Invest in collective health for future collective wealth

When Indonesia assumed the G20 presidency in December 2021, our ambition was clear on what we wanted to achieve on the G20 health track: to make lasting and concrete changes to the global health architecture that would allow us collectively to better prevent and better prepare for, and respond to, global health crises.

The COVID-19 pandemic has exposed vulnerabilities in the global health architecture and adversely impacted all our economies. We were clear that, in order to achieve our ambition, we needed to rethink the way we approached pandemic prevention, preparedness and response — one that reflected the interdependence between health and finance.

It is for this reason that the finance and health ministers of G20 member states have formerly come together for the first time under the Joint Finance and Health Task Force, aimed at identifying and filling major gaps in pandemic prevention, preparedness and response.

As co-chairs of the Joint Finance and Health Task Force, we have worked tirelessly with our counterparts in other G20 member states to establish a new mechanism, in order to raise and mobilize funds to fill the financial gap needed to adequately respond to global health emergencies. This gap is estimated to be $10.5 billion per year for the next five years, and is felt most sharply by low- and middle-income countries.

We are proud to announce that on June 30 the World Bank’s Board of Executive Directors approved the establishment of the G20-initiated Financial Intermediary Fund for mobilizing collective resources for pandemic prevention, preparedness and response. The fund will provide financing to narrow the critical gaps to strengthen national, regional and global capacity in areas such as disease surveillance, laboratory systems, health workforce, community engagement, and emergency communication and management.

We are already off to an encouraging start, having raised almost $1.1 billion before the fund was even established. This is thanks to financial commitments from the United States, the European Union, Indonesia, Germany, the United Kingdom, Singapore, the Gates Foundation and the Wellcome Trust. While the establishment of the FIF and the initial financial commitments are steps in the right direction, we still have a long way to go to ensure that the fund achieves its intended objectives.

First, we call on more G20 member states to make financial contributions to the FIF, so as to fill the estimated $10.5 billion gap to adequately respond to future pandemics. At the time of a global cost-of-living crisis this seems like a tall order. But based on our experience of dealing with COVID-19, it is clear that an upfront financial commitment to invest in the future health of our citizens is a drop in the ocean compared with the negative economic impact of a future pandemic.

Second, we want to stress that the FIF is an additional fund and should not divert any financial contributions away from other global health projects and programs. This is about minimizing the vulnerabilities that have been exposed during our collective experience responding to COVID-19. It is essential that these are addressed to better serve our citizens when, not if, we face our next global health emergency.

Third, the G20 must strike the right balance in agreeing on the appropriate governance of the FIF. We are looking at how best to leverage the World Health Organization’s technical expertise to advise how the money can be best spent. We must ensure balanced regional representation by including low- and middle-income countries in the management of the FIF, which is particularly important given that low- and middle-income countries most sharply feel the negative consequences of the financial gap to adequately respond to pandemics.

Fourth, the FIF should be efficient and agile enough to meet the multiple needs of pandemic prevention, preparedness and response. It is therefore incumbent on all G20 member states to agree on a clear mandate which avoids duplication with other global health funds and mechanisms, while allowing for multiple uses, as needed.

And fifth, we need to acknowledge that the FIF alone cannot be a silver bullet. It is part of a wider array of initiatives that the Indonesian presidency of the G20 health track is working to take forward. This includes the establishment of a global platform to coordinate emergency countermeasures during health crises, expansion of an international genomic data-sharing network to bolster pathogen monitoring, development of globally interoperable digital vaccine certificate verification mechanisms to facilitate safe international travel, and more equitable construction of research and manufacturing hubs for vaccines, therapeutics and diagnostics to ensure no country is left behind in their response to future health emergencies.

A common expression repeated during the initial days of the COVID-19 pandemic was "viruses know no borders". This is true, and this is exactly why our efforts to prevent, prepare for, and respond to, future pandemics should know no borders as well. We implore our colleagues in G20 member states to invest in our collective health and continue pushing for progress so that we can recover together and recover stronger.

Budi Gunadi Sadikin is the minister of health of the Republic of Indonesia; and Sri Mulyani Indrawati is the minister of finance of the Republic of Indonesia.
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