ONE OF the most disturbing lessons to emerge from the Ebola virus disease epidemic in West Africa in 2014-2015 was how unprepared the world was for it. David Nabarro, special adviser to the U.N. secretary general, told a Senate panel recently that the virus was missed in late 2013 and played down in 2014, even in July of that year when numbers of cases were doubling every three weeks. Ultimately, 11,314 people died in Guinea, Liberia and Sierra Leone.
When it was over, several studies concluded that the world needs a well-funded, rapid-reaction mechanism, a firefighting team ready to deploy quickly in the face of spreading disease. The World Health Organization proposed a $100 million contingency fund but so far has raised only $31.5 million, Mr. Nabarro said. “In multilateral work, funding is oxygen,” he added. “When it comes to responding to outbreaks, WHO is starved of oxygen.”
Now comes the World Bank with a novel program that could help realize the goal of rapid response to such emergency health threats and save lives. The bank has announced the issuance of $500 million in specialized bonds and derivatives that will help poor countries cope with a pandemic such as Ebola. The effort will create a trust fund, the Pandemic Emergency Financing Facility, that can be quickly deployed for pandemic response, complementing the WHO fund. Investors who buy the bonds and provide the trust-fund financing upfront will reap premiums (at first, Japan and Germany are covering the premiums) but will also be taking a risk. If there is a major outbreak, the investors will lose some or all of their cash. This is the first time such an approach has been tried for pandemic risk, but a similar idea underlies insurance against other natural disasters and catastrophes. One big advantage is that instead of waiting around for slow-moving national governments to fund a disease response, the resources necessary for saving lives will be available quickly, when they can do the most good. The trust-fund money will be used to respond to six viruses that are most likely to cause a pandemic, including influenza, Ebola, severe acute respiratory syndrome and Middle East respiratory syndrome. The financing to 77 eligible countries will be triggered depending on how far and fast a disease spreads and whether it crosses international borders.
When putting the program together, World Bank officials back-tested it against the history of the Ebola pandemic in 2014. They think, had it been in place, money would have flowed three months sooner than it did. Of course, money isn’t everything — political decisions, biomedical research, proper alerts and communication are also critical factors in a rapid response. But having a robust fund to send in the first teams is a promising and innovative step forward by the World Bank, and a worthy legacy of the Ebola catastrophe.