VENDREDI 10 DÉCEMBRE 2021 BIZWEEK ÉDITION 372 NGOZI OKONJO- IWEALA, director-general of the World Trade Organization THARMAN SHANMUGA- RATNAM, senior minister in Singapore and chair of the Group of Thirty LAWRENCE H. SUMMERS, Charles W. Eliot University Professor at Harvard University and a former US Treasury secretary POST SCRIPTUM FINANCE & DEVELOPMENT MAGAZINE Rethinking Multilateralism for a Pandemic Era Has multilateralism failed us during the pandemic ? Maybe not entirely, but we must organize ourselves on a whole-of-society basis within nations and rethink how we collaborate internationally to mitigate its profound consequences for livelihoods, social cohesion, and global order, World Trade Organization Director-General Ngozi Okonjo-Iweala, Singapore Senior Minister Tharman Shanmugaratnam, and former US Treasury Secretary Larry Summers write in the latest edition of Finance & Development Magazine. Future crises may depend on a fundamental reset of international cooperation We are nowhere near the end of the pandemic. Delta will not be the last highly transmissible variant. Large unvaccinated groups and the unchecked spread of the virus around the world raise the prospect of further mutations, possibly evading today’s vaccines, that will create new waves everywhere. Yet COVID-19 is also a forerunner of more, and possibly worse, pandemics to come. Scientists have repeatedly warned that without greatly strengthened proactive strategies, global health threats will emerge more often, spread more rapidly, and take more lives. Together with the world’s dwindling biodiversity and climate crisis, to which they are inextricably linked, infectious disease threats represent the primary international challenge of our times. Recognizing this new reality of a pandemic era is not fearmongering but rather prudent public policy and responsible politics. We must organize ourselves on a whole-ofsociety basis within nations and rethink how we collaborate internationally to mitigate its profound consequences for livelihoods, social cohesion, and global order. COVID-19’s only benefit has been to put the case beyond doubt. Our collective failure to heed scientific advice and invest in pandemic prevention and preparedness has inflicted a catastrophic toll. Official data put the number of deaths at over 5 million ; credible unofficial estimates are a multiple of that number. Many more people have survived serious illness, with longtermconsequences for their well-being and nations’human capital that have yet to be determined. The world has experienced the deepest economic contraction since World War II and a significant rollback in progressin education, poverty eradication, and inclusive development for a large swath of its population. The IMF has projected large cumulative losses in global GDP by 2025, with particular impact on the developing world. From aid to strategic investment Overcoming today’s pandemic remains the immediate task. Rich nations must make good on pledges to donate their projected substantial surplus vaccines, along with grants to bridge the $23 billion shortfall needed to get jabs into arms and provide test kits and other medical supplies. All that is « The current system of global health security is not fit for purpose. It is too fragmented, overly dependent on discretionary bilateral aid, and dangerously underfunded. We must repair the system with urgency. The next pandemic could strike at any time, whether from a deadly influenza strain or another pathogen that jumps from animals to humans. It may even strike while the world continues to struggle » with COVID-19 a very small price to shorten the pandemic everywhere. But we also need a more fundamental reset to avoid blundering into pandemics again and again with enormous human and economic costs. The current system of global health security is not fit for purpose. It is too fragmented, overly dependent on discretionary bilateral aid, and dangerously underfunded. We must repair the system with urgency. The next pandemic could strike at any time, whether from a deadly influenza strain or another pathogen that jumps from animals to humans. It may even strike while the world continues to struggle with COVID-19. We cannot avoid outbreaks altogether. But we can sharply reduce the risk that they will blowup into pandemics. The world has the scientific and technological capabilities and the financial resources to do so. However, to mobilize these resources, we need a new way of thinking about international cooperation. Rather than financing global health security under the mantle of «aid for other nations,» we must treat it as a strategic investment in global public goods that benefit every nation—rich or poor. The Group of 20 major advanced and developing economies (G20) established a high-level independent panel (HLIP) to conduct a full review of the gaps in global public goods. It was aided by extensive consultation with experts, the global health organizations, and the Global Preparedness Monitoring Board, an independent group established by the World Health Organization (WHO) and World Bank. The gaps the HLIP identified are large. We need a massively scaled-up network of genomic surveillance, integrating national, regional, and global capabilities. Such a network is critical to detecting and instantly sharing information on pathogens that could cause infectious disease outbreaks, identifying their genome sequences, and accelerating the development of medical countermeasures. We must also close long-standing gaps in core health care capacities within nations to thwart both emerging and endemic infectious diseases and mitigate comorbidities. These capacities benefit individual nations in normal times but are also critical to pandemic prevention and preparedness globally. They therefore require both domestic and international financing. This, coupled with a broader strengthening of public health systems, will require many developing economies to spend an additional 1 percent of GDP, at least over the next five years. The additional spending must be complemented by enhanced external grant support for investments in lower-income countries that are in the nature of global public goods. Global supply capacity Crucial too is building the global capacity needed to radically speedup supplies of vaccines and other vital materials to avoid prolonging a pandemic and repeating the staggering inequalities of access that COVID-19 has revealed. We need a globally distributed development, manufacturing, and delivery ecosystem that is kept in use in normal times and can pivot swiftly to provide the medical countermeasures specific to each pandemic. In the absence of a larger global supply capacity ready early in a pandemic, producing nations will remain prone to prioritize the needs of their own populations over global needs. The private sector currently has little incentive to invest in this ever-warmsupply capacity on the scale required ahead of a pandemic, even if there is scope for dual uses to meet ongoing needs in normal times. We can therefore build the necessary supply ecosystem only through a major public-private investment initiative. 5 Cont’d on page 6