Pandemic Preparedness and Health Systems Strengthening

What the World Bank is doing

The World Bank supports countries in their efforts to prevent pandemics by strengthening veterinary and human health systems, as well as the bridges between them. Under IDA 18 , the World Bank committed to help at least 25 countries develop pandemic preparedness plans and strengthen their governance and institutional arrangements for multisectoral health emergency preparedness, response, and recovery. To date, 37 IDA countries have already developed, costed, and prioritized these plans, with work underway in at least 14 more.

To enhance regional preparedness  following the devastation caused by Ebola in West Africa in 2014 and 2015, the World Bank expanded IDA financing for the Regional Disease Surveillance Systems Enhancement (REDISSE) Program.  The initiative is a series of projects to strengthen national, regional, and cross-sectoral capacity for integrated disease surveillance and response in selected countries in Sub-Saharan Africa.

Strengthening health systems and investing in outbreak preparedness is also one of the best ways to contain antimicrobial resistance which has dramatically accelerated by the over-use and misuse of antimicrobials, including antibiotics, in people and animals.

If AMR continues to spread unchecked, many common infections will become untreatable again, resulting in prolonged illness, disability, and death. There will also be enormous economic losses globally. Research by the World Bank finds that by 2050 in a worst-case AMR scenario, low-income countries could lose over 5% of their GDP.  Up to 28 million people, mostly in developing countries, would be pushed into poverty.

To help prevent this, the World Bank is supporting country efforts to tackle AMR by including interventions that address AMR issues in our health investments in the developing world. Together with partners, the focus is on developing more AMR-specific interventions like stronger antimicrobial stewardship that reduces overuse, increased infection prevention and control, and the appropriate use of antibiotics in animal husbandry. At the global level, the World Bank is creating an investment framework for the existing AMR Global Action Plan so policymakers can ensure that that AMR investments go where they are needed most.

Since the 10th outbreak of Ebola began in August 2018 in the Democratic Republic of Congo, the World Bank has committed US$350 million from IDA with an additional US$50 million disbursed from the Pandemic Emergency Financing Facility (PEF) – a financing mechanism housed at the World Bank. The funds enable responders to step up the frontline health response, deliver cash-for-work programs to support the local economy, strengthen resilience in the affected communities, and contain the spread of this deadly virus.

Specific results include:

• World Bank funding supports health clinics in all affected areas with free healthcare and provision of essential medicines. This has removed financial barriers for patients needing to access healthcare and has resulted in a three to five-fold increase in the number of patients seeking care leading to faster detection of Ebola.
• Ten Ebola treatment centers have been established in Beni, Bunia, Butembo, Goma, Katwa, Kayina, Komanda, Mandima, Manginaet and Tchomia. New case management protocols have been developed to improve the care of those suffering from Ebola.
• Over 5,200 handwashing stations have been set up to ensure hygiene and limit transmission.
• Seven mobile laboratories and 67 case tracking teams carry out contact tracing and disease surveillance.
• Twenty-one decontamination teams ensure cleanliness and safe disposal of infected items.
• Seventy-five psycho-social support teams have provided 3,000 psycho-social support kits to families of patients.
• Community engagement campaigns have helped increase knowledge on how to limit Ebola transmission, build community support through existing community structures, encourage vaccination and explain the need for safe and dignified burials to prevent transmission.
• Health facilities have received training on infection, prevention and control measures at health facilities to prevent nosocomial infections.
• Over 220,000 people have been vaccinated with the investigational Merck rVSV vaccine, through an innovative research protocol that has been integrated in the public health response supported by many partners, including GAVI.

The East Africa Public Health Laboratory Networking Project (EAPHLN) is an example of a regional laboratory network that includes Burundi, Kenya, Rwanda, Tanzania and Uganda.  This has significantly increased the regional capacity to detect outbreaks and mount rapid effective responses. The World Bank-funded network of efficient, high quality, accessible public-health laboratories in help strengthening diagnostic and surveillance capacity and disease outbreak preparedness. This is being boosted by 10 cross-border committees across the five countries; screenings at selected border crossing points; enhanced diagnostic capacities for laboratory-confirmation of pathogens (from 8% to 88%); 10 joint investigations on Ebola, Marburg and Cholera; continued strengthening of pandemic preparedness to address risks of cross-border transmission; and roll out of a mobile phone reporting system on disease outbreaks.