Not another pandemic fund, says Pandemic Fund

The Pandemic Fund wants to be the “main fund” for strengthening pandemic prevention, preparedness, and response and called against duplication and fragmentation as countries push for creating another fund in pandemic treaty negotiations. Creating a new fund with the same purpose would only duplicate what it was established for and is already doing, said Priya Basu, head of the fund’s secretariat. “If there is a new fund, there will be duplication, because it will be yet another fund that's designed to strengthen pandemic prevention, preparedness, response capacity,” Basu told Devex. The Pandemic Fund, which is housed at the World Bank, was created as a dedicated financing mechanism to help strengthen countries’ pandemic prevention, preparedness, and response, or PPPR, capacities, filling a gap in the global health architecture. To date, it has raised $2 billion, a large pot of money but short of the $10.5 billion financing gap needed annually to strengthen PPPR capacities. Its first call for proposals generated funding requests that were over $2.5 billion from more than 133 countries, more than eight times the allocated grant. The Pandemic Fund board wants to position the mechanism as “the main fund for strengthening PPPR.” In a recently released statement, it argued that it has the flexibility to meet evolving needs, and is “well positioned to serve as a key vehicle to support countries in fulfilling their obligations under a forthcoming Pandemic Agreement and relevant frameworks.” But the fund has received its fair share of criticisms, including for not being inclusive enough when it comes to its governance and implementers. And while donor and recipient countries have the same number of seats on the fund’s board, concerns about donors having outsized influence in decision-making remain. Its role is unclear in current pandemic treaty negotiations, and the latest draft text does not mention it. Instead, several countries are pushing for another fund to be created to strengthen PPPR capacities under the pandemic agreement negotiations. That fund can, “as necessary,” also provide surge financing in response to a pandemic for parties that require financial support according to the draft text seen by Devex. The fund will be under a new Coordinating Financial Mechanism set up to support the implementation of the pandemic agreement and the International Health Regulations. Its work will include promoting the “harmonization and coordination for financing pandemic prevention, preparedness and response” and IHR-related capacities.” But Basu said promoting coordination among international and domestic stakeholders is “one of the foundational pillars of the Pandemic Fund.” “So when we hear about the pandemic agreement discussions [on] coordination, we're saying we're actually doing it. Our projects are doing it,” she said. Room for flexibilities The Pandemic Fund was created to fill significant financing gaps in strengthening PPPR capacities that were identified during the emergency phase of the COVID-19 pandemic. The goal is that by investing in preparedness, the world would save trillions of dollars in the future. In 2022, the International Monetary Fund predicted the cost of the pandemic on the global economy to reach $13.8 trillion by 2024. Basu said the fund also has the flexibility to meet evolving needs, and its board has been discussing the topic of surge financing. “It’s a live debate right now,” she said. “If someone really comes up with a strong argument that a new institution or kind of a new window is needed for surge financing, then that is something that the pandemic fund could look at,” she added. “The board stands ready to consider proposals for how the Pandemic Fund, as part of the global health architecture, can help support the implementation of the Pandemic Agreement,” she said. That said, she reiterated that lessons from COVID-19 showed that money for response wasn’t the main constraint, but capacities. With vaccines for example, the supply was limited, and high-income countries procured much of the supply. In addition, she said setting up a new dedicated fund for surge finance “would seem to duplicate what other existing international financial institutions, including the MDBs [multilateral development banks], already do and were deemed to have done quite well in the wake of COVID-19.” Lack of understanding, or valid concerns? There’s no specific mention of the Pandemic Fund in the current draft text, despite calls from members of civil society to do so. A letter signed by more than 80 organizations last month called on WHO member states to include in the text a plan that makes use of existing mechanisms, “including but not limited to the Pandemic Fund for preparedness capacity development for LMICs [low- and middle-income countries] and the WHO Contingency Fund for early global outbreak response.” The letter said the pandemic agreement “should guarantee these mechanisms are fully and sustainably financed.” Aggrey Aluso, Africa regional director at the Pandemic Action Network, said they remain concerned that the proposal to establish a new financing mechanism remains in the latest draft. They fear it “will create unnecessary duplication, fragmentation, competition, and delays.” “The Pandemic Fund was set up explicitly to enhance global coordination and help low- and middle-income countries to bolster their prevention and preparedness capacities and we have been urging that it be called out explicitly in the draft Agreement,” he wrote to Devex. Apart from the Pandemic Fund, he also said the new Africa Epidemics Fund should also be supported as a regional-led financing solution. In her interactions with member states engaged in pandemic treaty negotiations, Basu said there isn’t a full understanding of the breadth of work the Pandemic Fund does, including its flexibilities, and governance model. In response, the fund intends “to do more outreach to make sure that people do understand our governance and our business model." The Pandemic Fund board has nine seats for donor governments, and nine for sovereign co-investors, which are composed of countries representing LMICs that can be recipients of Pandemic Fund grants. Of the nine sovereign co-investors, four are occupied by African governments. The board also has one seat reserved for a nonsovereign contributor and two seats for civil society organizations. Each region also decides who represents them on the board. For example, the Western Pacific region decided that the Philippines would represent them on the board. “That was, like, interesting for them because they hadn't quite understood that,” Basu said. “I think as we've explained the pandemic fund more to them, then I think they have a greater appreciation of what the pandemic fund can do and how it can help implementation of a forthcoming accord,” she added. But African countries are pushing for a new fund not just to cover obligations that would come out of the pandemic agreement, but also to have a mechanism with more member state oversight. They have concerns that the governance of the Pandemic Fund isn’t inclusive enough, and other groups have argued the need for better representation and meaningful engagement with the board. The Africa Centres for Disease Control and Prevention also questioned the fund’s inclusivity, after not being included as an implementing entity despite being well positioned to do so as a public health agency of the African Union. Africa CDC recently submitted an application to be an implementing entity. But the process is still ongoing. Basu said they now have at least a dozen applicants vying to be implementing entities, who are now being reviewed by an independent accreditation panel. That panel is expected to make its first set of recommendations to the Pandemic Fund board when it meets in early April. But applicants still need to go through a second evaluation process, and the result of that may come out before the end of April.