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January 30, 2015

Responding To: Week 2: The Ebola Epidemic Highlights Practical and Moral Challenges for Global Institutions

Issues Raised by Proposed Public-Private Pandemic Insurance Proposal

John Monahan

On January 27, 2015, World Bank Group President Jim Yong Kim delivered an engaging and thought-provoking  lecture that reminded all of us that, despite multiple warnings over the years, the global community is not ready to respond to a global pandemic or a similar public health threat.  The Ebola outbreak in West Africa is simply the most recent illustration that we are not prepared to address predictable pandemic threats and health emergencies in a timely, effective, and humane fashion.  

President Kim’s public lecture raises at least three points:

First, President Kim was passionate that imagining the Future of Development requires all of us to avoid employing old “mental models” in addressing big and vexing problems.  In the case of pandemic threats, he wants us to engage different players, such as the insurance industry, and explore different strategies, such as a global pandemic financing facility, in tackling a problem all too familiar to global health professionals.

Second, it seems that President Kim’s proposal for establishing a new public-private pandemic insurance facility may suggest a new way of doing business for the World Bank.   In the case of pandemic response, he is calling for the Bank to use its financial expertise and business relationships to craft a creative public-private solution to a global problem that affects all countries and all people (infectious diseases that respect no borders) yet disproportionately impacts the poor, who remain the focus of the Bank’s mission.  I look forward to seeing if this theme continues when he addresses climate change at Georgetown in March.

Third, I will be watching closely to learn more about the details of the World Bank’s public-private insurance facility.  Among the key design questions I will tracking are: 

  • How does the proposed insurance facility complement and reinforce the World Health Organization’s proposal for establishing a pandemic contingency fund and/or commitments made by 20+ countries in embracing the Global Health Security Agenda last year?
  • How does the proposed insurance facility create incentives, and provide resources, for investments that will increase the capacity of countries to prepare for, prevent, detect, and respond to pandemic threats as required in the International Health Regulations (IHRs)?  How will we know when countries have come into compliance with the IHRs and/or met milestones relevant to coverage under the proposed insurance facility?
  • How does the proposed insurance facility support and maintain the kind of standing capacity of trained health professionals, logisticians, equipment and other “hard assets” that can be deployed immediately when a public health emergency is detected and financial resources are made available ?   

John Monahan is the Senior Advisor for Global Health to President John J DeGioia; Senior Fellow, McCourt School of Public Policy;  Senior Scholar, O'Neill Institute for National and Global Health Law. 


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