5 urgent actions to stop future pandemics crushing the global economy

“It would take 500 years to spend as much on investing in preparedness as the world is losing due to COVID-19.”

That’s the sobering assessment of A World in Disorder, the latest report from the Global Preparedness Monitoring Board (GPMB).

The GPMB was launched by the World Health Organization (WHO) and the World Bank Group in 2018, as an independent monitoring and accountability body to ensure preparedness for global health crises.

It’s led by co-chairs Dr. Gro Harlem Brundtland, the former Prime Minister of Norway and former WHO Director-General; and Elhadj As Sy, Chair of the Kofi Annan Foundation Board and former Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC).

They say the coronavirus pandemic has “revealed a collective failure to take pandemic prevention, preparedness and response seriously and prioritize it accordingly”.

Preparing for and preventing pandemics costs a lot less than responding to one, says the GPMB, among a list of lessons learned from COVID-19.

It counts the response costs so far at $11 trillion, with a future loss of $10 trillion in earnings. By comparison, investments in preparedness would be an additional $5 per person per year – or about $39 billion.

The board is now calling for five urgent actions to “bring order out of catastrophe and chaos”.

1. Responsible leadership

Some leaders, such as New Zealand Prime Minister Jacinda Ardern, have been praised for their quick response to the pandemic. The GPMB recommends that from governmental heads to international organization executives, tomorrow’s leaders are decisive when confronted with the next health emergency – and led by science.

In order to effectively depoliticize crises, the board also recommends that nations should appoint high-level coordinators to lead responses, as well as routinely conduct simulations to maintain preparedness.

Access to vaccines should be “fair and equitable”, the central principle of the WHO-supported COVAX scheme. In future, healthcare workers and the most vulnerable should always be given priority, advises the GPMB. And each country should get an initial allocation of doses large enough to cover at least 2% of their population.

Figure 9: early COVID-19 spread and government inventions

2. Engaged citizenship

Citizens have an important role to play, too. They must demand accountability from their governments for health emergency preparedness, which requires that leaders empower their citizens and strengthen civil society, says the board.

And in an effort to counteract the spread of misinformation, every individual should take responsibility for “seeking and using accurate information to educate themselves, their families and their communities”.

They must also adopt health-promoting behaviours, protect the most vulnerable and be advocates for these actions within their communities.

3. Strong and agile national and global systems for global health security

While praising research to understand the virus and develop and assess countermeasures as “impressive”, the GPMB says even greater coordination and support for research and development (R&D) in health emergencies is needed.

This will involve creating a sustainable mechanism to ensure vaccines and treatments are developed quickly, available early and distributed equitably and effectively. And it will require world leaders to work to strengthen the WHO as an impartial and independent organization responsible for coordinating preparedness and response to pandemics.

At the same time, countries should also strengthen their own systems for preparedness. Measures recommended here include conducting work to identify pathogens with pandemic potential, building core public health capabilities and creating systems to protect vulnerable citizens.

4. Sustained investment in prevention and preparedness, commensurate with the scale of a pandemic threat

“Extraordinary events require extraordinary financing,” says the board. But the speed at which emergency R&D can be funded is hampered by the lack of mechanisms to provide such financing at the global level.

As such, it is asking G20 leaders to make sure adequate finance is made available to mitigate the current and future consequences of the pandemic. And heads of government should ensure robust financing for their national capacities to prepare for and respond to pandemics.

It also calls for the United Nations, the WHO and the International Financing Institutions (IFI) to develop a mechanism to sustainably finance global health security. This would recognize preparedness as a “global common good”, and not be affected by political and economic cycles.

5. Robust global governance of preparedness for health emergencies

COVID-19 has shone a spotlight on the complexities of how preparedness is governed.

The GPMB says that in the early stages of the pandemic the global scientific community was sharing data in record time and collaborating on the early development of diagnostics. But at the same time, many countries didn’t recognize the danger, leading to "delayed decisive action”.

The board, therefore, says the International Health Regulations (IHR) ­– a global framework that exists to protect people from health emergencies – should be amended. This would include strengthening processes for announcing and sharing information about such emergencies, making evidence-based recommendations on domestic and international travel and trade and developing mechanisms to assess IHR compliance.

World leaders, along with the WHO and UN, it says, should “develop predictive mechanisms for assessing multi-sectoral preparedness”, including simulations and exercises that test and demonstrate the capacity and agility of health emergency preparedness systems.