To get pandemic preparedness and response right, philanthropy needs to centre the response on equity, and root it in the community.

Covid-19 exposed the huge risks and costs a pandemic brings, overwhelming government budgets across rich and poor nations. There was needless morbidity and mortality because we were not prepared, and this resulted in the setback of the responses in other areas of health, including immunization, AIDS, tuberculosis, and malaria.

It also revealed the gap in the ability of countries to react quickly and efficiently to address the challenge. With shutdowns came severe limitations on civil society activity in some countries.

Foundations and other funders have a critical role in helping the global community establish more effective and equitable pandemic responses in the future.

In the last few months, we saw the launch of pandemic funds including the International Monetary Fund’s (IMF) Resilience and Sustainability Facility (RSF) to help low and middle-income countries, and the new Pandemic Fund from the World Bank (WB) which aims to provide dedicated investment for pandemic prevention, preparedness, and response (PPR) interventions at national, regional, and global levels.

Just this month, the Pandemic Fund announced $300 million in financing to help developing countries better prepare for and respond to future pandemics. New resources for preparedness is welcome news, but the commitment thus far is from adequate.

On a positive note, there is a strong desire to do something about future pandemic preparedness. The future of global health and pandemic response is on the table later this year at the G7 Japan Hiroshima Summit, the upcoming World Health Assembly, the 2023 New Delhi G20 Summit, and the 2023 High-Level Meetings (HLMs) on Pandemic Prevention, Preparedness and Response (PPR), Universal Health Coverage (UHC), and Tuberculosis.

So, we have the opportunity – and more political will right now than in the past two decades – to get this right. How will we do it? How do we ensure that pandemic preparedness doesn’t fail?

A human-centred approach

Effective and equitable preparedness will require engagement and advocacy for human-centred approaches, for inclusion of civil society, protection of current health programming, additional funding, and monitoring. Funders can help support this work.

After all, funders are connected to policymakers, health experts and advocates around the world. We can help ensure that lessons from previous epidemics, like HIV, are learned and incorporated into preparedness. We can support advocates in advancing a preparedness approach centred in human rights, equity and global solidarity.

One clear lesson is that stronger health systems are a foundation of true pandemic preparedness – systems that can deliver on people’s needs today are also poised to identify and respond to an emerging disease threat.

Leverage existing programs for Pandemic Preparedness and Response

While working to mobilize new resources for PPR, policymakers should look for opportunities to leverage existing programs that help build resilient and responsive health systems. At the same time, they must protect current programs. Additional funding is needed to harness existing programs, and these programs must be monitored and protected to ensure their work is not undermined by added preparedness work. The goal is to bring in new resources and to find synergies making current global health programs stronger.

So, what should the funding for the pandemic response be used for to ensure a more effective and equitable response than we saw with Covid-19?

Equity should be at the heart of it

Without equity, we will fail again. So, it’s important that we develop universal access to health without discrimination, with global solidarity and leadership. We need to support manufacturing capacity in low and middle-income countries. We need to invest in stronger primary care and health systems.

Community trust has emerged as a critical element in Covid-19 responses. Trained, well-equipped and integrated community health workers can educate community members regarding emerging health threats, diagnose infections and navigate clients to person-centred services. Effectively leveraging community responses requires increased investment in community delivery systems that have established trust with their constituents.

And to make all this work, we need expanded financing. Ensuring that investments are adequate to meet the need and demonstrating clear returns on investments will be key to the success of PPR efforts. Grantmakers can support work in all these areas.

Governance and transparency

To ensure resources are used effectively, good governance and transparency are essential. Funding priorities need to be decided with the engagement of nongovernmental, civil society, private sector and other voices.

The opportunity is now. The global HIV response has often been called “exceptional” because community advocacy and political leadership mobilized significant resources and aimed at universal access to quality services without discrimination. It’s time to integrate the exceptional into preparedness and broader health.

To ensure we’re successful, grantmakers should consider:

• Supporting community-led engagement and diverse voices in the design of preparedness programming and its connection to existing platforms.
• Supporting advocacy, with the goal of achieving adequately funded, effective and equity-based pandemic preparedness.
• Supporting solutions that work, such as regional manufacturing and strengthening existing health systems.

Kiti Kajana Phillips is Senior Program Officer at Open Society Foundations. Chris Collins is President & CEO of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.