Abstract
Global health security remains a critical concern, with recent outbreaks highlighting systemic weaknesses in pandemic preparedness and response (PPR) funding mechanisms. The COVID-19 pandemic, in particular, exposed significant disparities in resource allocation, coordination, and sustainability, echoing challenges observed in previous epidemics like H1N1, SARS, and Ebola (Fauci & Folkers, 2023; Peeri et al., 2020; Fineberg, 2014). This article re-evaluates existing funding frameworks. A mixed-methods approach was employed, combining a qualitative review of global health policy documents and expert reports with a quantitative analysis of publicly available funding data for PPR initiatives from 2009 to 2023. The study focused on identifying key trends, gaps, and the impact of funding modalities on response efficacy and equity across different income settings. Analysis revealed a predominant reactive funding model, characterized by surges in investment during crises followed by significant declines in inter-pandemic periods, leading to persistent underfunding of foundational preparedness capacities (Katz, 2023). Furthermore, a significant portion of funding was found to be earmarked, lacking the flexibility required for adaptive responses, and often failing to reach local levels effectively, exacerbating inequities (Alberti et al., 2020; Alakija, 2023). Current funding mechanisms are inadequate for sustainable, equitable, and effective global PPR. A paradigm shift towards more predictable, flexible, and equitably distributed financing is imperative. This includes strengthening pooled funds, enhancing national and regional capacities for resource absorption, and integrating equity as a core principle in all funding decisions to build resilient health systems capable of mitigating future pandemic threats.
Keywords
Pandemic preparedness, global health security, funding mechanisms, health equity, COVID-19, outbreak response, financing, lessons learned