The Global Preparedness Monitoring Board (GPMB) – the independent body responsible for assessing the state of the world’s preparedness for pandemics and other health emergencies – issued a warning today that the fragile progress to strengthen preparedness made in the wake of the COVID-19 pandemic is at risk, and the world’s capacity to deal with a potential new pandemic threat remains inadequate.
The GPMB report, ‘A Fragile State of Preparedness’, launched in Geneva today, highlights significant weaknesses or declining capacities in several critical areas of preparedness. Where there are signs of improvement, they are fragile, and in urgent need of reinforcement.
The GPMB lays out four key priorities to repair the weaknesses in global preparedness:
Strengthen independent and multisectoral monitoring and accountability;
Reform the global financing system for PPPR;
Achieve more equitable and robust research and development and supply chains;
Enhance multisectoral, multistakeholder engagement.
Monitoring and accountability
Evidence-based monitoring, including independent monitoring, is essential to increase effectiveness, ensure accountability, and build trust. Monitoring needs to be effectively integrated into the governance of health emergencies, especially the WHO Pandemic Agreement. The GPMB calls on Member States to include review and compliance mechanisms in the WHO Pandemic Agreement, supported by evidence-based, independent monitoring. To enable monitoring, countries need to invest in building their data collection and analysis capacities.
Financing
The GPMB urges leaders to strengthen the global financing system for PPPR by addressing urgent funding gaps and reforming the system to enable greater national investments and to bolster international financing through new modalities and sources of financing. The Pandemic Fund is an important step towards adequately and sustainably financing PPPR. However, the Fund has yet to be fully financed, and the GPMB has called for donors to ensure that it meets the US$10 billion need originally identified. However, PPPR financing requires fundamental reform to free it from the limitations of development assistance and place it on a sustainable footing, based on burden-sharing.
A full range of financial mechanisms should be applied to pandemic prevention, preparedness, and response including debt relief, collective contribution mechanisms and reforms to the international system to give countries more fiscal space for domestic resource mobilisation. There needs to be a scale-up in surge funding and the WHO Contingency Fund for Emergencies should be increased to meet pandemic Day Zero needs of US$500 million.
Robust and equitable R&D and supply chains
Globally, R&D capacity is concentrated in a few countries and regions. In the report, the GPMB notes that this imbalance played out in unequal access to COVID-19 vaccines. Strengthening regional capacities for R&D, manufacturing and supply is needed to address the inequities in global access to medical countermeasures. Regional capacities will need to be supported by a global framework that can serve to coordinate, prioritise, and share knowledge. The WHO Pandemic Agreement will be integral to this.
Public financing is the key source for funding R&D in the context of PPPR. Financing agreements for the development and production of medical countermeasures should include terms that support equitable access for all populations who need them, ensuring that the scenario of COVID-19 is not repeated.
Multisectoral, multistakeholder engagement
Pandemics are not just about health. Currently, coordination across sectors and levels of society is weak. A multisectoral, multistakeholder approach is needed to bring together all stakeholders and sectors involved in PPPR, and to support a more integrated, coherent response to pandemics and health emergencies. Civil society participation should be better organized and resourced, and preparedness should be more responsive to the needs of women, youth, and vulnerable groups.
The report finds that competing priorities, geopolitical tensions, and pervasive mistrust are holding the world back from finding solutions to improve preparedness. Mistrust between states is a geopolitical reality, but must be addressed in ways that encourage cooperation and advance mutual accountability. The GPMB believes that implementing the recommendations in this Report can help build trust, by establishing a more transparent and fairer system for PPPR.
Commenting on the launch of the report, Kolinda Grabar-Kitarović, GPMB co-Chair and former President of Croatia, said: “It is clear that a lack of trust at every level, both between and within countries, remains a significant obstacle to preparedness. We call on leaders to move past these divisions and forge a new path based on a shared recognition that our future safety depends on meaningful reform and the highest level of political commitment to health emergency preparedness.”
Joy Phumaphi, GPMB co-Chair and former Health Minister of Botswana, added: “Our report demonstrates that, although the state of the world’s preparedness is fragile, it is not without hope. There are many efforts underway to strengthen preparedness – but they will fail without the right resources and support. Leaders must double down on their commitment to learning from the lessons of the past and creating a world where we are all safe from pandemics.”
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