The Fund has launched a Working Group to consider criteria for resource allocation, but it has not yet reported back. How will the Fund consider or estimate those externalities? And how will it prioritise between projects that impact countries and regions differentially? There is no quick-fix, technical solution that can be deployed easily. On the other hand, planning for surge capacities to maintain essential service provision may be beneficial to recipient countries, but less so internationally. Some interventions may be good value for money at the global level but have poor value for money for the recipient country for instance, disease surveillance for a virus that causes low morbidity in a given country may be beneficial globally but not so for the recipient country. The presence of such externalities creates a complexity about how to, in theory, define value and to whom. Indirect benefits globally in terms of greater health security (same as above) that accrue to all other countries.
Whereas for the Pandemic Fund, we see two types of benefits arising from individual PPR projects: For instance, the benefits of the Global Fund’s vector control in malaria are straightforward: the intention is to limit the spread of malaria for the communities that receive the interventions. So here the Fund needs to carefully consider who benefits from greater PPR, and how those benefits materialise. Unlike other areas of global health, pandemic preparedness is truly a global public good that benefits everyone. The need to appraise interventions from a national and global perspective The methods for evaluating PPR are also not well established, partly due to lack of data on cost or effectiveness of interventions, uncertainty in the timing and nature of the threat, as well as uncertainty in the future economic and health system context (e.g., vaccine manufacturing capacities, health systems constraints). On cost-effectiveness of outbreak response, a review also found similarly few studies. Just on costing, a recent literature review found ten studies and argues for improved methods, greater interpretation, and comparison across studies. In addition to the decision-space being vast, the evidence base surrounding those interventions isn’t yet well developed to readily support in-country investments. Other experts have characterised a vision of PPR that builds on core health systems capabilities and universal health coverage which would further expand the scope into a wide variety of health system strengthening initiatives. A useful definition from McKinsey is organised around the following capabilities-which can be further broken down into a high number of interventions ranging from genomic surveillance to strengthening vaccine manufacturing capacities. There is not one definition of what may fall within the scope of PPR. The decision space is enormous and under-researched
In this blog, we ask how can it best fund discrete country-specific projects to effectively produce the true global public good of global health security? On what basis will the newly appointed Technical Advisory Panel evaluate projects? In particular, we identify three challenges that we think will make the definition of priorities complex: the vastness of the PPR agenda as well as the paucity of evidence the need to value projects from both a national and global perspective and the need to match the source of the funding with appropriate projects. While much of the details of how the Pandemic Fund will operate is still being discussed, we do know it will release its first call for proposals in early February, which will be an opportunity to pilot approaches and learn. This will require true collective action, and implementation of decisive and ambitious policies in as many parts of the globe as possible, since t he strength of PPR is, in part, the sum total of the performance of all national systems. Its mandate is ambitious: to successfully prevent, prepare and respond to emerging pathogens. The goal of the Pandemic Fund is to provide a currently missing dedicated stream of additional, long-term funding to support low - and middle-income count ries ( LMICs ) to support and reinforce pandemic preparedness and response (PPR) capacities. On November 13 th, 2022, the creation of a new Pandemic Fund, hosted by the World Bank, was announced.
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