Financing Pandemic Preparedness: The Urgency for Collective Action

00:00 Welcome by Priya Basu, Executive Head, the Pandemic Fund Secretariat, World Bank

01:20 Remarks by Ajay Banga, President of the World Bank

05:47 Remarks by Janet Yellen, United States Secretary of the Treasury

13:45 Remarks by Tedros Adhanom Ghebreyesus, Director General, WHO

18:25 Ministerial roundtable

• Ala Nemerenco | Minister of Health, Moldova 
• Nisia Trindade | Minister of Health, Brazil
• Lyonpo Dechen Wangmo | Minister of Health, Bhutan 

36:01 Remarks by Erica Gerretsen, Director of Human Development, Migration, Governance & Peace, DG International Partnerships, EU Commission

40:20 Panel discussion: Leveraging partnerships to strengthen pandemic preparedness and response

• Sabin Nsanzimana | Minister of Health, Rwanda & Co-Chair of the Pandemic Fund Governing Board 
• Frank Anthony | Minister of Health, Guyana 
• Svenja Schulze | Federal Minister for Economic Cooperation and Development, Germany 
• Budi Gunadi Sadikin | Minister of Health Indonesia
• Joy Phumaphi | Former Minister of Health of Botswana & Co-Chair of the Global Preparedness Monitoring Board

1:07:33 Interventions from the floor

• Chrysoula Zacharopoulou | Minister of State for Development, Francophonie and International Partnerships
• Zahid Maleque | Minister of Health and Family Welfare, Bangladesh
• HJamoliddin Abdullozoda | Minister of Health and Social Protection of Population, Tajikistan 
• Beth Dunford | Vice President of Agriculture, Human and Social Development, African Development Bank
• Danny Alexander | Vice President for Policy and Strategy, Asian Infrastructure Investment Bank 
• Elisha Dunn-Georgiou | President & CEO, Global Health Council & The Pandemic Fund Board Member

1:25:35 Closing remarks by Priya Basu, Executive Head of the Pandemic Fund Secretariat, World Bank

[Priya Basu] Hello and good evening. I'm Priya Basu, Executive Head of the Pandemic Fund Secretariat. A warm welcome to everyone in the room and online. We have hundreds of people joining online. We're livestreaming this event and we already have, I think, more than 200 people connected online. This event is an occasion to celebrate the Pandemic Fund's first anniversary and mark the rapid progress we've made. It's also an opportunity to underscore the urgent and enormous task that lies ahead of us in fulfilling our promise of building a world that's resilient to global threats. I'm thrilled by the fantastic turnout today. It's wonderful to see so many partners in this room and online who have helped stand up the Pandemic Fund and partners who are instrumental in making this fund a success as we implement. We have an all-star lineup of speakers today, so without further ado, I'd like to invite World Bank President, Ajay Banga, to deliver the opening remarks.

[Ajay Banga] Janet, I think that stool is for you. I'm sorry, I couldn't resist that. That was easy. That was an easy shot, right? Good evening, everybody. It's an absolute privilege to be with all of you here and to have the opportunity to open what I think is a very important conversation. The need for global health threats just exists, we know, the need to build for them cannot be overstated. Tedros is saying thank God he's saying that. Although we are still emerging from the COVID Pandemic, and by the way, my wife just tested positive today, so trust me, it's real, although I am not positive, Madam Secretary, since I've been hanging out with you. Although, I was positive a few months ago, as you remember. We must aggressively be planning and preparing for the next global health crisis. Experts predict that there's more than a 50% chance that another COVID-like pandemic will hit us within the next 20, 25 years. What I know is that these risks are actually exacerbated by climate change, and I'm deeply worried that we are not moving forward aggressively enough. Pandemic preparedness continues to suffer from chronic underinvestment, particularly in what people now call the Global South, a term I don't like, but I understand the moniker as it refers to it. The international community has a key role to play, both in bringing additional financing and in incentivizing countries to do more. The one bright spot is the Pandemic Fund, an innovative component of the International Health Financing Toolkit. First of its kind, a multilateral platform dedicated to making investments in pandemic preparedness during, what I call, peace time. It is designed so that when the battle comes again, and we know it will, we will have the health workforce that can be rapidly deployed in the face of a crisis, laboratories that can quickly ramp up testing and surge capacity that can be called upon to respond. The Pandemic Fund is doing things differently because it has the flexibility to work through a variety of institutions, complimenting efforts, drawing in co-financing and promoting coordination on the ground. Plus, most importantly, it incentivizes countries to prioritize this agenda and increase their own efforts. The World Bank is very proud to have been a part of this whole activity. What makes the Fund generally impactful is the collaboration with governments with the WHO, with UN agencies, MDBs, Global Health Initiatives, philanthropies, civil society, Dr. Tedros and the WHO. I think you deserve special thanks for the hard work, the expertise and the experience that you and your team are contributing to the Fund. As does the G20, who championed this initiative with their vision, but also with their generosity. The speed at which this Fund has come together to deliver financing is impressive. It's a great example of what we can do when we work together towards the common goal. In less than a year, the Pandemic Fund has raised 2 billion dollars in seed capital. It's awarded the first round of grounds to projects that strengthen capacity, both within and across borders with every dollar catalyzing an additional 6 dollars. However, we are still falling short of where we need to be. Joint analysis with WHO estimates that getting to the right level of preparedness will require an additional 10 billion of international financing annually over the next five years, coupled with twice as much in domestic financing. That's daunting, and to fulfill its promise of helping develop countries build resilience to future pandemics, it needs more resources on a sustained basis. This is the moment to scale up those efforts and Secretary Yellen, who's here, is someone who shares this urgency. She knows all too well the importance of preparing now for the coming storm. Without her, the Pandemic Fund would not have existed and I'm delighted that she's here to deliver the keynote address for her role in helping to set it up, but also her stubbornness, her desire to ensure it comes through. I cannot thank you enough for your leadership, Secretary Yellen. Thank you.

[Janet Yellen] Thank you, President Banga, for your words of support and introduction. Thank you also to Director-General Tedros, Minister Sabin and the Pandemic Fund Secretariat for all you've done to get us here. Hello, everybody. I'm glad to mark this occasion, the one year anniversary of the Pandemic Fund with all of you tonight. Over the past few years, COVID-19 has made us confront the tremendous human and economic costs of pandemics. Like with other recent global health events, it underscored the critical gaps in pandemic prevention, preparedness and response. When the G20 high-level independent panel called for a new financing mechanism to address these gaps in June of 2021, the international community came together and acted. President Biden echoed the panel's call at the Global COVID-19 Summit in September 2021 and announced an initial US contribution. Then, under the Italian and Indonesian G20 presidencies, Finance and Health Ministries worked to launch the Pandemic Fund in record time. In the years since this launch, the Pandemic Fund has raised nearly 2 billion dollars from 25 countries and three philanthropies. This past July, from its first call for proposals, the Pandemic Fund awarded 338 million dollars. It will leverage an additional 2 billion in co-financing from implementing entities and co-investor countries. Funding will go to 37 countries, including for a project in Zambia that will strengthen early warning systems through integrating public health data into an electronic surveillance and response platform. I saw how important this is firsthand when I visited the new emergency operations center for monitoring health threats in Lusaka in January. Another project supports 12 countries in the Caribbean on regional coordination, including through pandemic simulation exercises. These and the many other approved projects will tangibly improve our collective ability to prevent pandemics and to better withstand those that could still occur. As I've said before, the Pandemic Fund is truly a model for multilateralism. Many countries have worked quickly and effectively to address this global challenge. We should all be proud of what we've done, but I also want to stress now is not the time for complacency. More work is needed to realize the Pandemic Fund's full potential and to strengthen global health capacities. First, we know the Pandemic Fund will need more resources, 10 billion dollars per year over the next five years, as called for by the high-level independent panel. The US has already contributed 700 million dollars and we're requesting an additional 500 million from Congress as part of President Biden's fiscal year 2024 budget. We urge other countries to increase contributions and we also need to explore more sustainable financing models. I'm glad the board of the Pandemic Fund will focus on that in the coming year. Second, the Pandemic Fund doesn't exist in a vacuum. Its success will depend on the success of broader efforts underway to strengthen the global health and finance architecture. One such effort is our ongoing work to evolve the multilateral development banks, so they have the tools to better help countries assess and manage pandemic-related risks among other global challenges. This includes ramping up investments in regional and global projects to address pandemic preparedness and response gaps. It also includes integrating pandemic surveillance and preparedness measures as part of health projects wherever possible, as health security requires a holistic approach, and it includes considering how the MDBs can best compliment and catalyze other sources of financing. The United States is also supporting ongoing work in Geneva on the pandemic accord and amendments to the International Health Regulations. We welcome the work of the G20 Finance-Health Task Force to deepen our understanding of the interplay between health and economic shocks. The Task Force's work to help identify financing gaps and to develop a comprehensive response playbook for pandemics, and routine pandemic stress tests will be especially crucial. Again, congratulations to the many of you who have been instrumental in creating and operationalizing the Pandemic Fund. We've accomplished a lot very quickly, but there's much more to do to strengthen the Pandemic Fund and to continue building the global health architecture people around the world need and deserve. COVID-19 destroyed the lives and disrupted the livelihoods of too many. We cannot eliminate the risk of another pandemic, but we can make pandemics less likely and ensure that if they do occur, we're better prepared for them. Thank you all for being here. Our collective work saves lives, preserves livelihoods and fuels economies, and tonight is a call to recommit ourselves to taking it forward. Thank you so much.

[Priya Basu] Thank you, Secretary Yellen, for your vision and your leadership. Now, I'd like to call upon Dr. Tedros, Director-General of the WHO, to address us. Dr. Tedros.

[Tedros Adhanom Ghebreyesus] Thank you. Thank you, Priya. I will not joke about you like what Ajay did for you. Your excellencies, ministers, dear colleagues and friends, it's now, as has been said by Ajay and Yellen, it's already more than a year, almost a year since we started, so happy anniversary, and I hope this Pandemic Fund will go from strength to strength. As you also know, it's more than four months now since WHO declared an end to COVID-19 as a global health emergency. As the attention of world leaders moves to other crisis of which there are plenty, we are concerned that the lessons of the pandemic will go unlearned, and the cycle of panic and neglect will repeat. The world was unprepared for the COVID-19 pandemic and it remains unprepared for the next pandemic. History teaches us that the next pandemic is a matter of when, not if. Now is the time to invest in preparing for the pandemics of the future and to strengthen the global architecture for health emergency preparedness and response. The Pandemic Fund is a critical component of that architecture. WHO is proud to be part of the Fund and to provide technical leadership. I thank the G20 countries, you remember the relay, that started in Saudi Arabia and then followed by Italy, Indonesia. I think it's the effort of the three countries that made it happen, and I thank all three countries plus all G20 countries, for establishing the Pandemic Fund and all those who have supported it. The task now is to implement the projects funded in the first round, many of which WHO is supporting, and demonstrate their impact. The first round has shown that countries have a real need for this type of funding assistance to support national pandemic preparedness strategies. The demand is huge. For the first round, the fund received 133 applications from over 120 countries with requests for financing of over 2 billion US dollars. Given this level of demand, we would like to see an acceleration and disbursement in the second round, and I leave you with three major actions. First, we seek the commitment of all donors to continue to capitalize the Pandemic Fund in line with investment needs identified by countries. Second, we seek the commitment of multilateral and bilateral health programs to coordinate, align, and integrate investments more effectively in support of domestic financing and national plans. Third, we seek the commitment of all donors and countries to build resilience by integrating investments in health security with investments in health systems. My thanks to Ajay Banga for his partnership, and to Secretary Yellen, which I fully agree with Ajay beyond words in thanking her, for her leadership and all ministers here for your commitment and support for the Pandemic Fund. We look forward to our continued partnership as we build a healthier, safer, fairer world together. As the Head of Secretariat, I would also like to use this opportunity to thank Priya and the whole team. Thank you so much.

[Priya Basu] Thank you very much, Dr. Tedros, and thank you to you and Mike and Scott and everybody else from WHO for the excellent partnership. We now move to the next segment of our program. As you heard, on July 19th, the Pandemic Fund's board awarded a first round of grants to 19 projects totaling 338 million that will mobilize 2 billion to help 37 countries strengthen their capacity to prevent, prepare for and respond to pandemics. All geographic regions were covered by the 19 projects, 75% of them are in low and lower middle-income countries. They involve strong collaboration between finance and health and also with other ministries, agriculture, environment, animal husbandry, and almost all projects take a One Health approach and many of them include AMR surveillance. Each project brings multiple implementing entities together in a coordinated way and several projects include cross-country collaboration and regional capacity building. Unfortunately, we don't have time to showcase all 19 projects, we would have loved to do that, but we thought you'd be interested to hear about some of them, and how the grants of the Pandemic Fund are providing an opportunity to countries and regions to do things differently. With that in mind, I'm very pleased that we have three ministers here, Ala Nemerenco, Minister of Health, Moldova, Nísia Trindade, Minister of Health, Brazil, and Lyonpo Dechen Wangmo, Minister of Health, Bhutan, and if I can please invite the three ministers to come up on stage and speak about the projects and how you're going to be using Pandemic Fund grants to do things differently. Ministers, if I can please invite Minister Nemerenco, Minister Trindade and Minister Wangmo. Perhaps if we could start with you.

[Ala Nemerenco] Okay. Your excellencies, dear friends, good evening. Over the past years, Republic of Moldova put considerable efforts in building the country's core capacities to improve preparedness, risk assessment and response measures for public health emergencies. Our government developed and approved this April its five years action plan on the implementation of international health regulations. It primarily focuses on strengthening multi-sectoral coordination, reinforcing epidemic intelligence and surveillance mechanisms, risk communication and community engagement, building emergency response capacities of the health workforce and reinforcing further the immunization program. The Pandemic Fund will support implementation of the action plan and address the gaps identified in the joint external evaluation and intra-action review, such as the lack of a comprehensive electronic surveillance system and the limited capacity, including human resources capacity, to detect and respond to outbreaks in a timely manner. With this project, we propose to invest in strengthening the existing laboratory network and infrastructure to improve diagnostic capabilities for epidemic-prone diseases, provide necessary equipments and supply training of human resources, and the most crucial component, quality management and biosafety. It will also support the Ministry of Health’s role in developing strong cooperation among ministries and stakeholders under print by improved data analysis and strategic and operational decision-making. On a final note, I would like to express deep gratitude to the Pandemic Fund for selecting our country's project for funding and give assurance that this general support will bring the weighted changes in this still undeveloped sector as its implementation is a top priority on the government's agenda. It is my firm belief that the resilient health system is the foundation for public health emergency preparedness and response, and having a long-term investment in system strengthening is currently essential. Only together we can build a resilient, better world. Thank you.

[Nísia Trindade] Excellencies, dear colleagues and friends, honorable ministers of Moldova and Bhutan. In this case of Brazil, we just support initiative from a regional initiative from PAHO. I choose to speak here about our larger vision about the role of the Pandemic Fund. It's with great pleasure that I participate in this high-level event on the Pandemic Fund, especially as part of the [inaudible] and as the next president of G20. Pandemic prevention, preparedness and response will continue to be a priority for the G20 Health Working Group during the Brazilian presidency. Our ambition is to contribute to the discussion from a new perspective, local and regional production of medicines, vaccines and strategic health products. In line with President Lula's emphasis on social inclusion in sustainable development in its social, economic and environmental dimensions, we will also prioritize equity in access to health innovation, an integrated and coordinated approach to pandemic prevention, preparedness and response, as well as reducing global asymmetries in research and development, production and distribution of health technologies. Technologies are elements that can positively impact the quality of life of our populations and support us in achieving the sustainable development goals and beyond. In this regard, it is important that they work together to strengthen the global health architecture, avoid overlapping mandates and initiatives with WHO at the center. I hope to have the support of all of you for a successful presidency in G20. Ladies and gentlemen, the Pandemic Fund was conceived and extensively discussed by the countries of the group during the meetings of the Joint Finance-Health Task Force during the Indonesian presidents of G20, with technical support from the World Bank and WHO. In this sense, Brazil intends to build on the work of previous presidents and during its G20 presidency support the strengthening of the pandemic funding, including its financing. The first call for proposals, presented in early 2023, received projects with funding needs that exceed the available resources of the funding for grants. This fact demonstrated the significant structural needs of countries regarding pandemic prevention, preparedness and response, as well as the fact that the Fund is severely underfunded. We have to go together to face this kind of challenge. On our side, we are planning on making a contribution by the Brazilian side to the Fund to be announced in coming months to help mitigate this situation. PAHO, WHO and the World Bank project, One Health is a fundamental aspect of pandemic prevention, preparedness and response. Dear colleagues, for Brazil, its strong and resilient health and social protection systems, including surveillance with great recovery capacity are the basis for pandemic prevention, preparedness and response. Promoting research and development, production and distribution of supplies at the local and the regional levels with a future equitable access to health technologies is equally essential, especially for developing countries. Therefore, we believe that the scope of the Pandemic Fund could eventually be expanded to include financing for industrial and productivity capacities to support the diversification of magical production and facilitate timely deployment during pandemics. Let us continue to work together to reduce global asymmetries and health inequalities. Thank you.

[Lyonpo Dechen Wangmo] Thank you. Good evening, everyone. I want to congratulate and celebrate the first anniversary of the Pandemic Fund, not just the Pandemic Fund's first anniversary, but the anniversary of many lives that will be saved through this Fund. I think, with three brains together, Ajay Banga, with his capacity to mobilize resources, Dr. Tedros, with his passion to save lives, and Secretary, with the political commitment, I think the Pandemic Fund cannot go wrong. Bhutan's been very fortunate to receive the first round of funding. I say this because when the pandemic hit the world, Bhutan also had the honor and the privilege of being the president of WHA, the World Health Assembly, during which I think we witnessed something that is very painful. The inequity that existed globally, limited access, limited resources of many countries, smaller countries like Bhutan. We are a small country. Bhutan is wedged between two big countries, India in the south and China in the north. We are a population of 700,000 population. When the pandemic hit us, we realized that we had one ICU doctor. We are below what is a minimum threshold required by WHO. WHO says you need one doctor per thousand population. We were, to some extent, one doctor per 6,000 population. We were very, very focused on prevention. We realized we had one microbiologist, we had one genetic lab, one PCR machine. It was a challenging moment for us. But then, under the leadership of our King, who was in the forefront of this war, we managed to avert a major public health crisis. We were the only country that achieved 94% vaccination in four days, setting a world record. We did that not because we had a lot of capacity, sheer solidarity. I think for a small country, my country, we realized that every single citizen of Bhutan realized that the small country that we call home was under threat and that everybody had to take a responsibility, a shared responsibility, and that is how we averted a major public health crisis. Now, going forward, what the Pandemic Fund is helping us, is to achieve human capital, which is in very much aligned with the Bank's aspiration of building human capital. This is where we are training our health workforce. We are training microbiologists, we are training surveillance officers, so that we will have a robust surveillance system. We are also using the Pandemic Fund to establish collaboration beyond the Ministry of Health, but also collaborating with other agencies. We hope that with greater investment in the Pandemic Fund, that we will be able to collaborate across regions and across the world because that is what is needed. If we want to avert the next public health crisis, we must share data transparently. We must take responsibility, we must share our resources. Otherwise, I think we will not achieve what we want to achieve ultimately, and that is saving lives. Doesn't matter where you are, in which country you are, what nationality you have, but ultimately, the objective is to save lives. The Pandemic Fund, we wish and pray that it'll expand its investment. In smaller countries like us, there are many who are resource-challenged, who didn't have access to vaccine. We lost many health workers to the pandemic because we were not in position to provide N95 masks, PPEs, and we must not repeat that mistake. For me, coming to this event was very exciting, because I know that behind me, there are many countries like Bhutan, who would greatly benefit from these kinds of financial mechanisms, whereby they will use these resources to strengthen their health systems, build the resilience of the health system, so that next time when we have pandemic, COVID-20 for that matter, that we are better prepared to save lives. I want to thank and express our gratitude to people who are part of these instrumental methods or strategies for financing and building health systems in many countries. We are also looking at how we can collaborate in the region in terms of really looking at data sharings and building a robust surveillance system across the region as well, because one lesson that we have learned from the pandemic is just saving one country is not enough. We have to save the region, we have to save the world, so that's why I think this pandemic is a catalytic mechanism if you want to prevent the next pandemic. For everyone who's gathered here, I know one way or the other, you are connected to the Pandemic Fund. Please, know that this fund is making a difference in many countries like Bhutan. With that, thank you so much for your attention.

[Priya Basu] Thank you very much, ministers. That was wonderful to hear from you on how you're using the Pandemic Fund grants. We will now move on to the third segment of this event. We have a very distinguished panel that will discuss the role of leveraging partnerships to strengthen pandemic prevention, preparedness and response. But before I ask our panelists to come up on stage, I'd like to invite Erica Gerretsen, Director of Human Development of the European Commission to set the scene for us, and the European Commission has been a founding partner of the Pandemic Fund and thank you for your support.

[Erica Gerretsen] Good evening, distinguished guests, excellencies. It's a real honor for me to stand before you this evening to represent the European Commission. I would like to, first of all, send the apologies of Commissioner Urpilainen, who was supposed to stand here today, and who I'm honored to have been asked to replace tonight. We are here this evening, indeed, to ensure that the world never again endures a crisis like the one that we have just gone through, with COVID-19, and we are here also to pave the way toward the healthier and more resilient future. To achieve this, we must keep pandemic preparedness and response at the forefront of the international agenda, and this is exactly what is happening here tonight, as well as this week in New York. We have seen the devastating effects that failure to implement SDG3 can have, not only on health outcomes, but across all the SDGs. Last September, a year ago, the international community took a significant step forward by launching the Pandemic Fund. The European Union is proud to have played a leading role in this creation and contributed with an amount of 427 million euros. The fund is a vital instrument to build core capacities in countries around the world, and we have heard the witnesses from three countries and we'll hear more afterwards. Indeed, the first call has already come to an end with 37 countries across the six regions of the world who will get assistance; and indeed also, many requests for support that have not been able to be fulfilled at this point. We want to continue the momentum and build on the work that has been done on all the international commitments. We also need, indeed, to integrate the Pandemic Fund into the discussion around the future global health security architecture, ensuring close cooperation with other global health initiatives. We should also continue advocating for increased fiscal space in low-income countries and middle-income countries, which complement domestic financing. It is in this context that the EU has launched the Global Gateway, which is the EU's new international partnership framework for which health is one of the five major pillars. Through the Global Gateway, the EU aims to promote health sovereignty and autonomy around the world. Excellencies, let's work together in the multilateral framework to create a future where a pandemic can no longer bring the world to its knees. Thank you very much for your attention.

[Priya Basu] Thank you very much, Director Gerretsen. If I may please now invite our distinguished panelists to join us on stage. Ms. Svenja Schulze, Federal Minister of Economic Corporation and Development of Germany, Dr. Frank Anthony, Minister of Health, Guyana, Dr. Joy Phumaphi, former Minister of Health of Botswana and co-chair of the Global Preparedness Monitoring Board, and Minister Budi Sadikin, Minister of Health, Indonesia. Well, thank you all so much for making the time to join us during this very busy week. Our distinguished panelists need no further introduction. Over the next 30 minutes or so, we will hear from our panelists about some of the key achievements of the Pandemic Fund in its first year, their perspectives on what more it can do, and what they would like to see the Pandemic Fund accomplished in the medium term, and how to do all this with a focus on the role of partnerships. We will have time for two quick rounds of questions and interventions from you all, and then a rapid-fire round. Let me start with Minister Schulze. Germany has been a strong supporter of the Pandemic Fund. Can you tell us why you feel such a Fund was needed and share your perspective on what it would take to build a sustainable financing model for the Pandemic Fund and what the key ingredients of that sustainable financing model would be?

[Svenja Schulze] Thank you. Yeah, this one is better. Thank you very much. I think, the first lesson we learned is there is glory in prevention, and it is much cheaper to invest in a prevention system than to deal with a crisis, and that is something we need to advocate for, because we know it, we have the experience, and now is the momentum because everybody here in the room and outside is still aware of what it means to have a pandemic around the world and what the cost is that is connected to that. Let us use this momentum, let us talk about how to get more money for this Fund because this is really a special Fund. It is a Fund that’s organized collaboration. I think, the first thing that is needed is more donors to join us. Every country needs to be part of it. Preparedness is not just a task for the health ministers, it is the task for the whole society, the task for the whole government, also the task of the finance ministers. Second, what I’d like to say is, we need, by showing good progress and good results, that that is the right answer, and we have such inspiring examples here from Bhutan, from the other countries that shows that it’s the right instrument. Let us use this instrument and talk about it. Talk about it, not only in our circles, not only inside, we need to communicate to citizens, to parliaments, to the ones who decide about the budget because they are the ones we need to invest in that Fund. Just talk about how important it is to be prepared, how important it is to avoid a pandemic, as we see now with COVID-19, and to be better prepared for the next pandemic. Last but not least, let us mainstream into the work of other actors. I'm a minister for development and I know how important it is to have a global health system, how important it is to realize that pandemic preparedness is a global public good. It requires cross-border cooperation, it requires a collective global action and to provide that, we need all hands on deck. We need the multilateral banking system. Ajay Banga told us in the beginning what they can do and how important that is. We need everybody on board who is available. Let us talk about that, let us advocate for it. I know it is hard, but I think it is the right time now to do so.

[Priya Basu] Thank you, and thank you for that call for support to the Pandemic Fund. If I can now turn to Minister Anthony. Minister Anthony, you're also on the board of the Pandemic Fund and you're also actually on our Conflict-of-Interest committee, you play many roles on the Pandemic Fund. The Pandemic Fund's first call for proposals was eight times oversubscribed. Can you paint a picture for those in the audience of what is driving this demand and what the need looks like on the ground?

[Frank Anthony] Well, thank you very much, Priya. Distinguished panelists, excellencies. First of all, allow me to also extend my congratulations to the Pandemic Fund on our first anniversary. I think the eightfold demand that we are talking about shows that there's a real need for financing in terms of pandemic preparedness. We just heard from Bhutan and their need, and this is echoed by many countries who have applied to the Pandemic fund. In fact, I think there were 179 proposals, 133 of which was single country proposals, and the rest were basically from different regional groups, so it shows that there's a real need out there. The areas that the Pandemic Fund focused on that is human resources looking at surveillance systems, laboratory systems, shows that in the real world, these are things that are totally necessary. We saw that during the pandemic that one of the challenges was that countries did not have enough human resources, countries did not have capacity to surge, if they had a surge, how to prepare for that and have enough people to do that. But with the resources now that are being made available, countries would be able to now respond appropriately. Surveillance systems, most countries, our surveillance systems are either looking at human diseases or maybe in terms of zoonotics, we've been looking at that, but we don't have many surveillance systems that are combining both. That is why you see a lot of the proposals that came in, actually advocated for a One Health approach, where we can combine this and be able to see when there's a jump from a zoonotic disease into the human population. Of course, laboratory systems. We know that with COVID, many countries did not have the capacity to do genetic sequencing, which was absolutely essential for us to understand what was going on with the pandemic. The three-focused area of the Pandemic Fund is actually really good, and I think that's why so many countries responded because they needed to build that capacity within their countries or within the regions. I think that's what is driving it.

[Priya Basu] Thank you. Thank you, Minister Anthony. It's very reassuring to know that the three focus areas that you actually, the board of the Pandemic Fund prioritized were indeed the ones that countries felt were important, and I guess that also the demand speaks for itself. Dr. Phumaphi, as the co-chair of the Global Preparedness Monitoring Board, can you share your assessment of where the world currently stands in relation to pandemic risk and preparedness and talk about the role of the Pandemic Fund?

[Joy Phumaphi] Thank you so much. I hope you can hear me. Thank you. Your excellencies and distinguished guests, and participants. In about six weeks’ time, the Global Preparedness Monitoring Board will be sharing its first report that is based on the monitoring framework that we released in May this year. We are currently reviewing the assessments of the financing, of the governance and the systems of pandemic prevention, preparedness and response that we currently have globally, and the results are not encouraging. I want to highlight three key points that are emerging from our analysis. First, the trust deficit is the single biggest threat to resilience. Inequity, geopolitical divisions and the disinformation that we are all exposed to are just three of the underlying causes that feed on each other to widen the deficit even more. It is imperative that we rebuild trust through accountability and transparency, and I thank the honorable ministers, who are here, who are talking about how important it's to share data. Thank you, honorable minister. Community engagement. This is not just our battle, it's everybody's battle, and strengthening multilateralism. We are falling behind, that's our second message, major advances were made in response to COVID-19, but these advances are not being sustained, and there is evidence that the infrastructure created is being dismantled. We need concerted efforts to retain, to sustain and to extend preparedness and response capacities without which the world will be deeply vulnerable to the next crisis. The third message I would like to share is that there are huge knowledge and monitoring gaps in many key areas of pandemic prevention, preparedness and response. One of these, of course, is financing, but we also lack robust and current data on national expenditures and on international financing and their efficiency and effectiveness. Hence, the mechanisms to align resources with priorities are not there. We are particularly concerned that the lack of attention to independent monitoring, which is essential for providing objective assessments of capacities and capabilities in order for us to address the gaps effectively. The language in the political declaration that is going before our heads of state this week does not give us confidence as a board that countries will be able to recognize the importance of those gaps. We will say a lot more about this in our forthcoming report and also provide some recommendations to address these issues. Thank you so much, Priya.

[Priya Basu] Thank you, the role of independent monitoring. Minister Budi, thank you for Indonesia's leadership on the Pandemic Fund under your G20 presidency. Can you talk a bit about why you felt it's important to create a new dedicated financing mechanism for pandemic prevention, preparedness and response and what you hope to see accomplished?

[Budi Sadikin] In the aftermath of World War II in 1944, global leaders sit together with the spirit of teamwork and solidarity in Bretton Woods, United States and established two great financial institutions, called the International Monetary Fund and the World Bank, two great institutions in global finance architecture that not only saved the world for the aftermath of the World War, but also protected the many countries in the world for financial and economic crisis after the establishment of these two great institutions. History repeats itself. In 2022 in Bali, Indonesia, global leaders sit together again and established this Pandemic Fund that I believe will play a significant pillar in global health architecture, that not only will save the world for this current pandemic, but also, hopefully will protect the world in the future pandemics to come. I wish a hundred years from now when people talk about the Pandemic Fund, it's like people talk about the IMF and the World Bank, that this Fund protected the world during the pandemic years ago, but also protected the next generations or the generation after the next generation for future pandemics.

[Priya Basu] Tall order, Minister Budi. If I can now turn to our second round, Minister Anthony, can you talk a bit about how the Pandemic Fund is disrupting business as usual on the ground and how's this playing out in some of the projects that are being supported under the first round? We heard from Bhutan, Brazil and Moldova, but there are also projects in the Caribbean. What do you think it will take for the Pandemic Fund to help break silos in global health financing and promote partnerships and coordination? Are some of these projects already beginning to do that?

[Frank Anthony] Well, thank you very much. I think there are lots of things there. I think, first of all, the fund itself, it has shown that with every dollar that the fund is putting up that we're getting an investment worth 6 dollars more. I think that's very important. Now, we have all seen that with the call for proposal that there's really, we need more money to be able to finance all that we need, and we are way behind. Whatever monies we have right now, we have to make sure that it's making an impact. Now, one way of doing that is to make alliances. The way that the Pandemic Fund has been organized was to reach out to other organizations working in health, to regional bodies, and to see how to catalyze the funding that they have, so that we can make a bigger impact. I think, with the projects that would unfold, we'll be able to test that because in the current round, we have three regional projects and we have single country projects. We have single country projects of varying magnitude, and they're looking at different things, so we'll see how that works. But I think the need is real and we just have to make sure that we are making that impact, and also, to advocate so that we can get more money to continue this good work. As was said before, it's not if we'll get the next pandemic, it's when and how prepared are we going to be and that's why we really need this to work and we really need the financing to come in, so that we can be very well-prepared.

[Priya Basu] Thank you. Minister Schulze, if I can ask you, what would you like the Pandemic Fund to accomplish in the next three years? What would success look like for you, and particularly, what role do you see for partnerships in all of this?

[Svenja Schulze] Yeah. Thank you very much. I absolutely agree with what is said that this Fund need to contribute to better prevention, to better preparedness, to better partnership, to better working together. It needs to leverage existing funds and existing actors. It needs to be prepared or how gender aspects or participation of civil society are considered integrated at all tasks that are possible. I think what is needed is also a global learning process, because we know a lot. We know a lot in the One Health approach, but bringing that into the discussion about preparedness, learning from each other, sharing the data as you mentioned before, having more civilians, more monitoring, hopefully, good practice exchange, that is what is needed in the world and the Pandemic Fund can be a real contributor for it. I think having a catalytic role, that is what was mentioned before a lot of times, and I want to underline it, the Fund is able to be really a catalytic fund to bring knowledge to the world and that it's really, really important to be prepared.

[Priya Basu] Thank you. Minister Budi, you spent many years with the private sector before becoming minister, what kind of partnerships with the private sector would you want the Pandemic Fund to pursue?

[Budi Sadikin] I noticed, when the virus came, they didn't choose the finance minister against the health ministers. They didn't choose the CEO of Pfizer that maybe kills the virus or the CEO of Boeing that helps spreading the virus faster. There is no exclusivity for this virus to attack human beings, so that is also, I believe the reason why it cannot be exclusive to tackle this virus. We need to be inclusive, we need to work. It cannot be a program that was developed by G20 countries, or by WHO, or by the Ministry of Health in every county. It has to be developed as a movement where every one of us, whether you are public sector, you are private sector, you are young, you are old, you're coming from a developed country or a developing country, we work together to prepare for the next pandemic. I strongly believe, if we approach this as a movement where every one of us is working together, then we will become more prepared when the next pandemic comes.

[Priya Basu] Thank you, so really, all of society engagement. Dr. Phumaphi, the Pandemic Fund’s success will depend on other ongoing efforts, we are one tool in the global health financing architecture. In your view, what are some of the key external factors? You already talked about monitoring, independent monitoring, but any other external factors that will determine the Pandemic Fund's ability to fulfill its promise of helping developing countries build resilience to future global health threats?

[Joy Phumaphi] Thank you. I think, the one, obvious one, of course, is that the Fund needs more resources. I think one avenue that the Fund might like to explore is to look outside the traditional sources of funding, that is, outside the government. The resources right now in the global economy are with the private sector. I would say, even if it is a funding model where the resources are not attributed to the private sector, a partner who contributes, because I know that there are sort of political implications that are often associated with that, but I think it is worth exploring, tapping resources from the private sector, given the potential threat of the next pandemic, which we know definitely is coming. I would like to applaud the Pandemic Fund for adopting a model that is demand-led, that is led by the needs of countries, and for also harnessing the power of the multilaterals in supporting countries as implementing partners. This is a very, very important model, and I'm hoping that the next phase of this support, as implementing partners within countries, is to build the capacities of countries, so that the Fund reaches a stage where countries themselves are the implementing partners and not the multilaterals. I would really like to commend the multilaterals for working together as a cohesive role in supporting countries with this particular model. Lastly, the Fund does need to also operate outside the countries. I would like to see the Fund being able to support cross-country efforts, regional efforts at pandemic preparedness and response, because it is this holistic, more holistic funding, that will actually enable the preparedness that is required. Thank you.

[Priya Basu] Thank you. I think we have time for just a last round, quick messages, major messages that each of you would want to just fire at us. Maybe if we can start with Minister Budi.

[Budi Sadikin] If you have a good preparation for the next war, that is a guarantee you are 50% or 60% likely to win the next war, so just be prepared and save your money during peace time for the next wartime. Thank you.

[Joy Phumaphi] Thank you. It is three years since the GPMB called for the establishment of a fund. A fund that is flexible, a fund that is accessible to all stakeholders, and a fund that would be holistic. I just want to applaud every partner who has contributed to this Fund and plead with them to continue to support the Fund, but invite other stakeholders to contribute to this Fund, because without an effective fund to finance pandemic prevention, preparedness and response, the next pandemic is going to catch us with our pants down. Thank you.

[Frank Anthony] I think, the recurring theme here is that we need to put more money into the Pandemic Fund. We have a large need, we don't have enough resources to distribute to the countries, so that they can build up that resilience. Now, look at it. We are asking for about 10 billion dollars annually and that sounds like a lot of money. But look at the destruction to the economy over the last couple of years with COVID shutting down almost everything. Every sector was affected, not just health, the economy, education, everything you can think about. That cost the global economy trillions of dollars, so we need to think about that, and we don't want to be in the same place with the next pandemic. We need to upfront the money to make the investment to prevent that from happening again.

[Svenja Schulze] We need to remember that this is really a successful fund, but it is a very, very young fund. We just have the first anniversary, so we are still in the beginning of the Pandemic Fund's life. The learning process has started and is ongoing and let us integrate the lessons step-by-step to make the Pandemic Fund as successful as possible and let us advocate for more money. It is really needed.

[Priya Basu] Thank you. Thank you so much. That was a very rich discussion, more money for the Pandemic Fund. The Pandemic Fund is a catalyst for resources, but a catalyst for knowledge as well. A strong focus on learning, a strong focus on monitoring. Evaluation, and then doing better along the way, because we're still very new. Overall, thank you so much for your words of wisdom and for your encouragement, and we will do our best to fulfill the ambitions that you've set forward. Thank you again, and if you could join me in giving a huge hand too. Thank you. We are nearing the end of our program, but we do have some time for brief interventions from the floor. If I can call upon Minister Chrysoula Zacharopoulou, Minister of State for Development, Francophonie and International Partnerships of France to share a few words from the floor please, Minister Zacharopoulou.

[Chrysoula Zacharopoulou] Thank you very much. Of course, on behalf of the French government, I'd like to say congratulations to all of us, if I can say, for the first anniversary. As you said Svenja, that it is a success and France is proud also to be part of this board. Of course, I listened to all of you that you speak about money, I'm a doctor, I'm a physician. The money is good, of course, but I think that the pandemic and as I was in frontline, what I learned is that we need strong health systems. This is somewhere that I hope that with this Fund we can work to reinforce the health systems. When we speak about the health system, a resilient health system, we speak also about trained health workers. This is important, not only the infrastructures but also the training of health workers. Another thing that I'd like to underline and is my third message, I think that the most important is that the Pandemic Fund must be fully integrated to the new global health architecture. It must be coordinated with other initiatives, in particular those from the United Nation systems. Tomorrow, the United Nations General Assembly will hold its first high-level meeting of pandemics. As we speak, negotiations are ongoing in Geneva under the aegis of WHO on an ambitious pandemic agreement. I think, the Pandemic Fund must be a financing tool coordinated with this multilateral initiative to enable them to bear fruits, particularly for the vulnerable countries. Voila, merci.

[Priya Basu] Thank you. If I could now call upon Minister Zahid Maleque from Bangladesh, Minister of Health, Bangladesh.

[Zahid Maleque] I think it'll be better if I speak from there, so I can see the audience and the audience will not have the pain in the neck then. Sorry. Good evening. I am Zahid Maleque, health minister of Bangladesh, which has got a small population of 170 million. During the pandemic, you know how I had to go around and I just jumped here and during the pandemic, every day I used to jump around. That was a big job for all of us. The pandemic taught us a lot of things. It taught us the weakness of the hospital system that we have, the inadequacy of equipments, then manpower, and then supplies and also, of course, funding. Bangladesh, being a low middle income country, it tried to address the pandemic with the leadership of Prime Minister, Sheikh Hasina. We gave about 370 million doses of vaccines. In one day, we gave about 12 million vaccines in one day. Probably, that was one of the highest we did in one day, this 12 million in one day. During the pandemic, we employed about 12,000 doctors and 20,000 nurses during the pandemic. You can see the requirement. There was only one lab, and so we had to build 200 labs. Even in the private sector, they installed 600 labs. This fund requirement is, of course, very important. If we fail to prepare then we are preparing to fail. This is the first year anniversary, though we don't have a cake to observe this anniversary, but I know that many countries have already got slices of the cake. I am sorry to say Bangladesh just missed any cake or any slice. Hopefully, next time we will get it. A small slice will be enough for us, because we had to support our big population. We have to support the business also. About 15 billion dollars has to be pumped in one year, and we had to spend in only in vaccine about 4 billion dollars in vaccination only. Just to cut it short, the objective is to have an efficient surveillance system. That is one we felt, an early warning system, that saves lives. The laboratory network has to be strengthened because without proper laboratory you cannot treat your people. Doctors and nurses, they run away from the patient because they don't know what is the patient is about. That is very important. It has to be a multi-sectoral approach, regional approach. Of course, international approach has to be there. Of course, adequate funding is required. Everyone has spoken about the funding, and we know that without funding nothing moves, that is the lifeblood. Also, we have to have the planning. The planning has to be there, training has to be there, because only funding will not be able to treat people. That is all I have to say. Thank you for the patience hearing. Thank you.

[Priya Basu] Thank you. Thank you, Minister Maleque. If I can now call upon Jamoliddin Abdullozoda, Minister of Health and Social Protection of Tajikistan. I think you'll be interpreting? Yes, okay.

[Jamoliddin Abdullozoda] I'm sorry. With your permission, I will read my report in Russian and my friend will translate in English language. [Speaking in Russian] Dear moderator, dear colleagues, excellencies, on behalf of the government of Tajikistan, I would like to thank the World Bank for its consistent support of the health system, in particular, during the COVID-19 pandemic for Tajikistan. As you know, in September 2023, for the initiative of G20, the Pandemic Fund was created, which has 2 billion financing fund, it will strengthen health system and help solve existing shortcomings in budget for the next five years. In May 2023, the Ministry of Health and Social Protection of Tajikistan with support and collaboration with the development partners deviced the draft proposal and submitted to the Pandemic Fund. At the same time, Tajikistan also endorsed and supported the regional initiative for multi-sectoral, single window for Central Asia. The country proposal was focused on strength and increasing the potential of response agencies enclosed multi-sectoral cooperation, as well as logistical surveillance control, infection-pandemic surveillance. As you all know, climate change and its consequences often come together with outbreak of infectious disease. In some cases, it's epidemic and pandemic as well. Due to its geographical location the republic of Tajikistan is prone to such consequences. Mainly, we have the problems in the wintertime, some centers are cut from medical centers. In order to strengthen the health system in the future, the Republic of Tajikistan is willing to be in part of a negotiation process for the next funding proposal and we are willing to be part of those negotiations for funding. We hope for the support of the World Bank and the Pandemic Fund for this initiative to strengthen the prevention and control of, as well as the health system for Tajikistan. Thank you very much for your kind attention.

[Priya Basu] Thank you so much. I'm conscious that we're losing our audience, people have to move to other engagements. Is there anyone else that would like to come in with an intervention from the floor? Yes, I see a hand up there and another one there.

[Beth Dunford] Thank you very much. I'm Beth Dunford from the African Development Bank. I really wanted to just congratulate the Fund on its first year. We know that health crises are really a major source of shock and fragility on the continent of Africa that's dramatically increased, and we see how quickly that health service delivery infrastructure is overwhelmed. The Pandemic Fund is a key partner and player in really addressing this issue, and the African Development Bank is proud to be an implementing entity of the Pandemic Fund. What we do is we bring our experience in combining infrastructure financing with the focus on health service delivery and really look forward to partnering with the Fund and leveraging our strategy for quality health infrastructure as we advance and implement the fund on the continent. Thank you very much.

[Priya Bas] Thank you very much, and thank you for being part of our implementing partner group. I see, Danny Alexander from the AIIB.

[Danny Alexander] I'll be super brief, just to say that from the Asian Infrastructure Investment Bank, we also really appreciate being an implementing partner of the Pandemic Fund and congratulate you on what you've achieved. The pandemic really made us, as a new institution, recognize the importance of investing in health infrastructure. We will have committed nearly all of the 20 billion dollars we set aside for the crisis recovery facility to support our members to recover. We're really pleased also that the One Health Project in Cambodia has been selected as one of the first projects. I think it has a lot of characteristics that seem to be very much at the heart of what the Pandemic Fund is trying to do. It's a One Health project bringing human and animal health together. It's a collaborative project with AIIB, Asian Development Bank, World Health Organization, UNFAO, the World Bank, all coming together. It's a country-driven project, very much led by the government of Cambodia. We hope very much that there'll be more of these integrated, collaborative, country-led projects that we can work on together in future. Congratulations on your first anniversary and look forward to many more such anniversaries in the future. Thank you.

[Priya Basu] Thank you very much, and looking forward to the partnership. If I can just share, I think the majority of the projects that we've supported under the first round have a One Health focus that look at the interplay between sectors. Was there anyone else that wanted to? Elisha is our board member representing civil society.

[Elisha Dunn-Georgiou] Hi, everyone. Thank you, Priya. As she said, Priya said, my name is Elisha Dunn-Georgiou. I am on the governing board of the Pandemic Fund as a civil society representative for the Global North. I just wanted to also share everyone's congratulations that we're at one year. We're speaking of it as if it's an anniversary many years in future but it's one year. We're an infant. The Pandemic Fund is an infant, and that means that we need to be nurtured still, and I think we've heard that call from everyone who's spoken for financing, that is certainly key to the nurturing. But I also just want to raise up some of the principles that the Pandemic Fund started with, accountability, transparency, and inclusivity. Those too need to be nurtured. We've moved now from the governance phase of just the setup to first calls for proposals going out to countries. Those principles need to be replicated as we move into implementation. Certainly, I would be remiss, as a civil society representative, if I didn't stress the need to continuously include civil society and communities, not just in service of a project, but in the co-creation and co-design and the decision-making as projects are developed for future calls and are implemented. Of course, all of this requires money, so I will put in a plug as everyone has for funding, and I think that we're off to a terrific start with the way the Fund governing board is set up in being inclusive. We have donor countries, co-investor countries, philanthropies, civil society, all sitting together, making really important decisions about preventing future pandemics. We need to see that continue as the Fund gets to be 2, 3, 4, 5. I think, Mr. Budi was talking about it being as old as IMF and World Bank, so hopefully, we'll get there, but we just need to really think about what nurturing as a whole looks like, it's more than just money. Thank you.

[Priya Basu] Thank you. Thank you so much for sitting through. Thank you for your partnership. Thank you for your encouragement. Thank you for the ambition that you've put forward. We have drinks outside, so please join us if you have time. Thank you very much again. A huge round of applause for everyone.