Financing for Preparedness: GHSA & the Pandemic Fund Part 2
August 16, 2023
Building on the success of our Part 1 webinar held in April, this event aimed to offer a comprehensive update on the Pandemic Fund’s first Call for Proposals and facilitate a roundtable discussion on the experiences of participating countries and regional agencies. Priya Basu, from the Pandemic Fund Secretariat, shared a detailed analysis of proposals received during the first Call and provided valuable insights into the how the Governing Board selected proposals for funding. Furthermore, a moderated roundtable discussion with representatives from the Caribbean Public Health Agency, Ethiopia and Rwanda, whose proposals were recommended for funding by the Technical Advisory Panel. This discussion shed light on the intricacies of coordination, engagement with stakeholders, and prioritization that were pivotal in the development of robust Pandemic Fund proposals.
Dr. Jose Fernandez, Deputy Director for the Office of Pandemics and Emerging Threats in the U.S. Department of Health and Human Services, Office of Global Affairs opened the event by emphasizing the valuable lessons to be gained from the Pandemic Fund’s First Call for Proposals. Recognizing both achievements and challenges, these lessons will shape the approach for subsequent calls for proposal. One revelation was the overwhelming demand for Pandemic Fund grants which greatly exceeded the available funds. Despite the exceptional technical quality of the proposals received, not all could be awarded highlighting the urgent need to mobilize additional resources for the fund’s continued success. Dr. Jose Fernandez also emphasized the transformative potential of engaging philanthropic entities, private sector partners, and other stakeholders to bridge the financial gap, amplify impact, and supplement co-investments and co-financing within proposals.
Furthermore, Dr. Fernandez elaborated on the core design of the Pandemic Fund, highlighting its purpose in incentivizing further investments from various stakeholders, ultimately promoting long-term sustainability. He commended the outstanding achievement of proposals awarded that generated an additional $2 billion in investments, underscoring the commitment of both governments and partners to finance pandemic preparedness.
In the first part of this two-part webinar series, representatives from Pakistan, Thailand, and Senegal, shared their country experiences in the midst of developing their Pandemic Fund proposals. They highlighted how they leveraged platforms for coordination across ministries, prioritized activities for funding, and identified implementing partners for collaboration. Dr. Fernandez drew attention to the shared methodologies of the Pandemic Fund’s Results Framework and the GHSA’s overarching target, both rooted in the (International Health Regulations (IHR). This alignment showcases the promising synergy between these two initiatives, reinforcing the importance of our collective efforts in global health security.
In closing, these webinars aim to offer participants a comprehensive understanding of the Pandemic Fund, enriched by the experiences and insights of stakeholders. This collective knowledge will be instrumental in enhancing the Pandemic Fund’s development and ensuring its continued success.
The Pandemic Fund Presents Analysis on the First Call for Proposals
The Pandemic Fund’s inaugural call for proposals, as presented by Priya Basu from the Pandemic Fund Secretariat, showcased a rigorous evaluation process and a thoughtful approach to proposal selection. The presentation shed light on the fund’s journey in assessing 179 applications, resulting in a portfolio of 19 projects with a grant funding of $338 million to aid 37 countries in their projects to strengthen Surveillance, Laboratory and Workforce capacities.
Process and Evaluation
The first call drew a substantial response, with 179 applications submitted. An initial screening by the Secretariat identified 75% (135) of these proposals as eligible. These proposals collectively requested funding amounting to $2.2 billion. Notably, 82% of proposals received were single country proposals.
To ensure a comprehensive assessment, a Technical Advisory Panel (TAP) conducted an in-depth review of all eligible proposals. This review encompassed six key areas: 1) Context, rational, objectives and demonstrated needs; 2) Scope, priority areas, core capacities, and alignment with Pandemic Fund results framework; 3) Ownership, commitment, and co-investment; 4) Co-financing and overall available funding; 5) Coordination, collaboration, and co-creation; 6) Implementation plan.
Following this evaluation process, the TAP recommended 36% of eligible proposals comprising 23 highly recommended and 26 recommended proposals to be presented to the Governing Board. These recommended proposals sought a total of $972 million in funding, with $471 million coming from highly recommended proposals and $501 million from recommended proposals.
Scenarios and Decision Making
Because recommended proposals exceeded the $350 million envelope for this first Call, the Secretariat had to apply previously agreed criteria – geographic distribution, income group, and implementing entity – by the Governing Board to construct diverse portfolios options for Governing Board decision. The Governing Board considered six scenarios, taking into account co-financing, co-investment, gender equity, and the One Health focus. This meticulous process culminated in the selection of a strategic portfolio comprising 19 projects. These projects span single-country initiatives in Africa and East Asia and the Pacific region and multi-country proposals in Latin America, the Caribbean, and Central Asia.
Lessons Learned
The presentation candidly acknowledged the first call as a learning experience, prompting a comprehensive review of the fund’s inaugural year. This introspective evaluation aims to enhance future rounds and provide constructive feedback to applicants who didn’t secure funding.
Technical Insights
The Technical Advisory Panel’s dedication to establishing an equitable evaluation process was evident, as they pieced together a holistic understanding of each country’s unique situation. The role of Joint External Evaluation (JEE) and National Action Plans in the decision-making process was discussed which was one of many international indices and sources used to comprehensively assess country needs and priorities. Priya Basu underscored the importance of country ownership and co-investment as critical evaluation criteria, emphasizing the fund’s commitment to long-term project sustainability.
Next Steps and Future Outlook
The Secretariat is following up with all applicants. For applicants who were selected for funding, letters of commitment have been sent to Implementing Entities. For applicants not selected for funding, individual feedback is being prepared and will be shared in the coming weeks. The presentation culminated with the announcement of forthcoming second call for proposals by the end of the year.
The Pandemic Fund’s first call for proposals not only demonstrated a meticulous evaluation process but also highlighted the fund’s dedication to learning, adaptability, and supporting countries in their journey towards pandemic preparedness. With insights gained from this inaugural First Call, the fund is poised to make an even greater impact in its subsequent rounds.
Roundtable Discussion on Country and Regional Agency Experiences
Moderated by Mukesh Chawla World Bank Chief Advisor for Health, Nutrition, and Population, this roundtable discussion brought together distinguished panelists: Dr. Lisa Indar from the Caribbean Public Health Agency (CARPHA), Dr. Mebratu Massebo from the Ministry of Health of Ethiopia, and Professor Claude Muvunyi from the Rwanda Biomedical Center. The purpose of this discussion was to share their experiences in developing pandemic fund proposals, aiming to illuminate the challenges, strategies, and insights gained through the process.
Regional Approaches and Coordination
Dr. Lisa Indar emphasized the significance of regional approaches in pandemic preparedness. CARPHA, a regional public health agency serving 26 member states, is mandated by their heads of government to provide a response to public health emergencies, including pandemics. The Caribbean region faces common challenges, including small nation states, porous borders, varying epidemic response capacities, heavy dependence on tourism, and shared risks related to vector and foodborne diseases. These factors make a regional approach invaluable. A coordinated regional response is crucial due to the region’s interconnectedness and the potential for disease spread. CARPHA has been building early warning and response surveillance systems, laboratory systems, and workforce capacity using a One Health approach in the region. Dr. Indar emphasized the importance of coordination mechanisms within CARPHA, including communication with chief medical officers and regional coordinating mechanisms aligning efforts across member states, domestic and international agencies, and coordination across 11 major technical departments. CARPHA’s regional coordinating mechanism for health security brings together member states and various agencies involved in pandemic response. This unit was leveraged to develop CARPHA’s Pandemic Fund proposal
Professor Claude Muvunyi shared how the Expression of Interest process helped bring together various partners in Rwanda, including the Rwanda Agriculture Board, the Minister of Agriculture and Animal Resources, and the University of Rwanda, to develop a joint proposal. Rwanda also relied on existing coordination mechanisms and relationships with CSOs.
Dr. Mebratu Massebo shared how Ethiopia coordinated with multiple agencies, including the Ministry of Health, specialized entities in the ministry such as the Ethiopian Public Health Institute, animal health institutes, academia, CSOs, and bilateral and multilateral NGOs. They invited these entities to share their priorities, contribute new functions, and support the proposal writing process. Ethiopia was in the process of developing proposals for World Bank funding, the Global Fund, and others, which required additional coordination to determine priorities for each and avoid duplication of activities.
Engaging Civil Society and the Private Sector
The discussion also explored the engagement of civil society and the private sector. In Rwanda, Professor Claude Muvunyi highlighted how coordination mechanisms for engaging civil society for the Global Fund were leveraged for their Pandemic Fund proposal, along with Rwanda Biomedical Center’s relationships with CSOs through various programs and divisions. Rwanda’s experience underscored the importance of leveraging established relationships and networks to involve various stakeholders. Dr. Mebratu Massebo highlighted the private sector as a partner that needs to be engaged more in preparedness. Ethiopia approached private sector partners to generate innovative ideas for inclusion in their proposal, such as innovations for reaching rural communities. CARPHA also highlighted how the private sector is engaged in their work such as the Hotel Association through their Tourism and Health program.
Prioritization
Dr. Mebratu Massebo discussed Ethiopia’s approach to prioritizing activities for their proposal, explaining how gaps identified from JEE, SPAR, and 7-1-7 assessments were used to identify priority areas for their Pandemic Fund proposal. Professor Claude Muvunyi described a similar approach in Rwanda, looking at their JEE and NAPHS, which had a long list of needs that required brainstorming with all partners to prioritize. Rwanda also used its One Health Strategic Plan, which had yet to be funded, to determine priorities. Previous experience in developing proposals for the Global Fund was also beneficial for the team. The partnership and expertise from different stakeholders, such as WHO, FAO, and UNICEF, made a significant difference in proposal development. The panelists all recognized the importance of co-creation, as the inclusion of diverse stakeholders and the alignment of priorities ensured a comprehensive and effective proposal.
Recommendations and Lessons Learned
The panelists offered valuable recommendations for improving the proposal development process. Dr. Lisa Indar emphasized the need for better coordination among various agencies and entities involved in pandemic response. Dr. Mebratu Massebo highlighted the importance of supporting co-creation and country ownership of proposals. Professor Claude Muvunyi stressed the need for dedicated support in the writing process to facilitate successful proposal submission.
Conclusion
The roundtable discussion highlighted the complexities and successes of developing pandemic fund proposals from regional and country perspectives. The experiences of CARPHA, Ethiopia, and Rwanda provided insights into their coordination, engagement with stakeholders, and prioritization for their pandemic fund proposals. The Pandemic Fund will continue to be an essential resource for countries seeking to build their capacities. As global health security remains a shared priority, such discussions play a crucial role in refining strategies and fostering collaboration to address gaps in health security capacity.