Soccer and science: Can global health learn from FIFA's benefit sharing?

When the Paris Peace Forum nonprofit began working on pandemic preparedness to support the global health community's efforts in the COVID-19 response, they discovered a “profound and entirely understandable sense of injustice” expressed by the scientists in Botswana and South Africa who identified the omicron variant. “They had discovered and provided the world with the knowledge and data to combat these pathogens, yet they were the last to access medical products deriving from their discovery,” said Gabriel Butin, head of global health at the forum. He is also one of the authors of a field study on the lessons from FIFA’s fair benefit-sharing model for global health, conducted in 2022 in Botswana and South Africa. “There was a fundamental issue with the distribution of the value they created,” Paris-based Butin told Devex of the scientists in an email. The discovery of the omicron variant by Botswana-based virologist Sikhulile Moyo and South Africa-based bioinformatics scientist Tulio de Oliveira sparked strict bans on travel to and from southern Africa in the West, and they even received death threats. But while working with the forum, Spring Gombe, who has over two decades of experience in global health policy advocacy, had a moment where “a light went off.” Both her sons played in Germany’s soccer league. When they had turned 12 a few years earlier, they were made to get a “football passport.” Gombe recalled wondering why the national sports associations were “tracking kids.” After looking into FIFA’s solidarity compensation mechanism, the system used by the international soccer governing body, she learned that clubs signing a player have to pay a fee to the training clubs when a player signs their first professional contract and on each subsequent transfer until the end of the season of their 23rd birthday. Gombe began to wonder if the model could be replicated in global health to achieve greater equitable data sharing and distribution of benefits that results from this data such as vaccines. Now, after its study, the forum is calling for the creation of a compensatory mechanism that could meet the needs of scientists and reward them for their work in pandemic preparedness — a key sticking point in current pandemic treaty negotiations, which resumed on Sept. 9. It hopes that some form of innovative financing mechanism can be adopted and effectively put in place through an international instrument such as the treaty, Butin said. “Our proposal echoes these (treaty) discussions and could be one solution among others to the problem of solidarity that is resurfacing before our very eyes with mpox,” Butin said. He referred to benefit sharing as the equitable distribution of benefits derived from the use of resources, knowledge, or data. Benefit sharing can include financial returns, access to technology, capacity building, and other compensation. The concept is a vital component of the robustness of the entire pandemic detection and prevention chain, stressed Butin. “We heard (in the study) from frontline researchers about their sense of fatigue,” he said. “It is much easier to work in well-resourced laboratories in affluent countries than to sustain and develop laboratories in the Global South.” Without a global and robust scientific network that enables the tracking and detection of pathogens, the entire world remains vulnerable to pandemics. There are two main mechanisms via which benefits in association soccer are distributed — training compensation and solidarity mechanisms. The first guarantees that clubs are reimbursed for costs incurred in developing a player. A payment to the training club is made when a player signs their first professional contract and on each subsequent transfer until the end of the season of their 23rd birthday. Under the second system, introduced in 2001 by FIFA, when a player under contract is moved between clubs within different FIFA jurisdictions, part of the transfer fee up to 5% is allocated as a payment distributed to all clubs involved in their training and education between the ages of 12 and 23. Solidarity payments last throughout a player’s professional career and are made each time they are transferred when under contract. They ensure that clubs that contribute to a player's development continue to receive a windfall throughout their career, incentivizing continued participation in a player’s development and education. When star Cristiano Ronaldo moved from Real Madrid to Juventus in 2018, solidarity payments were made to Sporting CP and Manchester United. The latter were said to have reaped a windfall of about £2.2 million. Paris Saint-Germain handed over nearly €9 million to Santos after Neymar da Silva Santos Júnior was transferred from Barcelona, according to 2017 reports. Solidarity payments to member associations have increased sevenfold since 2016, a FIFA spokesperson told Devex in an email. “FIFA managed to create an instrument with real teeth, even with a very lean structure in the clearinghouse,” explained Gombe to Devex via email. “This was something that global health could certainly learn from. Solidarity is far more perfectly lived in the world’s game than for the world’s health.” The soccer body also astutely saw the need to create a clearinghouse that processes payments and conducts a strict compliance exercise to guarantee accuracy and fairness to address what Gombe described as the “David versus Goliath problem” — where powerful figures typically dominate benefit-sharing negotiations. She was struck by a very successful enterprise like FIFA clearly seeing not just the utility but the importance of investing in the game at all levels, everywhere. They recognized that sporting talent needed to be actively nurtured, ultimately in soccer’s interest. The study by Butin, Gombe, Brian Wahl, Atalay Demiray, and Nina Schwalbe, published in May in Oxford Academic’s Health Affairs Scholar journal, highlighted that the World Health Organization and the United Nations rely on comprehensive data sharing to effectively fulfill their mandates. Global health stakeholders such as research institutions and vaccine and therapeutic developers have benefits from early access to data allowing the development and marketing of interventions. They have benefits similar to professional soccer clubs under FIFA’s system, which come from other clubs’ contributions. These global health players should be given access to similar data to enhance public health initiatives, the study said. They should be protected from retaliatory actions like travel bans, it said. Financial windfalls from data sharing should be fairly distributed to support the institutions and systems that provide data. FIFA’s benefit-sharing model could not be applied directly without being adjusted significantly, the study noted, adding that it would need to be approved by countries with different “needs, capacities and perspectives.” They recommended setting up a centralized clearinghouse, similar to FIFA's, which could help with sharing pandemic-relevant specimens and global health data. This could “streamline and automate the tracking and distribution of benefits,” the study said. They also recommended a web-based data platform for getting access to data, fostering collaboration, and organizing activities among stakeholders for prevention, preparedness, and response. The European Union and the Council of Europe have recognized that FIFA’s model guarantees fairness by increasing transparency and accountability, the research underpinned. However, it has faced criticism for potentially perpetuating wealth disparities and for challenges in enforcement, the research said. Critics argue that it could disproportionately benefit wealthier clubs who have more resources to inject into player development. If adopted in global health, richer countries or organizations might have an advantage, the study warned. But Gombe said that it had surprised her that scientists had a “shared recognition that the global health sector needs a more equitable and systematic approach to benefit-sharing, and FIFA’s model provided a tangible example of how it could be done.” Wahl, an adjunct assistant professor in the department of international health at Johns Hopkins Bloomberg School of Public Health, said that despite global health’s challenges related to the complexity and diversity of stakeholders, unlike in soccer, there was no single governing body with equivalent authority. “To overcome these challenges we must ensure a flexible benefit-sharing framework, align it with existing legal structures like the International Health Regulations and involve stakeholders in designing a fair and equitable system,” he told Devex in an email. Wahl said that benefit sharing was a critical component of the pandemic negotiations. “Ensuring equitable distribution of resources and data is essential for fostering international cooperation and trust, which are vital for effective pandemic preparedness and response activities,” he said. “Components of the FIFA model could help address some of the most challenging issues, including traceability of samples and fair compensation.” Using professional solidarity to mobilize innovative financing for a community could also be applied in the fields of environment, agriculture or education, said Butin. Given the complexity of the geopolitical framework in which development evolves, fiscal constraints, and an aid reduction, the sector must mobilize “non-traditional players” to achieve its objectives. “We can no longer operate in silos — we saw what happened with Covid!” said Butin. “If we really want to tackle the issue, we need technical solutions that can be applied quickly, like the compensation mechanism we are proposing.”