Four years after its landmark report A Global Deal for Our Pandemic Age, the G20 High Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response, recently reconvened by the South African G20 Presidency, has found that the world remains dangerously underprepared for future pandemics and must take urgent, coordinated action to accelerate financing for sustainable and equitable pandemic prevention, preparedness, and response (PPR).
In its new report, Closing the Deal: Financing Our Security Against Pandemic Threats, the Panel issues five recommendations for practical and bold action to take pandemic threats off the table and warns of compounding risks: global health financing is eroding just as the threats of pandemic and deliberate biological events are rising.
“Pandemic preparedness stands at a precipice,” said Victor J. Dzau, Panel Co-Chair and President of the US National Academy of Medicine (Panel Secretariat). “The world has become distracted from preparing for the next pandemic, even as biological risks multiply. Our collective ability to prevent and respond to health emergencies remains dangerously insufficient.”
While progress has been made since 2021—including the creation of the G20 Joint Finance and Health Task Force and the Pandemic Fund at the World Bank—financing and implementation have lagged far behind need and ambition.
High-income countries are pulling back foreign aid, development banks remain underpowered, and few nations have integrated pandemic preparedness and response into their domestic budgets. Meanwhile, the frequency and diversity of infectious disease outbreaks continue to increase.
The Panel’s findings and recommendations also highlight the imperative of security spending, as well as health financing. Advances in synthetic biology, gene editing, and artificial intelligence are essential for accelerating pandemic preparedness but also have lowered technical barriers to engineering pathogens, increasing the likelihood of catastrophic biological events.
“The global system for pandemic prevention is fraying just as the risks are accelerating,” said Jane Halton, Panel Co-Chair and Chair of the CEPI Board. “If COVID-19 taught us anything, it’s that preparedness cannot be treated as optional. It is a global public good and a matter of national security—an economic and biodefense imperative as well as a moral one.”
COVID-19 cost the global economy an estimated $10–15 trillion in lost output and 255 million jobs in 2020 alone. Global losses from future pandemics are estimated to be, on average, over $700 billion each year.
“We are spending less on the tools that keep us safe, even as the risks rise,” said Jean Kaseya, Panel Co-Chair and Director General, Africa Centres for Disease Control and Prevention. “Failing to invest in global and regional preparedness is not fiscal prudence—it is negligence with catastrophic consequences. The cost of inaction will always dwarf the cost of prevention.”
The Panel’s report identifies five growing financing gaps for global pandemic PPR:
- Domestic resource mobilization and non-ODA financing. Pandemic PPR remains severely under-financed. Countries are not tracking or investing sufficiently in PPR through national budgets. Security and private sector financing remain elusive, and financing for PPR in high-risk fragile settings, often beyond the reach of government systems, is inadequate.
- Medical countermeasure (MCM) access and surge manufacturing. Production is not sufficient and remains geographically concentrated and dependent on donor funding.
- Development bank incentives. Low- and middle-income countries must be able to act early and procure MCMs when threats emerge. Multilateral development banks (MDBs) lack clear at-risk financing mechanisms for rapid pandemic response, and approved products wait too long for pre-qualification.
- Tests, treatments, and personal protective equipment (PPE). Innovation and manufacturing remain underfunded and fragmented, yet these products are crucial in the earliest days of a crisis.
- The Pandemic Fund. The Fund is still not sustainably capitalized or operating at scale, yet its regional, country-led and collaborative model is fit for purpose in the current aid landscape.
“The architecture for pandemic preparedness is full of cracks,” said Benedict Oramah, Panel Co-Chair and former Chair of the Board, African Export Import Bank (Afreximbank). “We cannot rely on outdated systems and hope they hold under pressure. The next pandemic will not wait for us to fix what’s broken.”
To address financing gaps, the report presents five operational recommendations designed for implementation by or before the September 2026 United Nations (UN) High-Level Meeting (HLM) on Pandemic Prevention, Preparedness, and Response.
- Increase domestic investment and non-ODA incentives. Rigorously track pandemic financing. At the UN HLM, governments should announce their intention to meet minimum benchmarks for pandemic financing across health and security budgets, linked to prioritized, costed national plans. MDBs and international finance institutions should better align and directly finance civil society organizations and regional institutions in fragile settings. The G20 Joint Finance and Health Task Force should launch an annual Global Pandemic Spending Tracker to hold countries accountable, and to monitor national and private-sector spending across health, security, and development budgets toward the benchmarks below.
- Accelerate geographically diversified access to MCMs. The International Finance Corporation and other development finance institutions should establish at least one dedicated MCM surge financing facility with a “standby” roster of regional manufacturers and pooled procurement mechanisms. Philanthropies should support an associated operational platform for technical assistance, market assessments, and stress testing, to expand the list of regional manufacturers, particularly for under-invested products.
- Enable at-risk financing for MCMs by development banks. All MDBs and relevant public development banks should establish and clearly communicate mechanisms for borrowing at-risk to allow countries to purchase promising candidate medical countermeasures before regulatory approval—accelerating access and saving lives. At the same time, the World Health Organization (WHO) and national regulators must accelerate pre-qualification or temporary authorizations for products already approved by WHO-Listed Authorities at Maturity Level 3 or higher.
- Operationalize Financing for Tests, Treatments, and PPE. The world needs designated regional and global anchor institutions and a financing strategy to coordinate innovation, manufacturing, and scale-up for these products, which are critical when crises emerge, yet chronically underprioritized. This includes at least one PPE manufacturing hub per region with regional stockpiles for essential long-shelf-life products.
- Strengthen and cement the Pandemic Fund as the world’s premier facility for external support for preparedness financing. The World Bank , regional development banks, and public development banks should commit to using their tools and a standing allocation to ensure renewable support for the Fund and its work. The Fund should double down on its core preparedness mandate as well as its role in tackling cross-border threats, catalyzing domestic and non-ODA resources, enhancing access for civil society implementers in fragile settings, and partnering more systematically with MDBs to leverage their lending.
In addition, the High-Level Independent Panel calls for Minimum Benchmarks for Pandemic PPR Financing: Governments should allocate, at a minimum, at least 0.1 to 0.2 percent of gross domestic product per year, per country directed toward pandemic PPR spending. This should be complemented by at least 0.5 to 1.0 percent of security and defense budgets per year from G20 and other high- and upper-middle income countries, directed toward biosecurity, biosurveillance, and the 100 Days Mission to support deterrence, operational resilience, and to prevent deliberate and accidental misuse of biological agents at home and globally. The Panel underscores the 2021 benchmark for leaders to invest at least $15 billion annually in international financing toward regional and global public goods to fight cross-border threats. To achieve these goals in 2026, decisive and sustained international leadership is required. The Panel is committed to working with the G20 and all other relevant actors to bring these recommendations into reality in advance of next year’s UN HLM.
“This report is a blueprint for rapid action,” said John-Arne Røttingen, Panel Co-Chair and CEO of the Wellcome Trust. “By mobilizing and tracking domestic and non-ODA financing, diversifying manufacturing, and strengthening the Pandemic Fund, it is possible to substantially reduce pandemics as a threat to humanity. We urge the G20, international financial institutions, and all governments to act now to implement these actions.”
Download the full report here: Closing the Deal: Financing Our Security Against Pandemic Threats
Read more about the report in The Lancet.
Attend a public briefing: The Panel co-chairs will discuss the report’s recommendations during a webinar on Nov. 21 from 11 a.m.-12:30 p.m. EST. Register now.
Media Inquiries: Dana Korsen ([email protected])
High-Level Panel on Financing the Global Commons for Pandemic Preparedness & Response*
- VICTOR DZAU (Co-Chair), President, U.S. National Academy of Medicine
- JANE HALTON (Co-Chair), Chair of the Board, CEPI
- JEAN KASEYA (Co-Chair), Director General, Africa Centres for Disease Control and Prevention
- BENEDICT ORAMAH (Co-Chair), Former President and Chair of the Board, Afreximbank, and Chair of the Board of the African Medical Centers of Excellence
- JOHN-ARNE RØTTINGEN (Co-Chair), CEO, Wellcome Trust
- NGOZI OKONJO-IWEALA, Director General, World Trade Organization
- PATRICIA REILLY, Member of the Cabinet of European Union President Ursula von der Leyen
- KEIZO TAKEMI, Former Member of the House of Councillors, Japan
- SYARIFAH LIZA MUNIRA, Senior Advisor, JLI Center for Health Diplomacy
- CHRIS ELIAS, President for Development, The Gates Foundation
- KIRAN MAZUMDAR-SHAW, Founder and Executive Chairperson, Biocon
- RACHEL GLENNERSTER, President, Center for Global Development
- DAVID MILIBAND, President and CEO, International Rescue Committee
- AMANDA GLASSMAN, Executive Advisor to the President, Inter-American Development Bank
- SETH BERKLEY, former CEO, Gavi, the Vaccine Alliance
* Members of the High-Level Independent Panel participated in their individual capacities and not on behalf of their affiliated organizations.
