Title page
Contents
Abstract 1
Introduction 5
Definition of the pandemic cycle 6
Categorization of pandemic actions 8
Key epidemiologic and economic concepts 11
Infectious disease epidemiology 11
Infectious disease economics 12
Policy implications 15
Definition of pandemic financing 17
Health financing frameworks 17
Definition of pandemic financing 19
Instruments for pandemic financing 20
Mapping instruments to external stakeholders 23
How much pandemic financing is needed? 37
The large economic impact of pandemics and epidemics 37
The small investment required to address pandemics 37
Unequal distribution of financial resources as measured by health expenditures 38
Case study of the COVID-19 pandemic financing 39
Pandemic financing considerations 41
Prevention and preparedness 42
Response: early and late 46
Recovery & reconstruction 50
Conclusions and recommendations 51
Lessons from COVID-19 52
Recommendations 54
Conclusion 56
References 57
TABLE 1. Pandemic actions categorization through the pandemic cycle 8
TABLE 2. Pandemic financing instruments matched to pandemic phases 31
TABLE 3. Cost estimates for pandemic preparedness and response using different definitions and methodologies 38
TABLE 4. Health expenditure by country income group, 2019 38
TABLE 5. Development assistance for health (COVID-19) during the pandemic, 2020-2023 39
FIGURE 1. Framework for the phases of the pandemic cycle 6
FIGURE 2. Classification of official development finance for health ODA 18
FIGURE 3. Classification of external pandemic financing tools by key characteristics 20
FIGURE 4. Development assistance for health (COVID-19), 2020-2023 40
FIGURE 5. Multilateral funding was large but slow compared to COVID's spread 41
FIGURE 6. Cumulative World Bank disbursements for COVID-19 health and social response by financing instrument, March 2020 to May 2021 41
FIGURE 7. Instruments and financing mechanisms for pandemic phases 54
Boxes
BOX 1. Overview of the types of external financing instruments 22
BOX 2. Organizational stakeholders in external pandemic financing 24
BOX A. The new mechanism for pandemic prevention and preparedness: The Pandemic Fund 26
BOX B. Financial instruments for emergency response to outbreaks/epidemics 26
BOX C. Insurance-like prepaid mechanisms 27
BOX D. Instruments for product development/manufacturing/purchasing and distribution 29