The G-20 includes the United States, France, Italy, Russia, Brazil, China, India, Japan and others.
But the announcement came without a pledge of any new funding, inviting criticisms from those already furious that the rich nations of the world are doing too little to help poor countries still being ravaged by the coronavirus.
“We remain committed to build on the lessons learned from the covid-19 crisis to increase investment into longer term health capacity,” the G-20 health and finance ministers said in a joint statement. “We expect the Task Force to report on how health and finance collaboration can strengthen efforts to prevent, detect, and respond to future health emergencies with cross-border potential.”
Treasury Secretary Janet L. Yellen and Indonesian Finance Minister Sri Mulyani Indrawati had written the G-20 earlier in the month seeking support for the new initiative. Yellen and Sri Mulyani had asked for the G-20 leaders to commit to “ensuring the financing capacity” of the development banks, such as the World Bank, for meeting pandemic threats.
“The current pandemic revealed a lack of readiness at the country level and a lack of coordination among us,” Yellen and Sri Mulyani said. “For this reason, we strongly support launching a forum where health and finance ministers could begin the work of facilitating global cooperation and coordinating prevention, detection, information sharing, and, if needed, response.”
The coronavirus pandemic, which was detected in China in 2019 but moved quickly around the world in 2020, exposed major lapses in coordination between countries as they struggled to determine the best responses. Nations also clashed over access to treatments, protective equipment and data.
In January, the G-20 tasked a High Level Independent Panel (HLIP) with proposing the financial framework needed to reduce the world’s vulnerability to future pandemics. In its July report, the panel called for a global governance and financing mechanism that would bolster existing institutions, including the World Health Organization. It called for a public funding increase of at least $75 billion over the next five years, or $15 billion per year. Doubling current spending levels was justified, the panel concluded, because the higher costs were “negligible compared to costs of another major pandemic.” The new G-20 announcement does not include such money.
The forward-looking nature of the announcement and the lack of financing prompted criticism from some economists who said the G-20 stopped far short of what was needed, particularly at a time when the coronavirus pandemic continues to devastate poorer countries. Joseph Stiglitz, a Nobel Prize-winning economist at Columbia University, criticized the wealthy nations of the G-20, saying: “People are dying today — to talk about preparing for ‘the next one’ to me is unforgivable.”
“Covid has shown that pandemics are not just health issues,” said David Miliband, president of the International Rescue Committee and former foreign secretary of the United Kingdom, who served on the independent panel. “The World Health Organization is central, but pandemics are economic, national security and political, and they need more than health ministers to get the right kind of response.”
Only heads of state can accomplish the corralling, peer pressure and accountability necessary to take action in real time, Miliband said, recalling how the virus was allowed to spread rapidly in February 2020, in part as a result of inaction at the highest levels.
The ongoing pandemic is also revealing the need for greater coordination across public and private groups by bringing industry, trade and others to the table, said Sara Bennett, professor of international health at the Johns Hopkins Bloomberg School of Public Health.
“While vaccine funding is essential, in many low-income, fragile contexts there are significant challenges in getting shots in arms,” Bennett said. “The need to strengthen health systems drawing upon both public and private actors is key.”
J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies (CSIS), also expressed disappointment in the G-20 announcement, 20 months into the pandemic after “plenty of good analysis about what is failing and what needs to happen.”
The WHO, Morrison said, has demonstrated it does not have the authority and gravitas to tackle these kinds of threats in a fragmented world, in which global powers cannot agree. He also expressed concern that the lack of financing in the G-20 plan would deflate enthusiasm from the Biden administration.
The initiative will shift to a “coalition of the willing” approach, Morrison suggested, noting that the United States and Norway are already in talks at the United Nations.
Lawrence Gostin, professor of global health law at Georgetown Law, said he was underwhelmed by the announcement.
“This is a document that says all of the right words and provides no clear pathway for a solution,” Gostin said. The G-20 has had an “extraordinarily bad track record” of providing financing for global health preparedness, Gostin said, and has failed to take an all-of-government approach. This new body, which will not be led by heads of state, also lacks political heft, he said.
In some ways the efforts draw attention to existing systemic failings in the approach to pandemic preparedness, said David Peters, chair of the Department of International Health at Hopkins.
“It’s good that the efforts should strengthen a global health architecture, but we should also recognize that we don’t really have a global health architecture,” Peters wrote in an email. “Architecture implies design. We have global health organizational sprawl, with elements of good architectural ideas within a fragmented and deeply flawed system.”
The pandemic offered an opportunity to unite behind shared goals that has not been met by Friday’s announcement, experts said.
“We are beyond the time of meeting to do careful thinking,” Morrison said. “We know what the issues are. What’s needed is action at a high level.”
Miliband described the G-20 response as at the “lower end of expectations for muscularity and impact,” failing to fill gaps in preparedness at the national, regional or global levels.
“There is a real danger with this G-20 that people will think future pandemics have been taken care of,” Miliband said. “They haven’t.”