SINGAPORE - To overcome the fragmented global health security system, a new global mechanism is needed to mobilise and govern health financing.
How to do this without adding to the complexity and fragmentation of the system is an important challenge that can be overcome, said Senior Minister and Coordinating Minister for Social Policies Tharman Shanmugaratnam on Wednesday (Sept 1).
Mr Tharman, who is also chairman of the Group of 30, a global council of economic and financial leaders, was speaking on the topic Resolving Today's Global Health Crisis And Avoiding Future Pandemics at a virtual discussion organised by European economic think-tank Bruegel.
Other panellists included Indonesian Finance Minister Sri Mulyani Indrawati, Bruegel director Guntram Wolff, Wellcome Trust director Jeremy Farrar, and Centre for Global Development executive vice-president and senior fellow Amanda Glassman.
They discussed, among other issues, the recommendations of the Group of 20 (G-20) High Level Independent Panel (HLIP) on Financing the Global Commons for Pandemic Preparedness and Response, which Mr Tharman co-chairs with World Trade Organisation director-general Ngozi Okonjo-Iweala and former United States Treasury secretary Lawrence Summers.
The panel in July released its recommendations - including setting up a US$10 billion (S$13.5 billion) Global Health Threats Fund with contributions from the international community, as well as an inclusive G-20-plus board comprising health and finance ministers - which are now being actively considered ahead of the G-20 ministerial meetings and summit in October.
Noting the sharp deterioration in global trust and increase in protectionism since the pandemic started, Mr Tharman said the world does not have a system that can adequately supply - on a global scale and within a short time - the vaccines, therapeutics or protective equipment the world needs.
"That kind of supply chain had to be invented in the middle of a pandemic, and when you start in the middle of a pandemic, it takes a long time," he said, adding that this is a new public policy challenge.
"You're not going to be able to change nation-state democracies in either the rich world or the rest of the world... They will give extra attention to their own, everywhere in the world. But we do want to tackle the pandemic everywhere because it's in everyone's interests.
"How we reconcile these two objectives, and avoid the tension between the two leading to what we saw in the last year and a half... is by building up global supply capacity in advance of a pandemic, not in the middle of one."
This means having an ever-ready manufacturing capacity of multiple vaccine candidates. But without knowing which vaccine will be successful, the private sector has no commercial incentive to make advance investments, he said.
"It requires public investment together with the private sector... so that we have an over-supply of capacity in advance of a pandemic."
International R&D is also needed in new, lower-cost and modular manufacturing technologies that will allow for interchangeable manufacturing facilities - so that if one vaccine is not going to work out, repurposing can be quickly done to manufacture the successful vaccine at scale.
This requires global capacity and global financing that will be everyone's interests, added Mr Tharman. "That's the only way we're going to bring trust back."
Dr Sri Mulyani, whose country has just begun to ease restrictions following a surge in cases in July, said Covid-19 is a "perfect example" of a global problem without borders.
"The virus is changing, and its mutations are also overwhelming all countries, regardless of whether (their people) are vaccinated or not," she said.
Indonesia will hold the presidency of the G-20 in 2022, taking over from Italy.
Dr Sri Mulyani added that global collaboration and coordination are essential, and so are good national health systems that provide access to large segments of the population.
There is also a need for countries to discuss how to set up early warning systems for future pandemics, she said, adding that this can be tricky, as it involves sensitivities over sovereign jurisdiction.
"There is always a tense relationship between sovereignty versus the global governance that needs to be established - whether it exists in the form of resources, the governance or decision-making process, or information sharing, but failure to do that will lead to catastrophic damage, as we can see from this pandemic."
Wellcome Trust's Mr Farrar said pandemics can no longer be considered a purely health-related issue, as they lead to economic disruption in the form of opportunity loss in education, trade, and travel.
"We are living in a new era of politics where your domestic agenda and international agenda are absolutely, intricately linked.
"Sometimes, as with Covid-19, that will pull you in different directions - where your domestic political agenda may be, for instance, to offer vaccines to your population before anybody else. But your international commitment, and actually your enlightened self-interest, would be to offer those vaccines around the world as well.
"This is also true of climate change, energy and clean water access, and many issues we face in the 21st century. And I don't think international financial and other multilateral institutions have really grasped this challenge," Mr Farrar said.