to promote collective action, to assess and address health emergencies with cross-border impact and to encourage effective management of resources for Pandemic Preparedness and Response (PPR), while adopting a One Health approach.In this context, this working group will work, and report by early 2022, on the modalities for setting up a financial facility, which will be designed in an inclusive manner with the central role of WHO coordination, led by the G20 and engaging low- and middle-income countries from the outset, other non-G20 partners and multilateral development banks, to ensure a n adequate and sustainable funding for pandemic prevention, preparedness and response.“ (Communiqué by G20 Leaders – Rome 31 October 2021)

Sustainability, innovation and multi-year funding

As G20 Heads of Government and Finance Ministers recently said, health financing is a long-term investment, not an expense.

To address the complex and persistent challenges of Pandemic Preparedness and Response (PPR), donors should commit to a multi-year funding program, at least for an initial period of five years.

Multi-year funding will allow the Financial Intermediary Fund (FIF) to focus on building core programming areas, without constantly worrying about replenishment, especially at launch.

Donor countries, lacking multi-year budgetary mechanisms, should engage in long-term contribution schemes through other existing legal frameworks.

The FIF should promote innovative and blended financing mechanisms that leverage FIF investments. In the fight against climate change, governments, multilateral development banks, philanthropy and the private sector are developing new, highly effective partnerships to achieve Net Zero.

The G20 Health and Finance Taskforce should establish an expert group to identify best practices among green finance models that could be deployed by the FIF for PPR investments.

Sufficiency and scale

WHO and the World Bank estimate the annual funding gap for PPR at $10.5 billion. This is the minimum amount of additional funding required to support equitable global access to vaccines, tests and therapies, global surveillance, research and development, manufacturing and health system strengthening.

To justify the significant transaction costs involved for all stakeholders, particularly in low- and middle-income countries (LMICs) in establishing a new FIF and related governance architecture/Threats to Global Health, the BIF should strive to meet this minimum annual budget of $10.5 billion, for a total of $50 billion in initial multi-year funding for its first five years.

Given the significant and persistent constraints on fiscal space in the LMICs, the IFF should recognize additional new domestic investments in public health systems and PPR by low-income countries as “in-kind” contributions to the IFF .

Complementarity, additionality and effective evaluation

The FIF is being created at a time when key global public health goods are severely underfunded, in particular the WHO COVID-19 Tools Access Accelerator (ACT-A), which plays a pivotal role in Addressing the current glaring inequality in access to Covid Tests, Treatments and Vaccines between high-income countries and LMICs.

It is essential that the FIF does not undermine funding for existing urgent public health needs. Contributions from high-income countries to the IFF must be additional to existing official development assistance (ODA) to ensure that the IFF does not take advantage of other critical health and development needs as LMICs struggle to recovering from the economic crisis caused by Covid.

It is also essential that the BIF articulates clear added value and complementarity to existing PPR efforts, to avoid duplication and ensure a coordinated and equitable global response to PPR.

The FIF must have an effective evaluation mechanism, which ensures the effective and efficient use of these new investments.

Fund stakeholders should be held accountable for investment decisions and their outcomes.

Decision-making processes must incorporate holistic and multidimensional measures based, for example, on the United Nations Sustainable Development Goals as well as other measurement models that highlight the importance of health beyond the economic dimension.

This evaluation mechanism should give donors confidence that there is a measurable return on their long-term commitment to the FIF.

Inclusivity and universality

The G20 Heads of State and Government recognized in their October 2021 declaration that universal access and participation in governance is necessary to achieve the legitimacy, equity and inclusion needed to generate buy-in PRITIs.

The FIF should move away from an outdated and inequitable donor/recipient framework and adopt a global public goods approach where all countries contribute in some way and all have access to the benefits of the fund.

Equal representation should be ensured between high, middle and low income countries in the formal governance structure of the FIF, and it should also include key global and regional implementing institutions such as WHO and Africa CDC, as well as independent civil society experts from various backgrounds. set of countries.

The WHO represents 194 countries, enhances the legitimacy and inclusiveness of the IFF, given its unique position to provide a truly global perspective.

Many of the pandemic preparedness and response roles envisioned for the FIF require deep expertise, capacity and implementation support that only WHO can provide.

WHO’s involvement in the FIF should go beyond a technical or operational advisory role. WHO should have a seat at the decision-making table and a central role in the implementation of the FIF.

Transparency and Accountability

The FIF should establish principles of accountability that decision-making bodies, donors, recipients, operational bodies and technical parties must follow.

The Fund should prioritize PPR investments that strengthen recipient country governance.

The FIF could be a cornerstone in building a truly global PPR system under the International Treaty on Pandemic Prevention, Preparedness and Response, sponsored by the World Health Assembly.

G20 Finance and Health Ministers must prevent any territorial disputes – this is why the IFF should be hosted by the World Bank, with the WHO to play a key role in the development and execution of the IFF strategy .

Both organizations must however recognize that in order to develop the expertise and capacities necessary to ensure the successful implementation of a robust PPR, they must actively encourage the wider involvement of all stakeholders through new and innovative partnerships. it’s clear.


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