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In May, the World Health Assembly — the decision-making body of the World Health Organization — will have its 77th annual meeting. At this year’s meeting, delegations from WHO member states will discuss and agree upon a plan to respond to future pandemics.

As we reflect on these last four years of the global response to COVID-19 — and previously, the Ebola response in West Africa, among others — it is clear that countries (especially developing countries) and development sector funders need to put in place financing frameworks to support both general and disease-specific emergency response plans. Without financing frameworks developed to rapidly deploy resources for medical treatments and health commodities, we do not stand a chance of limiting the spread of highly infectious diseases. It is also evident that without meaningful engagement from the private sector in the preparedness effort, countries will be hamstrung in their preparedness, unable to develop and implement effective response plans.

In advance of this crucial meeting, the article below explores a topic that should be top-of-mind among the Assembly’s delegations: the role the private sector should play in financing and implementing preparedness plans for future pandemics and epidemics.

Emergency Financing for Pandemic Response Efforts

As we saw with both the COVID-19 and Ebola response efforts, when a pandemic or major epidemic hits, there usually aren’t adequate funding reserves and systems to enable the fast mobilization of finances. Part of emergency preparedness and response is ensuring that financing is planned for ahead of time, with mechanisms to release this support when needed. This includes financing for medical treatments, vaccinations, IV fluids, protective gear and other healthcare commodities. It also includes resources to support people during lockdowns and to reimburse businesses in industries that are affected, like airlines, as well as small business owners.

Because this financing is needed quickly, countries worldwide should consider setting up emergency financing frameworks to guide the release of funds and other support. This includes setting disease-specific thresholds at which differing levels of financial and other support can be unlocked. In developing these frameworks, we can learn from the World Bank’s experience with the (now closed) Pandemic Emergency Financing Facility, which helped fund COVID responses in over 60 countries. These proposed frameworks would be implemented through such a facility, and would have predetermined thresholds or triggers, which would make preset payouts when reached. These triggers or thresholds could be based on the total number of cases, the timeline from the initial case, the rate of spread, the number or frequency of fatalities, or other factors. In this way, if a country hits a certain ceiling of cases or an estimated infection rate, funds would be released. The goal is to have these funds released so action can be taken to keep the disease outbreak from becoming a larger in-country or regional epidemic or pandemic. As cases increase, higher levels of financing and other types of support would be unlocked. Countries, or regions, could implement such a facility as an insurance policy, so in the event of a health crisis, they have resources to support the measures that are most needed, along with a framework to guide this process.

This financing facility should also fund the response from various industries that play a role in limiting the spread and impact of epidemics. For example, we saw during the COVID-19 pandemic how challenging it was for industries to mobilize or pivot to provide equipment and commodities at massive scale on short notice. Already, a number of countries are working to improve these supply chains’ effectiveness during emergencies, with some, such as Kenya, developing emergency supply chain frameworks to guide their efforts during these times of crisis.

In addition to this valuable work, a robust epidemic/pandemic preparedness plan could include template agreements with manufacturers that can be signed and deployed immediately. It could also include procedures for rapid in-country approval of new medical products and technologies, and procurement plans for the transport of goods to last-mile locations. And it could enable fast-tracked plans for vaccination dissemination and rapid deployment of emergency human resources in a surge capacity. The financing facility discussed above would fund the implementation of these plans, and ideally, limit the spread and impact of epidemics.

The Need for Private Sector Engagement in Epidemic Preparedness and Response

The private sector is an often-underestimated player in epidemic/pandemic preparedness and emergency response. It is crucial for emergency response partners to meaningfully engage the sector, because it is both significantly affected by epidemics (and especially by response actions, including lockdowns), and because it can help buttress efforts to prevent and respond to them. The private sector can play key roles in the following areas:

• Investing: Private investors can provide funding for preparedness, and specifically for research and development around vaccines and therapeutics. For example, the Partnerships for African Vaccine Manufacturing Framework for Action and the Africa Vaccine Manufacturing Accelerator initiative championed by Africa CDC and Gavi to enhance vaccine manufacturing capacity on the continent will go a long way toward enhancing Africa’s epidemic preparedness and response.
• Technology and innovation: The private sector can develop various tools, especially those that predict and monitor epidemics and those that model their likelihood and evolution. It can also create solutions that support emergency response and communication efforts. IDinsight, for instance, partnered with Reach Digital Health to develop chatbots to aid communication within communities during the COVID-19 pandemic. Private sector players can also help governments take targeted actions by leveraging artificial intelligence to help identify the areas that are likely to be most affected by a pandemic (e.g., based on living or sanitation conditions), or that are likely to require response actions (e.g., based on socioeconomic status). This is what happened in Sierra Leone during the COVID crisis, as the country — with the support of private partners — used prediction modeling to inform the duration of lockdowns based on the likelihood of access to basic necessities in different communities.
• Health service delivery: In many countries, private healthcare providers account for a significant proportion of care across the value chain — from diagnosis, treatment and prevention (including vaccination), to rehabilitation and logistics (e.g., laboratory specimen referral). These providers must be engaged to contribute effectively to pandemic preparedness and response. For instance, some countries have leveraged private laboratories to provide advanced laboratory testing for COVID and other conditions, and the practice of using private companies in specimen referral is commonplace, with HIV, TB and other specimens often transported by private sector players — even between public sector facilities. Other private businesses are offering more novel approaches — e.g., using drones — for health commodity transportation in parts of Africa and elsewhere. These companies and networks are well-placed to be leveraged during epidemics.
• Insurance: The private sector plays a significant role in insuring epidemic preparedness and response operations. This includes underwriting key elements of epidemic preparedness plans, like human resource mobilization, and medical equipment and commodities procurement and supply chains, as well as the provision of health insurance coverage. The sector should be engaged to ensure adequate and timely payouts and to minimize denials. This can be done through proper structuring of products to enable both adequate coverage for beneficiaries and financial viability for underwriters. The World Bank’s Pandemic Emergency Financing Facility, for instance, leveraged third-party insurers.
• Infrastructure and supply chains: Private manufacturing can be ramped up or repurposed to cater to increasing needs during epidemics. For instance, manufacturing facilities can be refitted to produce response commodities like personal protective equipment and other materials in high demand, and non-medical facilities can be repurposed to create hospitals.
• Workforce protection: The private sector must be engaged in initiatives to protect businesses’ human resources, including taking the lead in responses such as remote working. The private sector led the way with this sort of innovation during the COVID-19 pandemic, such as by creating or scaling up teleconferencing facilities and adapting company policies to support remote collaboration. These changes are still being felt to this day.
• Policy advocacy: The private sector can advocate for policies to enhance preparedness at various levels. These policies should serve the broader public good while also ensuring businesses’ economic interests. They may involve epidemic preparedness/insurance, private sector engagement in national response councils, data-driven decisions on lockdowns to minimize economic and public health harm, etc.
• Community engagement: Private sector involvement is critical in helping with messaging aimed at mobilizing communities to take specific action. The role of the media (both traditional and social media), for instance, is essential in fighting misinformation, communicating messages for urgent action, and rallying communities to adopt and accept various interventions.

Across these various areas, public/private partnerships between government agencies and the private sector are necessary to facilitate information sharing, resource mobilization and coordinated response strategies, without which countries face an uphill task in implementing effective epidemic preparedness and response measures.

As countries and their development partners strengthen their epidemic/pandemic preparedness efforts, these plans will be suboptimal if they are not undergirded by reliable, adequate and timely financing through well-structured epidemic financing facilities, and buttressed by well-structured engagement with the private sector. Without this upfront effort, alignment and financial commitment, countries will not be able to adequately resource or operationalize their emergency action plans. Or worse, the time they spend jumping through bureaucratic hoops to finance their efforts may be the difference between a localized, controlled disease outbreak and a country-wide epidemic or global pandemic with dire social and economic consequences. By ensuring adequate private sector engagement, countries can leverage a significant enabler that will allow them to achieve timely, broad-reaching and meaningful action, which could prevent — or minimize the impact of — future outbreaks.

Frida Njogu-Ndongwe is the Regional Director of East and Southern Africa, and Emily Coppel is Communications Director at IDinsight.

Photo courtesy of World Bank Photo Collection.