International health fund needed to fight pandemics

While the United States and the European Union have expedited their vaccination drive to contain the COVID-19 pandemic, India and South America are struggling to control the second wave of infections due to their slow, even faltering response to the novel coronavirus, especially their failure to vaccinate their respective populations. The new virus variants have put millions of people in different countries, especially in developing nations, at increasing risk.

To prevent the pandemic from causing further harm, there is an urgent need to coordinate international resources to ensure low-to-middle-income countries have access to tests, therapies and vaccines under the framework of COVAX, a global initiative aimed at equitable access to COVID-19 vaccines directed by GAVI, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations and the World Health Organization.

Unfortunately, the COVAX initiative faces many hurdles, such as shortage of vaccine supply, a handful of listed vaccine producers, sovereign legal protection against vaccine exports, complexity of patent waiver, restrictions on materials needed to make vaccines, poor logistics and delivery system in low-income countries, and financial constraints.

True, with the recent inclusion of Sinopharm vaccines in the emergency use list — along with Pfizer/BioNtech, Oxford/AstraZeneca, Monderna and Johnson & Johnson vaccines — the WHO has more producers to source the vaccines from. Yet the WHO should also urge the US and other rich countries to lift their export restrictions on the vaccines, while those running COVAX should take measures to clear the hurdles so the initiative can become a permanent platform in the post-pandemic world. For example, it could register as a not-for-profit organization and have access to an international health fund, which could be established with the signatory countries as stakeholders.

There are a quite few advantages in establishing a global health fund. First, it can buy out vaccine patents, instead of struggling to get intellectual property waiver from pharmaceutical companies, while complying with the market principle of rewarding vaccine makers to ramp up production and promote further innovations to tackle virus mutations.

Second, the fund could be used to streamline vaccine production, boost manufacturing capacity, and strengthen the supply chains and logistics to ensure developing countries get efficacious vaccines.

Third, the fund could make up for the de facto absence of public finance in the field of global public health. Until now, the Bill & Melinda Gates Foundation has been the main organization promoting global vaccine distribution. Though praiseworthy, this philanthropic endeavor is far from enough.

The pandemic has taught us a bitter lesson: that the world needs a permanent international institution tasked with mobilizing resources to cope with health crises in the future. Such an institution would also prompt major world powers to rise above their differences and geopolitical interests and establish a global cooperation mechanism to protect humankind against diseases.

The international health fund could also foster an environment of virtuous competition for channeling resources to address common global challenges such as climate change, in order to promote long-term global benefits.

This is the right time to lay down the institutional foundation for an international health fund and earmark funding from major countries. The COVAX initiative has secured $6.6 billion in pledges, most of them from the advanced economies. The initiative's target for this year is about $10 billion, and the gap could be filled by donors including China.

In the next three to five years, major countries should be persuaded to allocate 10 percent of their official foreign aid for this purpose. Beyond this period, the proposed international health fund could ask the main donors to allot a fixed percentage of their official foreign aid to the initiative.

With the re-allocation of the existing foreign aid from major countries, the international health fund could secure several hundred billion dollars, and/or issue long-term bonds for additional funds. Also, it could build support systems for the development of vaccines for a wide spectrum of infectious diseases, consolidate the global public health infrastructure, store global data in cloud and operate disease surveillance systems to assist public health professionals across the world to warn against possible health crises in advance.

And as an infectious disease spreads, officials of the proposed international health fund could help the WHO and relevant governments to minimize the systemic risks, by extending short-term financing. As for its governance framework, the fund can adapt it from the International Monetary Fund and the World Bank with necessary modifications after consultations with the stakeholders. Considering the catastrophic consequences of the COIVID-19 pandemic, the costs of the COVAX initiative and the proposed international health fund are nominal, but the outcome could be a game changer in pandemic prevention and control.

The author is a professor of economics at the School of Public Policy and Management, and director of the Academic Committee of the 21st Century Development Institute at Tsinghua University.

The views don’t necessarily reflect those of China Daily.