ARABILE GUMEDE, FINANCIAL JOURNALIST: As we continue our look into financing the future of the COVAX, I'm delighted to be joined by Mamta Murthi, who is Vice President for Human Development at the World Bank. The World Bank responded rapidly to the pandemic in 2020, setting aside, last October, a $12 billion package that will help countries respond to vaccines, testing, and even treatments. Now, the urgent need for decisive action was very clear, particularly by the Bank's own estimates that 150 million people will be driven into extreme poverty as a result of the pandemic. Many of these will be people who have only recently escaped poverty. It is a reminder, then, that COVID-19 represents not only the greatest public health challenge of our time, but also an economic one.
Mamta, again, thank you so much for joining us today. Gavi and the World Bank have been partners since the Vaccine Alliance was established back in the year of 2000. Both organizations really share the same fundamental vision, that is to improve people's lives and to provide the commodities and infrastructure to underpin long-term sustainable economic growth. All the progress made in recent years is now, of course, at risk as a result of this pandemic. In the Bank’s view, what is needed now to put countries back on a sustainable trajectory, particularly for long term health, and that impact?
MAMTA MURTHI, WORLD BANK’S VICE PRESIDENT FOR HUMAN DEVELOPMENT: Thank you, Arabile, for this really important question. You emphasize that the World Bank is a founding partner of Gavi and we've worked very closely with them to strengthen health systems, globally. And, of course, we're working with them now on this largest ever rollout of vaccinations in history. But this has taken place in the context of a pandemic that is really ravaging the developing world. And, of course, we are very concerned. In addition to the loss of lives, we're concerned by the fact that routine immunizations are being missed. We're concerned about the fact that many women cannot get reproductive health services. We're concerned about the missed appointments and treatment of non-communicable diseases, the rise of malnutrition, and more. And all of this is likely to have long-term impact on people in the developing world, and on their opportunities to go on to live fulfilling and productive lives. And that's why it's so important to bring an end to this pandemic.
Now, in response to the pandemic, as the World Bank, we have mounted the largest ever crisis response in our history. And this involved over $40 billion of support for developing countries. It started with supporting the emergency health response: resources so that countries could purchase PPE, diagnostic tests, medical equipment, equipment, and of course support their healthcare workers for frontline response. The resources were also to expand safety nets and cash transfers so that select people whose incomes had stopped could receive support. The resources also supported private sector development as well as governments who needed resources to put in place policies and investments to respond to the pandemic.
So, I would say that it's very important that this kind of support continues, so international agencies, partners and governments themselves continue to work on responding to the pandemic with all the resources that they can bring to bear. There continues to be the need to support public health measures and testing and treatment. In addition, of course, developing countries need access to vaccines.
ARABILE GUMEDE: If you needed any clearer example of just how global and how fast moving this pandemic is, just look at how we're having this conversation from three different parts of the world that are just as ravaged by this pandemic and hurt by it in multiple different ways. And that tells you the story of just how immediate the response needed to be, how impactful things have become, and how much need there will be for consistent help moving forward. We recently outlined the latest World Bank thinking on how we vaccinate every country, resting particularly on three pillars, those being: the fulfilling of commitments, ones that were laid out before; contractual transparency, which is a significant one; as well as the increase in vaccine production. As we try to look even beyond 2021, with perhaps COVID-19 still there and what we hope will be an end to the acute phase of COVID-19, how can we best prepare for 2022? What is needed? How do we then take a leap forward?
MAMTA MURTHI: So, I would say, first of all, that it remains the case that without bringing the pandemic under control, millions of additional people will be pushed into extreme poverty. And this is something that needs to be a guiding principle for us. We need to bring the economies of the world back on track, and that means bringing the pandemic under control.
Now, as you've said, there are really three elements that we see, and it's very important that this continues into 2022 in order to fully have the pandemic under control. The first is the commitment of financing: events such as this one, which are trying to ensure that there is enough money for the GAVI AMC, are extremely important. On our side, we have already committed $2.4 billion in over 20 countries to support acquisition and deployment of COVID-19 vaccines, and we expect to reach 4 billion by the middle of the year. And this is an effort that we intend to keep up and continue. We're also trying to aggregate the demand from countries that can be financed by the World Bank, and make sure that Gavi and COVAX have visibility on this demand, so that they can make purchases for vaccines beyond the 20% that will be financed through donor contributions.
Now, it's clear that while financing is needed, it's not the only part of the story. Expanding supply is also important. This financing is really so that developing countries can get in the queue for COVID-19 vaccines, because it is the case that the majority of vaccine availability is really now in the richer countries of the world. And with the expansion of vaccinations for children and boosters, we are very concerned, as are our other partners, that developing countries will continue to be at the back of the queue. That's why we are strongly advocating for the donation of surplus vaccines, so that vaccines can become available earlier in developing countries.
And there are many ways in which these donations can be made. We are advocating that the donations be made through COVAX, so that the commitment that has been made to provide 20% coverage of the population in developing countries can be fulfilled. That's the first part of the story. The second part of the story is really around expanding manufacturing. And here, our private sector arm, the International Finance Corporation (IFC) has already made investments of about $1billion in medical services and in manufacturing, so that the kinds of equipment and services that are needed to respond to COVID-19 are provided, and these investments are in developing countries, including in Sub-Saharan Africa. In addition to the $1 billion or so investments that have been made, they have a $4 billion platform that they are further putting to the service of developing countries. IFC is also looking to make early investments, at-risk investments, in promising medical technologies, including vaccines and medical services, to alleviate the worldwide shortage of vaccines.
The final point I would make is really around transparency, and here we've been advocating that governments, manufacturers, agencies that are involved in the production and the delivery of vaccines really be very transparent about what capacity has been installed and is available, and what doses have been contracted. I think this allows for much greater clarity on what supply is available, what has been contracted and what remains. Countries also need to be ready to absorb vaccines. And that's why with Gavi, with UNICEF, WHO, Global Fund, we engaged in producing assessments of readiness for vaccine deployment. We've done this in over 140 countries, in partnership with the countries, and it's extremely important that countries work on being ready to deploy vaccines
ARABILE GUMEDE: How can the Bank and Gavi and COVAX leverage innovative financing upfront, in order to tackle the issue at hand, in summary?
MAMTA MURTHI: I would say that we've learned a lot through this crisis response. We've learned that prevention is better than cure. If a country or the international community is prepared, it's much easier to respond. That's the first thing I would say—so, investment in preparation and in preparedness.
The second thing we've learned is that a crisis response has to be multi-sectoral, so it starts with a One Health approach. We have to look at animal health and human health and health of the environment. After all, we're talking about a zoonotic disease that leapt from animals to humans.
But we need to also think about the resilience of systems. We need to support education systems in such a way that they can be resilient to a lockdown. We need to make sure that countries are in a position to provide cash benefits to people in the event of a lockdown. We need infrastructure, especially digital infrastructure, to make sure that countries can respond to a future pandemic.
So, I would say that preparation, cross-sectoral support, and making sure that there is financing that can be triggered, that can surge in response to a pandemic, is what is needed. We have some experience doing this at the World Bank and we'll be very happy to make this expertise available to all, as we discuss how to fight this pandemic, and how to prevent and be better prepared for the next one.
