Overdue: Global Fund Against Pandemics

Disease outbreaks are accelerating and intensifying, sped up by climate change, deforestation and wildlife trade.

It doesn't have to be this way.

Learn about the plan in the infographic below.
Then join the movement to win.

ADDITIONAL RESOURCES:

World Bank Ratifies HISTORIC Pandemic Fund, but our global health breakthrough is threatened by exclusions of poor countries and spillover prevention. Read our statement here.
Read R2HA's recommendations responding to problematic World Bank white paper on financial intermediary fund (FIF) for Pandemics
R2H submits input to the World Health Organization's Health Emergency Preparedness and Response (HEPR) Paper at the 2022 World Health Assembly. Read our statement here
LEAKED World Bank Board Memo leaves out countries and communities—and fails to stop pandemics.
INFOGRAPHIC below is based on a memo co-written by Right to Health Action and Health in Harmony. Download the memo here.

Graph by Vora et al, 2022. Available at: https://www.nature.com/articles/d41586-022-01312-y

Deadly diseases are accelerating rapidly and become more deadly

Economists conservatively predict that COVID-19 will cost the global economy at least $16 trillion

Containment-alone, without action to prevent outbreaks, is ineffective, costly, colonialist, and dangerous to global communities

Stop outbreaks before they happen

The Pandemic Fund must be accessible and accountable to low-income countries, stigmatized populations, and front-line communities

Borneo Model of listening to communities brings results:

67% decrease in infant mortality
>90% reduction in logging households—corresponding with a steep reduction in outbreak risk.
significant declines in malaria, tuberculosis, neglected tropical diseases, chronic obsuctructive pulmonary disease, and diabetes
poverty alleviation
21,000 hectares of forest regrowth
$65.3 million in averted carbon loss

Break Deadly Silos:

Development and conservation work has been for too-long isolated in health, security, agriculture, education, or microfinance silos.

Global health and climate advocates rarely sit at same table.

It's time for donor governments to fund an intersectoral, systems-based approach.

Pandemics are coming faster—and getting worse.

There were 6 times more zoonotic spillovers of disease from animals to humans in 2010 than in 1980.[1,2] Scientists report a direct link between zoonotic diseases and tropical deforestation.[3] We already know what to do to definitively stop the pandemics of the future.

A G20 High Level Independent Panel reported “The current pandemic was not a black swan event. Indeed, it may ultimately be seen as a dress rehearsal. …There is every likelihood the next pandemic is coming within a decade or even in the next year, and could be even more profoundly damaging to human health and the global economy than COVID.”[4] Policymakers must anticipate, and plan for a pandemic sooner, rather than later, that is as contagious as COVID and as deadly as Ebola.[5]

Inaction is more expensive than prevention

The costs of COVID to the U.S. economy alone is estimated at $16 trillion.[6] Experts from McKinsey to Harvard's Center for Climate, Health, and the Global Environment agree

comparatively modest global investments of as little as $20 billion annually will avert $31-$50 trillion in economic losses—and save millions

of lives.[7][8] By all counts, insufficient action is overwhelmingly more expensive than even the boldest pandemic prevention plan.

We need both containment and prevention

More than two years after COVID-19 exploded worldwide, policymaker discussions of “pandemic preparedness” are still overwhelmingly focused exclusively on containment — that is, detecting future outbreaks sooner, and responding faster to stop the spread of diseases. Containment is urgently important, as is every possible measure to support developing countries to fully implement an expanded version of WHO's International Health Regulations (IHRs) agenda.

But, as COVID-19 has demonstrated repeatedly, even the most prepared, best resourced national containment plans are defeated in the face of increasingly aggressive viral antagonists — even more when factoring in vaccine hesitancy.

What is missing is action to stop outbreaks from happening in the first place. Global leaders seeking to stop pandemics must incorporate an additional, high-priority focus on tackling the environmental drivers of zoonotic spillover. Without true prevention measures, the globe is merely paying to send outmatched firetrucks to a raging conflagration. We propose instead models that stop the fire from ever igniting.

A pandemic prevention model:

Set measurable goals for containment--traditional global health security. Put funds on the table to meet the IHRs in all low- and middle-income countries in five years. But don't stop there.
Direct funding towards the proven spillover prevention models that reduce deforestation by 80-90% and higher, steeply reducing risk of outbreaks. Bring these models to scale, and replicate across all high-risk zoonotic spillover communities.
Spillover prevention includes significant knock-on benefits for human and animal health, human rights, and climate, biodiversity and wildlife conservation.
Support large-scale, pathogen-agnostic global surveillance systems
Always-warm system ready to produce vaccines worldwide in 100 days (not three years) and share the products of public research.
Train and retain professional and community health workers needed to support the health systems we need to stop pandemics and realize the right to health.

What a Global Pandemic Fund should fund:

Pandemic Containment and Prevention Plans in low- and middle-income zoonotic spillover hotspot countries.[9]
Set a deadline to meet World Health Organization IHRs and Global Health Security Agenda targets to contain outbreaks, building health systems, and moving towards the human right to health.
Support community health, jobs training, and policy changes to halt deforestation and unsafe wildlife trade.
U.S. contributions to a Global Pandemic Fund should be matched by other donors 2:1
Repeat success by copying the Global Fund to Fight AIDS, TB and Malaria’s lean structures of Secretariat / North-South-CSO Board / Country Coordinating Mechanisms (see below).

Case Study Indonesia: Cost-Effective Pandemic Prevention

In 2007, a program in Indonesia asked Indigenous communities in the Borneo Rainforest, “What do you need to stop logging?” The community deliberated and finally responded that, in a deforestation-based local economy, they would need alternative livelihood training—new jobs. They also responded that the highest local costs to individuals was health care.

In response, Health in Harmony, the NGO leading the work, invested $5.2 million over 10 years in an Indonesian medical center, as well as a locally operated jobs training program. The organization is now replicating this model, protecting nine million hectares of tropical forest at sites in Indonesia, Madagascar, and the Amazon — an area larger than the UK. Researchers from Stanford University analysed 10 years of data from the most mature site in Borneo, and published their findings in the Proceedings of the National Academy of Sciences. [10]

How a Global Pandemic Prevention Fund should operate:

To facilitate locally-designed, country-owned health systems and solutions that are effective and sustainable, a new pandemic prevention initiative can borrow pages from the Global Fund to Fight AIDS, TB and Malaria (GFATM):

Donors contribute to a pool. Poor countries apply, jointly with civil society, faith-based organizations (FBOs) and the private sector.
The initiative’s board should include an equal number of donor and implementing countries, and include protected seats for civil society, Indigenous people, and communities disproportionately impacted by COVID-19 and future pandemics.
Replicate GFATM’s “Country Coordinating Mechanism” to convene civil society, public institutions, and communities to create national and community-level Pandemic Prevention Plans and submit for funding.
At the national- and community-level in zoonotic spillover hotspot countries, convene public sector health officials, civil society, faith-based organizations and public health institutions to devise costed country- and community- owned plans to to stop spillover events, and meet IHRs priority actions identified in joint external evaluation (JEE) reports.
Use online listening and training programs in conjunction with WHO to convene in-country teams to meet with Indigenous and local rainforest communities to learn about the drivers of - and determine solutions to - forest degradation.

Fund Memos

This infographic was adapted from a memo co-written by Right to Health Action and Health in Harmony. Download the memo here

References

[1] Smith, K., Goldberg, M., Rosenthal, S., Carlson, L., Chen, J., Chen, C., Ramachandran, S. (2014). Global rise in human infectious disease outbreaks. J R Soc Interface, 11(101). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223919/

[2] McKay, B., Dvorak, P. (2020). A Deadly Coronavirus Was Inevitable. Why Was No One Ready? | The Wall Street Journal. [online] Available at: https://www.wsj.com/articles/a-deadly-coronavirus-was-inevitable-why-was-no-one-ready-for-covid-11597325213

[3] Bloomfield, L.S.P., McIntosh, T.L. & Lambin, E.F. Habitat fragmentation, livelihood behaviors, and contact between people and nonhuman primates in Africa. Landscape Ecol 35, 985–1000 (2020). https://doi.org/10.1007/s10980-020-00995-w

[4]G20 High Level Independent Panel Report on on Financing Pandemic Preparedness and Response, A Global Deal for Our Pandemic Age. [online] Available at https://www.g20.org/wp-content/uploads/2021/07/G20-HLIP-Report.pdf

[5]Kiley, S., Formanek I., Kottasová, I. The Coming Contagion: Hunting for 'Disease X' CNN [online.] https://www.cnn.com/2020/12/22/africa/drc-forest-new-virus-intl/index.html

[6] Powell, A. (2020, November 10). What might COVID cost the U.S.? Experts eye $16 trillion. Harvard Gazette. [online] Available at https://news.harvard.edu/gazette/story/2020/11/what-might-covid-cost-the-u-s-experts-eye-16-trillion/

[7] McKinsey & Company. Not the last pandemic: Investing now to reimagine public-health systems. Accessed online: 30 Nov 2020: www.mckinsey.com/industries/public-and-social-sector/our-insights/not-the-last-pandemic-investing-now-to-reimagine-public-health-systems

[8] “Ecology and Economics for Pandemic Prevention,” Andrew P. Dobson, Stuart Pimm, Lee Hannah, Les Kaufman, Jorge A. Ahumada, Amy W. Ando, Aaron Bernstein, Jonah Busch, Peter Daszak, Jens Engelmann, Margaret Kinnaird, Binbin Li, Ted Loch-Temzelides, Thomas Lovejoy, Katarzyna Nowak, Patrick Roehrdanz,and Mariana M. Vale; Science, July 24, 2020. Accessed online at https://science.sciencemag.org/content/369/6502/379

[9] Allen, T., Murray, K.A., Zambrana-Torrelio, C. et al. Global hotspots and correlates of emerging zoonotic diseases. Nat Commun 8, 1124 (2017). https://doi.org/10.1038/s41467-017-00923-8 [online] https://www.nature.com/articles/s41467-017-00923-8

[10] Jones, I. J., & et. al. (2020, November 10). Improving rural health care reduces illegal logging and conserves carbon in a tropical forest. PNAS. https://www.pnas.org/content/117/45/28515

[11] Deforestation has slowed down but still remains a concern, new UN. (2020, July 24). UN News.

https://news.un.org/en/story/2020/07/1068761#:%7E:text=The%20annual%20rate%20of%20deforestation,12%20million%20during%202010%2D2015.

[12] Kinari, Webb. Reentering the Paris Climate Agreement is a must, but no panacea. The Hill, Dec 2020. [Online] https://thehill.com/opinion/energy-environment/530967-reentering-the-paris-climate-agreement-is-a-must-for-the-us-but

[13] Jones, I. J., & et. al. (2020, November 10). Improving rural health care reduces illegal logging and conserves carbon in a tropical forest. PNAS. https://www.pnas.org/content/117/45/28515