The economic consequences of large-scale disease outbreaks can be enormous: the international financial institutions estimate that pandemics could cause $570 billion per year in average economic losses over the coming decades. Health security threats have an especially destructive impact on development investment and GDP in low-income and lower-middle income countries (LICs and LMICs): for instance, the global economic loss from SARS in 2003 was $52 billion, and the 2014-2015 Ebola outbreak in West Africa wiped out nearly five years of existing investments in the region, gravely setting back the region’s future development prospects.

The financing gap for preparedness is one of the starkest problem in health security, particularly among LICs and LMICs. The World Bank has estimated the gap at $4.5 billion per year.  Investment in preparedness is cost-effective and affordable, but low-income and lower-middle-income country governments continue to underinvest. At present, there is no financing mechanism and no adequate incentive structure to motivate governments in high-risk countries to invest in preparedness.

However, there is a significant step forward by the World Bank (WB) and the World Health Organization (WHO), with the May 2018 launch of the Global Preparedness Monitoring Board (GPMB). The GPMB is an independent mechanism to monitor worldwide readiness for outbreaks, pandemics, and other health emergencies. It focuses on strengthening public health capacities as a foundation for preparedness; monitoring progress of relevant research and development and of preparedness financing, both public and private; and generating risk analyses, including economic and social vulnerabilities, based on assessments from stakeholders and partners.

The World Bank organized a meeting on prioritizing investment in preparedness at the country level on 30th April 2019. The objectives included identifying concrete ways forward to accelerate investments in preparedness. The International Development Association (IDA), a World Bank initiative, is a key part of the discussion, and will emphasize preparedness at its 17-20 June Replenishment meeting in Addis Ababa, Ethiopia.

Another key follow-up concrete action is WHO Strategic Partnership for IHR and Health Security (SPH) engagement with financial institutions such as the Asian Development Bank, the African Development Bank, the European Investment Bank and the World Bank on how to harness multisectoral financing for health security preparedness. It was agreed at this meeting that the WHO SPH Portal can serve as one-stop platform for donors and partners in tracking global and regional health security investments.