A severe pandemic would harm health, economies, and communities in all countries, but especially in poor and fragile states. Pandemic prevention requires robust public health systems (veterinary and human) that collaborate to stop contagion promptly.
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What is the Pandemic Emergency Facility?The World Bank Group (WBG) is working with WHO and other partners, including the private sector, to develop and implement a new Pandemic Emergency Financing Fac... Show More +ility (PEF). The PEF is a global financing facility that would channel funds swiftly to governments, multilateral agencies, NGOs and others to finance efforts to contain dangerous epidemic outbreaks before they turn into pandemics. The PEF is being designed flexibly so that it can function effectively within the evolving new global health architecture. Financing from the PEF will be linked to strong country-level epidemic and pandemic emergency preparedness plans, thereby incentivizing recipient governments and the international community to introduce greater rigor and discipline into crisis preparedness and reduce the potential for moral hazard.Why do we need a Pandemic Emergency Facility?The Ebola crisis and other similar crises point to the need for prevention, preparedness, early detection and timely support to help countries deal with infectious disease outbreaks. Financing for a pandemic emergency is essential—to ensure that the right amount of money is available at the right time, minimize the human and economic impacts, and spur better preparedness. The better prepared, the faster and less expensive our response. In a world of scarce resources and fast-moving, unpredictable crises, the traditional approach of mobilizing resources in the wake of an outbreak is slow, inefficient and fragmented.How big is the economic risk of a pandemic? According to a 2013 survey by Towers Watson of 30,000 insurance industry experts around the world, pandemics topped the list of extreme risks that matter most for the insurance industry over the long term. The World Bank Group released a report in April 2015 showing that the Ebola epidemic continues to cripple the economies of the three hardest-hit countries—with a projected $2.2 billion in lost GDP for 2015. Estimated economic losses for 2015 across sub-Saharan Africa range from at least $500 million to as high as $6 billion if the epidemic were to spread further through the region.Ebola isn’t our first wake-up call that pandemics are costly. From 1997-2009, six major outbreaks of highly fatal zoonoses—animal-borne diseases that can be transmitted to humans, such as Ebola, SARS, avian and H1N1 flu—caused an estimated $80 billion in economic losses. The human and social costs are incalculable. Many pathogens are even more infectious than Ebola.What activities would the PEF finance?The PEF is expected to cover a range of response activities such as: (i) rapid deployment of a trained and ready health work force (“global health corps” or ‘white coats”); (ii) medical equipment, pharmaceuticals and diagnostic supplies; (iii) logistics and food supplies; and (iv) coordination and communication. The PEF would not cover pandemic preparedness or reconstruction efforts. These would need to be financed through existing channels, domestic resources, bilateral development assistance, and multilateral financing, including IDA, the World Bank Group’s fund for the poorest countries, and IBRD loans for middle-income countries.Who would receive the money disbursed by the PEF?The PEF is envisaged as an open platform that would make finance available not for the World Bank Group itself, but directly to eligible, affected countries or international organizations such as the World Health Organization and other partners that could help contain the outbreak. Both low and middle income countries would be eligible to receive funds, provided they prepare an appropriate disease risk management plan.How would the PEF work with existing WBG financing instruments?The PEF would build on existing WBG financing instruments, including the IDA Crisis Response Window and the CAT DDO (catastrophe deferred drawdown option). The IDA CRW provides urgent financing to help the poorest countries to respond to crises. A total of $1 billion is available for all 77 poorest countries through June 2017. The WBG has already committed more than half the total amount to help countries deal with the Ebola crisis just 6 months into IDA17. The CAT DDO provides a line of credit that allows middle-income countries to access immediate financing following a natural disaster. To access the funds, countries have to develop a disaster risk management program to demonstrate that they have taken the necessary steps.The pandemic facility is complemented by the Ebola Recovery and Reconstruction Trust Fund. The WBG established this fund in September 2014 to complement financing for Ebola emergency response efforts and help affected countries address the social and economic impacts and pave the way for recovery. The fund is focused on activities such as restarting agricultural production; getting children back in school and learning; and expanding cash transfer and work-for-food programs to help those who have lost their incomes.What role would the World Bank Group, WHO and other international institutions play in the PEF?The World Bank Group (WBG) is playing a lead role in conceptualizing the facility, working in coordination with international organizations, including the WHO, the private sector and other development partners. The WBG supports a strong WHO and the efforts underway to ensure WHO is adequately financed and equipped to respond to pandemics. The PEF will provide additional and complementary financing tools needed to ensure a swift and comprehensive response. Funds from the PEF would be channeled via international organizations, including the WHO and other UN agencies, governments, NGOs, etc. to finance efforts to contain dangerous epidemic outbreaks before they turn into pandemics.What role could the private sector play?Private sector participation in the PEF will be essential to ensuring that the response to future pandemics is timely and effective. The private sector could be involved in a variety of activities, including developing insurance against pandemic threats, training healthcare workers, and playing an active role in coordinating the humanitarian response to crises. The private sector could also play a role in preparing communities for future outbreaks.What products could the PEF offer?The PEF’s design builds on the existing suite of crisis response tools, within and outside the WBG, and on the WBG’s experience in kick-starting market mechanisms, and could offer a variety of complementary products:Private insurance mechanism. The PEF, on behalf of countries, could buy insurance coverage from the private sector to cover risks associated with the outbreak.Public funding mechanism. The PEF would rely on long-term donor pledges to IBRD, which could, through bonds or the Bank’s liquidity, be disbursed to contain the outbreak.How would the PEF insurance mechanism work?The PEF would purchase insurance coverage from the private sector on behalf of developing countries to cover costs associated with disease outbreak response. When a pre-agreed parametric trigger (based on public and observable data) is activated, the private sector would make the agreed payouts to the PEF, which would disburse resources to eligible implementing partners to finance critical containment measures. Such a mechanism would be able to disburse resources quickly once the trigger is activated, rather than relying on a loss assessment, which typically takes time. The insurance mechanism would need to start small but could be expanded in terms of geography, size, events covered, etc., as the market for pandemic/epidemic risks in developing countries develops.How would the insurance mechanism be funded?The leading options to finance the insurance mechanism are through bond markets and insurance companies. These can be very easily combined in a manner to lower the overall cost of premium; this is very frequently done in the private sector to optimize costs and coverage. In both options, the insurance premium would need to be funded largely by donors, but potential beneficiaries may also contribute.What are the key benefits that the insurance mechanism would bring?The insurance mechanism would help create a new market for insuring epidemic and pandemic risk. This would help bring market discipline to crisis response by creating positive incentives for data reporting and monitoring of diseases and for country-level investments in preparedness to tackle pandemics. One idea that is being explored in this context is whether the level of premiums could be linked to country preparedness as measured against the benchmarks set by WHO’s International Health Regulations.Are there other, similar, insurance mechanisms?The underlying concept of using insurance to pre-finance sovereign risks is well-recognized, and has been employed in the management of climate and disaster risks faced by governments. Programs such as Mexico's MultiCat (for earthquake and hurricane), African Risk Capacity (for drought) and the Caribbean Catastrophe Risk Insurance Facility (for earthquake, droughts and extreme rainfall) have been well-studied and are considered successes by multilaterals, donors, beneficiary governments and rating agencies.How would the public funding mechanism complement the insurance mechanism?To enable the PEF to cover higher frequency events, the WBG is also working with partners on other instruments, including a public funding mechanism, to complement the insurance mechanism. With the public funding mechanism, the WBG could take long-term donor pledges/lines of credit and use its own liquidity or borrow on the capital markets against these pledges once an outbreak happens.What are the next steps needed to further develop the PEF?The WBG is currently in discussions with international organizations, including the WHO, governments, potential donors, the private sector, and other development partners to flesh out the design of this proposed facility so that when the next global health emergency is declared, the world has the resources to quickly deploy the financial resources, trained health workers, equipment, medicines and whatever else is required. Show Less -
WASHINGTON, May 20, 2015 — The World Bank Group’s Board of Executive Directors today approved US$15.1 million for women and children to expand access to maternal, child health and nutrition services i... Show More +n Faranah and Labe, two of the poorest regions in Guinea.The Primary Health Services Improvement Project, funded with a grant and credit from the International Development Association* (IDA), will target women, and children under five, by making available urgently needed medicines and recruiting and training health workers for rural health centers in Faranah and Labe. These two regions are home to around 1.9 million people, or approximately one fifth of Guinea’s total population. Of those, 52 percent are female and 20 percent are children under five.The Ebola crisis, which first emerged in December 2013, has taken a major toll on families, communities and the economy in Guinea. The outbreak has further weakened an already weak health system. Visits in some health facilities have dropped by 50 percent in part due to the reluctance of the general population to access the health system for fear of contamination. In addition, already limited numbers of health workers and financial resources have been directed towards the Ebola response effort, and many health centers outside of Conakry are simply not functional. Too many women and children are dying from preventable illnesses, such as low nutrition, malaria and poor prenatal and maternal care. “By giving health providers the inputs to improve their services, and strengthening community level trust and demand, this project supports the Government’s strategy to build on its Ebola response and improve health outcomes and reduce health disparities in Guinea,” said Cheick Fantamady Kante, the World Bank Country Manager for Guinea.The project aims to support the government’s push to improve the utilization of maternal, child health and nutrition services at the primary care centers in the targeted regions by improving the availability of essential supplies and equipment at rural health centers. By training and recruiting frontline health workers moreover, and providing payment for health care costs that poor households can’t afford, the project will help ensure that rural health centers remain operable. At the same time, the Primary Health Services Improvement Project will lay the foundation for more comprehensive health system reform in Guinea. This will be facilitated by helping to strengthen the government’s capacity to plan, implement, and monitor health services, particularly by boosting supervision of health activities at the local level. Funds will also support data collection and evidence generation to inform wider efforts to develop a health system that will improve access to health services for the many poor families living outside of the capital city of Conakry.“Enhancing primary health care for women and children in Guinea will help prevent the outbreak of disease epidemics and strengthen the resilience of communities and households to common illness, medical complications and other shocks,” said Ibrahim Magazi, one of two World Bank Task Team Leaders for this project.“This project’s focus on improving health services for women and children in two of the poorest regions is an initial step towards reducing poverty and boosting shared prosperity in Guinea,” adds Christopher H. Herbst, the other World Bank Task Team Leader for this Project. * The World Bank’s International Development Association (IDA), established in 1960, helps the world’s poorest countries by providing grants and low to zero-interest loans for projects and programs that boost economic growth, reduce poverty, and improve poor people’s lives. IDA is one of the largest sources of assistance for the world’s 77 poorest countries, 39 of which are in Africa. Resources from IDA bring positive change for 2.8 billion people, the majority of whom live on less than $2 a day. Since 1960, IDA has supported development work in 112 countries. Annual commitments have averaged about $18 billion over the last three years, with about 50 percent going to Africa. Show Less -
Presented in discussion of item 16.1 and adoption of resolution pursuant to documents A68/24, A68/25, A68/26 and A68/27. May 19, 2015 - Tim Evans, Senior Director, Health, Nutrition and Populatio... Show More +n, World Bank Group Hon’ble Chair and ExcellenciesThe World Bank Group welcomes the draft documents and discussions related to the Ebola virus outbreak and follow-up to the Special Session of the Executive Board on Ebola.At the outset, the World Bank Group acknowledges and supports the leadership of the Governments, especially the Ministries of Health, of Guinea, Liberia and Sierra Leone in their fight to get to, and sustain zero cases of EVD -- AND in their efforts to get their essential health services and economies back on track. The World Bank Group acknowledges the untiring and selfless efforts of the health and development communities in these three countries, members of which have worked in very adverse circumstances and against tough odds to contain this epidemic.The World Bank Group welcomes the update on the Ebola outbreak, and appreciates the frank assessment as well as the actionable recommendations of the Ebola Interim Assessment panel as presented in its First Report. The World Bank Group very strongly supports a strengthened and well-funded WHO, which can support all countries as they prepare to meet the challenges of increased global interdependence and shared vulnerability. More specifically, the WBG acknowledges the important focus of the First Report on financing. The Report's focus on the chronic under-financing of WHO arising from the Zero Economic Growth policy is critically important -- we urge all member states to reconsider this policy that places at risk all of WHO's core functions in the longer run. The World Bank Group strongly supports the establishment of a Contingency Fund to support WHO’s emergency response capacity. The WBG sees this as one critical part of rebuilding the financing architecture for pandemic risk management. On its part, the World Bank Group working closely with WHO and other development partners and the private sector is developing a global Pandemic Emergency Financing Facility. The PEFF, upon receiving an agreed "trigger" or "signal" from WHO, will disburse resources of sufficient scale - swiftly - to priority needs. In this regard, the PEFF will complement the proposed WHO Contingency Fund by providing resources to countries and implementing agencies, including WHO, WFP, UNICEF and others, as well as NGOs, to finance containment activities in affected countries.The World Bank Group also welcomes the plan for a Global Health Emergency Workforce to respond to acute or protracted risks and emergencies with health consequences, which is fully aligned with the White Coats initiative proposed by Chancellor Merkel. The proposed Pandemic Emergency Financing Facility will support the rapid deployment of medical and health personnel during outbreaks, and considers this to be a very critical component of a surge response.As various processes – such as the UNSG High Level panel, WHO’s Ebola Interim Assessment Panel, the Institute of Medicine Pandemic review – move toward conclusions, it will be critical to agree how their recommendations for strengthened global risk management for pandemics can be financed swiftly and sustainably drawing on existing and new mechanisms. In this regard, the World Bank Group looks forward to organizing with WHO and other partners, in early September 2015, a high level consultation on "pandemic financing", that aims to reach consensus on both an overall framework for financing and on the specific mechanisms that will fuel the recommendations for a renewed and revitalized pandemic preparedness and response capacity. We also invite all interested in discussing pandemic financing further to a technical session tomorrow morning at 7:45am on the 8th Floor of the Palais in the Delegates Restaurant...Thank you. Show Less -
Results- All 39 reports of suspected highly pathogenic avian influenza (HPAI) cases in poultry reported and fully investigated in 2014. - Reporting time of ne... Show More +w outbreaks and return of laboratory confirmation to the affected commune was reduced for both veterinary and health sectors from 8.7 days for veterinary and 10 days for human health in 2006 to 2.4 and 3.4 respectively in 2014- Fatality rate of human H5N1 cases was reduced in all 11 provinces. By June 2014, all 44 provincial hospitals and 124 district hospitals have developed their preparedness plans for an influenza pandemic.- Eight laboratories were provided with equipment and staff trained for ISO 17025 standards for AI testing.- 87 District Preventive Medicine Centers in 11 provinces fully equipped and have adequate capacity to implement their responsibilities and functions in compliance with MOH decisions on Preventive Medicine.- 68 cross sector simulation exercises were organized by 2014 for key stakeholders: people's committees, animal and human health workers, army, police, youth and women unions to promote coordination and labor division- Good biosecurity practices were applied by all poultry traders in Ha Vy wholesale live bird market and in 76 upgraded markets and slaughterhouses in the 11 provinces- 98.8% of target population can accurately identify and practice at least one key preventive behaviors- 69,012 health staff were trained, more than three times the level initially envisaged- The communication program reached 367 primary schools and more than 500,000 students. Show Less -
MAY 1, 2015--- Teachers and students returned to schools in Sierra Leone on April 14, nine months after the start of the Ebola epidemic in the country, which had claimed 3,877 lives as of last week.Th... Show More +e World Bank Group (WBG) is helping Sierra Leone, along with Guinea and Liberia, reopen schools and get students learning again, while preventing, in the school system, any further spread of Ebola.Education in Sierra Leone, Liberia, and Guinea was hit hard by the Ebola outbreak. Schools were closed for six to eight months at the height of the epidemic, leaving five million children without access to learning. Sierra Leone “I hate Ebola because it stopped my schooling,” Mohamed Mansaray, 12, from Rokupa community said in March. “I miss my teachers and playing with my friends.”Ten-year-old Yama Bundu added, “I like (learning) math, and I’m not happy that we stopped going to school because of the outbreak.”Entire families have been devastated by the outbreak, through the loss of life and economic hardship. Households must be quarantined for 21 days when any household member comes into contact with a person who has Ebola. This means that parents or other breadwinners in the family have no income during the quarantine period.Closure of businesses during the epidemic also left many parents without a steady income. Now, they wonder if they can pay for school fees and supplies to send their children back to school.Mariatu, an Ebola survivor from Rokupa, lost a husband and seven children to Ebola. Without her husband’s income, she doesn’t know if her surviving daughter, 12-year-old Adama, will be able to continue her studies.But Adama is optimistic. “I wanted to stay in school. In the end, I’ll be a lawyer and will be in a better position to take care of my mother, if my mother lives to see that day,” she said.The Government of Sierra Leone announced measures to help with the financial burden on families. This includes waiving standard examination fees and subsidizing secondary school matriculation fees over the next two years.The WBG is supporting the education sector in Sierra Leone in the Ebola recovery through new grant funds, restructured project funds, and technical assistance amounting to about $8.95 million of pooled resources from the International Development Association, Global Partnership for Education, and United Kingdom Department for International Development (DFID).This financing has helped the country procure and distribute over 36,000 hand washing stations (following government specifications), disinfect schools previously used as holding centers and clean all other schools prior to reopening, launch a grassroots social mobilization campaign aimed at parents and communities to help disseminate information about returning to school, and provide school feeding to encouraged the most vulnerable of children to return to school. These efforts, carried out collectively with other partners and led by the Ministry of Education, Science, and Technology, are targeting 9,000 schools, including formal and non-formal institutions.In addition, the WBG is exploring means of shoring up the medical training field since many medical personnel lost their lives to the epidemic.Some parents want to be assured that all safety measures are in place before sending their children back to school. However, students like Mohamad and Adama are anxious to become students again.“I want learn how to be a doctor because I want to treat people,” said Mohamad.LiberiaIn Liberia, schools started reopening in February 2015. Teachers at Billytown Public School in Montserrado County still take the temperature of students and make sure that they wash their hands before and after they enter the school building.Every day, they raise awareness of Ebola, telling their students: “When you come to school, do not touch each other and wear your jackets. Don’t share your food and bring your own bottle”.Karotee W. Washington, Billytown Public School’s principal, is vocal about letting parents know that school is a safe environment. Megaphone in hand, she tells them: “Let the children come to school. They shouldn’t stay home. We have preventative measures for Ebola.”Because the children were out of school for many months, parents asked Washington for special study classes to help students catch up on lessons after school hours.With the help of Washington, teachers, parents, and the town chief, the school was able to register 500 students upon school reopening.In Liberia, WBG support for Ebola recovery in the education sector total $4.2 million. About 15,000 teachers will undergo curriculum refresher training, and 590,000 students will receive new textbooks.GuineaSchools reopened in Guinea in January 2015. Ousmane Sacko, who teaches philosophy at the Groupe Scolaire Woodia Berete Primaire Lycée in Conakry, recounted what it was like seeing his 11th and 12th grade students again.Everyone was happy to be back in school. “The epidemic traumatized students,” he said, “By staying home for so long, they forgot about what they’ve learned in the past,”In Guinea, the WBG is assessing the impact of Ebola on learning outcomes through surveys. Ongoing projects, with UNICEF and Agence Française de Développement (AFD), will continue to provide support post-recovery. New grant funds and realigned pooled funds total $4.7 million. These will support activities such as rehabilitating existing latrines and water points in 850 schools, building new water and sanitation infrastructure, communicating about and monitoring health and hygiene in all 6,365 schools, and redesigning training programs to include modules on Ebola and related issues to benefit 12,000 teachers. Show Less -