On 13 November 2022, the G20 (G-20) hosted the official launch of the new World Bank Financial Intermediation Fund, the Pandemic Fund, to facilitate pandemic preparedness and response (PPR). At that event, Priya Basu, Executive Director of the World Bank’s Pandemic Fund Secretariat, suggested that the fund had received only $400 million of the $1.4 billion pledged by donors. well below the claimed estimated $10.5 billion). Additionally, when asked about whether substantial new funds will go into the fund or be diverted from the existing aid budget, Bass said: This is new money. ”
However, an analysis of new Official Development Assistance (ODA) and country-level resource management data reveals worrying trends that could temper this optimism. These trends suggest that not only did his ODA peak during COVID-19, but resources were reallocated to his COVID-19 and his PPR activities at the global and national levels. increase. Moreover, there is evidence that these changes are exacerbating existing health vulnerabilities and weakening overall global health. If these trends continue, it will have a huge impact not only on global health, but also on her PPR policy and ability to raise the funding of pandemic funds around the world.
Peaks and Shifts in Official Development Assistance
In May 2022, the Development Assistance Committee of the Organization for Economic Co-operation and Development (OECD DAC) released its annual data on ODA to health. Data are now available for 2020, the year COVID-19 was declared a pandemic. In order to be able to trace his ODA for COVID-19 control, the OECD DAC has introduced a new code for reporting his COVID-19 ODA.
The data show that public donors spent $29.1 billion in health ODA in 2020. That’s a massive 31% (or $6.9 billion) increase compared to the previous year (all data reported in his 2020 prices). Thus, in 2020, health ODA reached a record high. Private funding flows to healthcare also increased by 21.6%, from $4 billion to $4.9 billion (Figure 1).
Figure 1. Trends in medical ODA expenditures and medical private flows
Source: OECD DAC CRS.Total spend, constant USD price in 2020
Donors disbursed a total of $4.4 billion in 2020 in response to the COVID-19 pandemic. A significant proportion (63.9%) of the increase in health ODA comes from donor funding for COVID-19 control. In addition, ODA for infectious disease control increased from $2.3 billion in 2019 to $3.1 billion in 2020. Much of this increase can be attributed to support activities for pandemic preparedness and response, including COVID-19 surveillance, research and development. vaccination.
But the data also reveal concerns. Even before the COVID-19 pandemic hit, most low- and middle-income countries (LMICs) have committed to achieving Sustainable Development Goal 3 (“Ensure healthy lives for all at all ages”) by 2030. , promoting welfare”) was not on track to achieve. The SDG target 3.8 goal of achieving universal health coverage (UHC) by 2030 has always been ambitious, but it appears to have been undermined by his ODA post-COVID-19. For example, ODA to basic healthcare fell from $3.4 billion in 2019 to $2.3 billion in 2020, a 34.5% decline. ODA for basic nutrition decreased by 10.1%. Combined with concerns about donor fatigue in the face of growing global challenges (climate, Ukraine, food security, etc.), the prospects for reducing ODA spending and/or diverting existing funds look high.
Resource migration and its impact on global health
Beyond ODA data, there is further evidence that the pandemic exacerbated UHC vulnerability through diversions within the national health budgets of LMICs. Especially from areas such as malaria, tuberculosis, and HIV, to COVID-19 and other his PPR-related activities. Additionally, a study on Ghana found that the COVID-19 pandemic had a negative impact on Ghana’s healthcare financing system. This includes a reallocation of government funding to the health sector to his anticipated COVID-19-related priorities.
Further evidence indicates that reallocation of COVID-19 resources is reversing progress in health outcomes. For example, the broader secondary impacts of COVID-19 on health systems and outcomes can be seen in malaria, tuberculosis, sexual and reproductive health and other health related HIV, non-communicable diseases and neglected tropical diseases, among others. Evidence suggests deprioritizing above concerns. The World Health Organization reported that 43 countries, including 13 with a high TB burden, have used his GeneXpert machine for COVID-19 testing instead of diagnostic testing for TB. In addition, 85 countries reported redeploying TB staff to COVID-19-related duties, and 52 countries confirmed that they had reallocated TB budgets to COVID-19 activities. There is also considerable evidence that medical personnel are being reassigned from other health subsystems to his COVID-19-related activities. In the case of Indonesia, the diversion of human resources to pandemic response efforts has disrupted polio immunization services and endangered the country’s polio-free status.
The Prospects Don’t Look Good — For Pandemic Funds or Global Health
There is good reason to believe that by focusing on COVID-19 and PPR, resources are being drawn from UHC to have impact on broader health outcomes. This, combined with the reduction in ODA and the reallocation of budget for increased PPR activities, increases the strain on an already strained health system, while increasing the available funds for new initiatives (opportunity cost). raises concerns about reducing There are also indications that global health care providers may cut medical aid further, reversing the ‘cycle of panic and neglect’ that is a common pattern in global health financing. This condition exacerbates vulnerability and health consequences. Moreover, this would undermine the credibility and sustainability of the Pandemic Fund. Because existing funds will be diverted and new funds will remain scarce.
This highlights the need for sustainable long-term funding not only to adequately prepare for the next outbreak, but also to strengthen health systems and support the health of the population. As the COVID-19 pandemic has shown, responding in a crisis is far more costly than investing properly in global health, including strong and resilient health systems.