The Race to Strengthen Global Health Security
How the Pandemic Fund is reshaping global health security through smarter, faster, and country-led investments
Q&A with Priya Basu, Executive Head of the Pandemic Fund
The last pandemic brought into sharp focus the disruptive nature of disease outbreaks when we are unprepared. Previous outbreaks – like Avian Influenza, SARS, Ebola – also highlighted weaknesses in prevention and preparedness capacities. What has changed?
The pandemic revealed the stark reality that health systems around the world—particularly in low- and middle-income countries—were unprepared to detect and contain the virus. Since then, there has been growing recognition not only of the human, social, and economic costs of being unprepared—and the benefits of preparedness—but also of what is required to be better prepared in the future.
We’ve learned a few important lessons. First, investments in disease surveillance and early warning systems, laboratories, testing and diagnostics, and the health workforce—areas that have suffered from chronic underinvestment in the past—are central to building strong and resilient health systems and achieving universal health coverage. These capacities need to be built so that they can serve day-to-day needs of the entire health system—not siloed away in vertical disease programs—and be surged in times of crisis. The resources needed for this are a fraction of the costs of being unprepared.
Second, since many infectious diseases tend to be zoonotic in origin, it’s essential to take a multisectoral approach to strengthening preparedness—one that includes a focus on animal health, human health, and the environment—what we call “One Health.”
Third, such investments need to be anchored in national health strategies, institutions and budgets, not in donor-dependent health programs that run parallel to a country’s health system, and they must be disease-agnostic, because we don’t know what the next pathogen with pandemic potential will be.
Fourth, alongside building capacity at the national level, it’s vital to invest in cross-country collaboration, including data sharing. Investing in country-specific programs is a necessary but insufficient approach. Regional and global surveillance systems are not merely collections of national platforms but rather require investment in cross border collaboration to ensure that in an outbreak, countries have interoperable systems that allow for surveillance and genomic data to be shared in real time. These cross-border investments are essential to strengthening all countries’ capacity to detect, contain, and ultimately prevent infectious outbreaks from reaching their shores.
This is where the Pandemic Fund comes in: by helping to finance these cross-border, cross-cutting, disease-agnostic, high-impact investments, we’re building a more resilient and secure global health architecture.
The Pandemic Fund was created to fill a major gap in global health financing. In a crowded landscape of initiatives, what does it do differently?
The most notable difference I would say is that the Pandemic Fund is the first and only multilateral financing mechanism dedicated solely to strengthening pandemic prevention, preparedness, and response capacities in low- and middle-income countries. This means, in times of budget cuts and personnel shortages, we help countries sustain these critically important investments in pandemic readiness. There are many other organizations that contribute to pandemic prevention, preparedness, and response (PPR) investments, but they do so alongside other competing priorities. In contrast, the Pandemic Fund’s sole mandate is to strengthen pandemic PPR.
What does the Pandemic Fund do differently? First, the Fund is country-led and country-driven. Grants are demand-based, aligned with national or regional plans. Second, we promote strong coordination. Our projects foster multisectoral collaboration, bringing together ministries of health, finance, agriculture, and environment under a One Health approach, and engage civil society, communities, and the private sector. As I’ve said, we also support cross-country efforts, recognizing that outbreaks don’t respect borders. Third, our financing model is catalytic. We channel grants through trusted institutions like multilateral development banks, UN agencies, and global health initiatives, requiring them to co-finance and leverage their in-country presence. We also encourage countries to invest in their domestic resources. So far, every $1 from the Fund has mobilized $7 in additional international and domestic financing. Fourth, our operating model avoids duplication and saves costs by working through existing institutions. Our annual operating costs are under 0.5% of total funds raised. Fifth, our governance is inclusive. Sixth, we operate with high standards of transparency and accountability.
And how will you measure whether the Fund is making a real impact?
In just three years, and through awarding two funding rounds, the Pandemic Fund has built a US$7 billion portfolio of projects across 75 countries spanning six regions. A third funding round is expected to conclude later this year, expanding our reach even further. Ultimately, success means that low- and middle-income countries are able to detect and contain outbreaks early, before they become pandemics. The real measures of success, though, are the concrete results we’re already seeing on the ground. For example, last year, in the wake of the mpox outbreak in Africa, our Board decided to fast-track support to 10 countries. One of those was Rwanda, which was hit by a Marburg virus outbreak soon after mpox. The Pandemic Fund’s investments in Rwanda not only helped manage mpox but also helped detect and contain Marburg. In Burundi, the Pandemic Fund helped expand the number of laboratories capable of diagnosing mpox from just 1 to 56 and speed up laboratory testing so that results became available within 2–3 hours. With support from the Pandemic Fund, the Caribbean has developed an innovative electronic Mass Gathering Surveillance System that enables real-time tracking of health threats during major events enhancing regional preparedness and response. This is the kind of impact that matters.
You’ve had a front-row seat to how countries are thinking about pandemic preparedness. What gives you hope that the world will be better prepared next time?
Governments are juggling multiple, overlapping priorities, and many are still dealing with the aftershocks of the last pandemic. But what gives me hope is that in low- and middle-income countries —where the risk of the next pandemic emerging is highest—pandemic preparedness is increasingly seen as a smart, long-term investment. I hear this consistently from both Health and Finance Ministers in Africa and beyond, and I see this in the strong demand for our funding. Every call for proposals we’ve launched has been oversubscribed by many multiples. And it’s important to understand that the Pandemic Fund doesn’t simply hand out grants. Recipient countries co-invest with us from their domestic budgets and take on significant responsibility for implementation. They’re putting their skin in the game, so to speak.
This sets the foundation for long-term ownership and reduces dependence on foreign aid over time. That’s also something our donors value. They’re contributing from their own, often constrained, budgets, but they know that their investments will be multiplied and translated into tangible, lasting impact that will make the world safer and more prosperous.
I’m encouraged by the foresight and vision that our donors are demonstrating, and by the strong interest and commitment from recipient countries. Leaders across Africa and other regions are championing pandemic preparedness, mobilizing domestic resources, and driving long-term solutions. They want to strengthen health systems in ways that are sustainable, efficient, and aligned with national priorities—training the health workforce, upgrading laboratories, and improving surveillance to detect outbreaks rapidly. The urgency hasn’t faded—it’s turning into concrete action on the ground.
Where do you worry we’re still falling short?
I worry that time is not on our side. The next pandemic threat is already out there, and the window to prepare is closing fast. The Pandemic Fund is ready to scale and to maximize its catalytic potential—mobilizing resources, driving partnerships, and turning momentum into real protection on the ground. But we need sustained, predictable financing to do it. Viruses never rest, and we’re still not at the level required to get the most vulnerable countries across the finish line. That’s what keeps me up at night.
To learn more about the Pandemic Fund: https://www.thepandemicfund.org/