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Call for reform at World Bank to drive pandemic R&D

Image: Kristi Blokhin, via Shutterstock

Pandemic panel calls out ‘collective failure’ over global response to Covid-19

In a damning assessment of the global response to Covid-19, an international panel on pandemic preparedness has called for a shake-up at the World Bank to ensure emergency funds are available for R&D during health emergencies.

The Global Preparedness Monitoring Board (GPMB)—convened by the World Health Organization and the World Bank—warned in 2019 that the world was unprepared for a deadly pandemic. 

Now, in a report on the Covid-19 situation published on 14 September, it says there has been “a collective failure to take pandemic prevention, preparedness, and response seriously and prioritise it accordingly”.

The board—made up of politicians, civil servants and top health researchers including Anthony Fauci, Jeremy Farrar and George Gao—says some “fragile” progress has been made on coordinating global R&D during the pandemic. But “rapid funding of emergency research and development is hampered by the lack of mechanisms in international financing Institutions to provide such financing at the global level”.

At the heart of the problem is that the World Bank—a global financial institution that provides loans and grants to governments in poorer countries—has traditionally focussed on funding large projects, not research. To date, its response to Covid-19 has centred around funding health systems, including via a controversial system of pandemic bonds, designed to help developing countries with their public health response. This financing system has been criticised for having overly strict conditions that prevented it being triggered until almost four months into the pandemic.

The GPMB says the bank and other institutions should make R&D eligible for financing, and that mechanisms must be developed to provide financing for global R&D for health emergencies.

In a statement to Research Professional News, the board said that such a mechanism would most likely require financing institutions such as the World Bank to make changes to their business models.

As a trustee of the Coalition for Epidemic Preparedness Innovations, the international initiative that has financed rapid vaccine R&D during the Covid-19 pandemic, the World Bank can play a role as a financial intermediary and could potentially make R&D a supported expenditure, the GPMB told Research Professional News.

In response, the World Bank was unable to confirm whether it is able to fund R&D during pandemics. But it highlighted actions it has taken in helping more than 100 countries with their health response to Covid-19.

Gro Harlem Brundtland, former Norwegian prime minister and co-chair of the GPMB, urged action to change the system of global governance for pandemics, telling a webinar that “past experience warns us of the perils of falling back into the cycle of panic and neglect”. She added that she would be addressing a joint meeting of G20 finance and health ministers on 17 September to press them to take action.

A substantial proportion of global health R&D in developing countries is paid for through overseas aid by high-income countries, but Brundtland said global health security “cannot continue to rely on development assistance—it is inadequate in scale, unpredictable in nature and depends on the generosity of a small group of countries and donors”.