COVID-19 has exposed significant gaps in the pandemic preparedness and response system, from leadership and accountability to the collective financing of global public goods. Policy proposals to address these gaps have recently been put forward by both the Independent Panel for Pandemic Preparedness and Response (IPPPR, commissioned by the World Health Organization) and the High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response (HLIP, commissioned by the G20). This paper seeks to compare and critically analyse the financing proposals put forward by the panels and discuss the implications of the various policy recommendations that arise.
In summary, the proposals from the IPPPR and HLIP report converge towards three core aims:
- Strengthening the World Health Organization, both financially and as the central normative leader of the global health security system.
- Increasing the finances available to fund global public goods for pandemic preparedness and response, at national, regional, and global levels.
- Improving oversight and accountability of preparedness for and response to global health threats at an international level.
To these ends, the panels propose organisational and financial reforms to the WHO, a novel pooled financing mechanism to support collective functions for global health security that goes beyond official development aid, and a high-level, multilateral council or board to provide independent oversight, monitoring and accountability of the system and complementary to WHO. Together, these proposals would provide a framework for operationalisation, financing, and oversight of a variety of essential global health security functions including surveillance and alert; development, procurement and rollout of tools and technologies; health systems strengthening; and emergency response. This paper provides an in-depth analysis of the IPPPR and HLIP proposals pertaining specifically to eight collective global functions, a summary of which is highlighted in Summary Table 1. Core questions remain on which collective functions novel pooled finances should be mobilised towards, how pooled finances would be allocated, and which stakeholders from within the complex global health ecosystem should be involved in or lead the proposed mechanisms for operationalisation, governance, and accountability.