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Unleashing the

Potential of the
Private Sector
Recommendations for the
Board of Governors and Secretariat
of The Pandemic Fund
Acknowledgments:
ThinkWell would like to express our sincere gratitude to all
individuals and organizations who contributed to the ideas
presented in this report. We are especially grateful to the
G20 Global Innovation Hub for Improving Value in Health
(‘the Hub’), the Global Initiative on Health and the Economy
(GIHE) at the U.S. Chamber of Commerce, as well as member
organizations of the Chamber who contributed to the
development of this paper.

Authors:
This report was prepared by Yogesh Rajkotia and Cal Pierce
for the U.S. Chamber of Commerce (‘the Chamber’).
Acronyms
ACT-A Access to COVID-19 Tools Accelerator
AVAT African Vaccine Acquisition Trust
AVATT African Vaccine Acquisition Task Team
AMC Advanced Market Commitments
C19-RM COVID-19 Response Mechanism
COVAX COVID-19 Vaccines Global Access
CSO Civil Society Organizations
DIB Development Impact Bonds
FMCBG Finance Ministers & Central Bank Governors
FIF Financial Intermediary Fund
GIF Global Infrastructure Facility
G20 Group of Twenty
GFATM Global Fund for AIDS, TB, and Malaria
HLIP High Level Independent Panel
IPPR Independent Panel on Preparedness and Response
JFHTF Joint Finance-Health Task Force
PPR Pandemic Preparedness and Response
TAP Technical Advisory Panel
WHO World Health Organization

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Table of
Contents
Acronyms....................................................................................... 3

Table of contents.......................................................................... 4

I Introduction............................................................................. 5

II Paper objectives...................................................................... 6

III Approach...................................................................................7

IV Findings.................................................................................... 8
Road to establishing the Pandemic Fund........................... 8
Insights from the private sector........................................... 8

V Recommendations.................................................................14
Governance.............................................................................14
Funding priorities..................................................................15
Financing mechanisms.........................................................16

References....................................................................................19

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I. Introduction
Given the urgent need to step up country level, as well as at regional and
investments to strengthen the capacity of global levels. The fund is expected to
developing countries to prevent, prepare bring additional, long-term, dedicated
for, and respond to future global health resources for PPR, incentivize countries to
threats, and with broad support from the increase investments in PPR, and enhance
G20 and beyond, the World Bank Board coordination among partners.
of Directors approved the establishment
of a Financial Intermediary Fund (FIF) for As the design, function, and priorities of
Pandemic Prevention, Preparedness, and the Pandemic Fund are formalized, the
Response (PPR) (‘the Pandemic Fund’) on perspectives, voice, and expertise of the
June 30, 2022. private sector will be critical to ensure
that investments made through the fund
The Pandemic Fund aims to help low maximize the unique capabilities of the
and middle-income countries strengthen private sector.
PPR and fill existing capacity gaps at

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II. Paper objectives
The Chamber commissioned ThinkWell • Solicit private sector perspectives on
to work with private sector enterprises the Pandemic Fund, including how the
involved in PPR to better understand private sector might best be engaged to
their perspectives on the private sector’s support the delivery of PPR.
roles in PPR and how the Pandemic Fund
can be designed in a way that optimizes • Provide specific recommendations to
their participation and contribution. the Board of Governors and Secretariat
Specifically, ThinkWell set out to: of the Pandemic Fund on how the
capabilities and experiences of the
• Assess the structure, governance, and private sector might best be engaged by
operation of the Pandemic Fund to Pandemic Fund investments.
identify opportunities for private sector
engagement and participation.

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III. Approach
ThinkWell conducted an extensive desk Chamber members were invited to
review of relevant sources, including (i) reflect on: (i) the case for private sector
the reports and analyses authored by the participation and engagement in PPR
World Bank, WHO, and G20 establishing and (ii) how Pandemic Fund investments
the case for a FIF for PPR; (ii) the might best unlock the capabilities and
responses received as part of the White experiences of the private sector, based
Paper consultation on the proposed fund; on respondents’ previous experience with
and (iii) the foundational documents of similar multilateral financing mechanisms.
the fund, including the White Paper, Board
Report, and Governance Framework.

In addition, ThinkWell undertook semi-


structured interviews with members of
the Chamber (n=6) with prior engagement
experience in multilateral financing
mechanisms, purposively sampled to
reflect the diversity of the health sector.

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IV. Findings
The evolving vision of private CSOs were successful in securing two
sector engagement in the seats on the Governing Board’s Technical
Pandemic Fund Advisory Panel (TAP).

The stakeholders responsible for the Despite the early vision for the private
creation of the Pandemic Fund have long sector in the fund and its investments,
recognized the value of the private sector the recently established rules and
to PPR. Across the foundational reports frameworks for the Pandemic Fund leave
and analyses used to establish the case few clear pathways for private sector
for the fund, the World Bank, WHO, G20, participation. For instance, although the
and other leading stakeholders make the earlier White Paper for the Pandemic Fund
case for private sector engagement in suggests the possibility of private sector
the operationalization of the fund and the engagement in both: (i) the Governing
delivery of its objectives. Board (as Observers), and (ii) the TAP, the
fund’s Governance Framework, approved
The relationship between the World Bank, by the Board in September 2022, has
as trustee, and external constituencies no clear mechanisms for private sector
like civil society and the private sector has representation, in contrast to those for
evolved together with the vision, scope, and civil society.3
objectives of the fund. On the journey from
inception to operationalization of the fund, Insights from the private sector
civil society organizations (CSOs) have
been particularly effective at advocating We present here a high-level summary of
their position, including through mobilizing the case for private sector participation in
support for extended consultation sessions the Pandemic Fund, followed by summaries
attended by more than 350 civil society of private sector perspectives across three
and non-governmental stakeholders from themes that emerged during the analysis of
more than 40 countries and regions.1,2 the responses, namely: governance, funding
Through mobilization and engagement, priorities, and financing mechanisms.

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The case for private sector products and services to hundreds of
engagement in the Pandemic Fund millions of consumers daily and which
can be readily repurposed for population-
On interview, respondents highlighted the level response efforts, were considered
private sector’s unique capabilities and particularly valuable in the context of PPR.
expertise in PPR, which both complement
and strengthen those of the public sector. Decisionmakers for the fund were urged to
The ability of the private sector to develop consider the central role of the private sector
and rapidly scale the production of in delivering the technological innovation
vaccines, diagnostics, and other medical necessary to counter emerging pandemic
countermeasures to support the global threats. During the COVID-19 pandemic, for
response to COVID-19 was frequently instance, the private sector successfully led
cited as an example of private sector value the discovery, testing, and commercialization
in PPR. Beyond COVID-19, respondents of a wide range of innovative life-saving
pointed to the private sector’s track technologies in record time, working in
record in the manufacture and delivery of partnership with academic institutions,
essential medicines, personal protective research agencies, and regulators.
equipment (PPE), and other critical inputs
to support the global response to Ebola, Respondents were unanimous in their
monkeypox, and other emerging threats. willingness to partner with governments
For summary highlights and case studies and multilateral institutions in support
of the private sector’s contributions across of PPR efforts globally. Private sector
all domains of PPR, see Table 2 overleaf. partners have been proactively engaged
in multilateral financing and procurement
Respondents called attention to the private mechanisms for PPR, like COVAX and
sector’s valuable expertise in PPR beyond AVAT, delivering hundreds of millions of
the clinical setting, for instance, in data doses of vaccines and other life-saving
systems, supply chain management, and medical countermeasures at concessionary
logistics. Respondents valued the global or ‘at-cost’ prices. Respondents noted
financing mechanisms focused on the the private sector’s track record of
delivery of medical countermeasures, like participation in the governance and
the COVID-19 Vaccines Global Access implementation of other multilateral
mechanism (COVAX) and the African financing instruments for health, including,
Vaccines Acquisition Trust (AVAT), and for instance, the Global Fund for Aids, TB,
recommended that the proposed fund and Malaria (‘the Global Fund’), where
augment these initiatives by catalyzing robust rules for transparency and oversight
investment in other critical domains of PPR. allow for the capabilities of the private
The private sector’s footprint and networks, sector to be harnessed, at the same time as
which support the reliable delivery of managing potential conflicts of interest.

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Table 2 Examples of private sector contributions to the core components
of PPR from the COVID-19 response

PPR Component Examples


PPR strategy, Private sector partners played an active role in
coordination, and PPR coordination, including through proactive
emergency operations engagement in the global mechanisms for
COVID-19 response, such as COVAX and the
Global Fund COVID-19 Response Mechanism.
Prioritized Private-sector pharmaceutical companies were
research, equitable able to develop effective COVID-19 vaccines in
access to medical record time and worked in close partnership with
countermeasures and Governments and multilateral mechanisms to
essential supplies rapidly deliver billions of doses globally, including
for hard-to-reach populations.
Surveillance, Private sector enterprises rapidly developed
collaborative intelligence, diagnostic technologies to support and strengthen
and early warning surveillance efforts and scaled access to these
through multilateral partnerships, including the
Access to COVID-19 Tools Accelerator (ACT).
Public health and social Social media companies offered free or
measures and engaged, concessionary services to the WHO, national
resilient communities Governments, and public health authorities,
enabling rapid dissemination of critical public
health messages to hundreds of millions of people.
Life-saving, safe, Industry was able to rapidly scale the production
and scalable health of medical countermeasures in response to
interventions, and COVID-19, for instance, delivering tens of billions
resilient health systems of items of PPE, including through the expansion
or repurposing of existing production capacity.
Companies utilized high-quality, centralized
manufacturing facilities to coordinate distribution
around the globe.

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Case Study 1: Case Study 2:

The COVID-19 pandemic exacerbated At the height of the pandemic,


blood shortages across Sub-Saharan Johnson & Johnson (J&J) committed
Africa, with many national blood to provide its single-shot COVID-19
services collecting up to 80% less vaccine globally at a not-for-profit
than pre-pandemic rates. Terumo price. To date, the Company has
Blood and Cell Technologies shipped approximately 80% of its
conceptualized, founded, and global vaccine supply to LMICs.
launched the Coalition of Blood for This has been achieved through
Africa (CoBA) in 2022, the first and combination of country donations
only multi-stakeholder platform and advance purchase agreements
dedicated to ensuring access to (APAs), including APAs with the African
adequate, safe and sustainable Vaccine Acquisition Trust (AVAT) and
blood for Africa. In March 2021, Gavi, the Vaccine Alliance. Further, J&J
CoBA partners drawn from private delivered a landmark agreement with
sector, not-for-profits, media, and South African manufacturer Aspen SA
charities held a 3-day countrywide Operations (Pty) Ltd, to enable the first
blood drive with the Kenya National COVID-19 vaccine to be manufactured
Blood Transfusion Service. The and made available by an African
Drive increased blood collections company for people living in Africa.
by over 1300% during the period The agreement enables Aspen, using
and demonstrates the breadth and COVID-19 vaccine drug substance
capacity of the private sector to supplied by Johnson & Johnson, to
crowd-in, mobilize and deliver critical produce Aspen-branded finished
services and infrastructure during vaccine and make doses available to
pandemics, particularly in low- the public sector in Africa, including all
resource settings. 55 Member States of the African Union.

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Governance: Ensuring the fund that specifically accounts for the
engagement and effective activities of other financing schemes, and
partnerships the possibility of a shared application for
country-level beneficiaries whereby one
Interview respondents suggested that the application is used to assess eligibility
proposed fund should draw on successful for funding across several mechanisms,
examples of private sector participation including the Pandemic Fund.
in the governance of similar multilateral
financing mechanisms, both within Funding priorities: Making the
and beyond the health sector. Many most of the private sector’s
respondents pointed to the Global Fund capabilities and expertise
as a positive example of private sector
engagement in a multilateral financing Respondents urged stakeholders in
mechanism. The presence of private sector the fund to engage the broadest range
representation on the Global Fund Board, of private sector capabilities in PPR,
as well as the Fund’s explicit framework for including those capabilities ‘outside’ of
private sector partnership, were highlighted the health sector, like supply chain and
as examples that facilitated private sector logistics, data systems, and information
engagement and contributions. technology. Previous national and
multilateral financing instruments for
The need for strong coordination at global, PPR have had some success in recruiting
regional, and country levels was frequently private sector capabilities for (i) research
highlighted, in particular, to ensure that and development or (ii) the production
Pandemic Fund investments complement and supply of vaccines and medical
those of existing financing mechanisms. countermeasures. There has been less
Given the broad scope of investments financing available to strengthen access to
and activities needed to strengthen other key PPR components like diagnostics
PPR globally, the targets of fund and therapeutics (beyond vaccines
investments may overlap with those of and antivirals), genomic sequencing
other multilateral financing mechanisms capabilities, and digital health.
for health, particularly those involved in
PPR including, for instance, the Global Respondents frequently highlighted the
Fund’s COVID-19 Response Mechanism importance of investing in health system
(C-19RM). Several mechanisms were strengthening for PPR. Even where
suggested for optimized coordination, private sector partners were able to scale
including board-level information sharing production capacity and output for medical
between the Pandemic Fund and other countermeasures, there were widespread
multilateral mechanisms, the development challenges in stimulating country-level
of a strategic investment framework for demand for these commodities (e.g.,

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for rapid diagnostics) and in increasing development impact bonds (DIBs),
country-level absorption capacity (e.g., for advanced market commitments (AMCs),
vaccines). These challenges reflect gaps advanced purchase commitments (APC),
in broader health system strengthening and others. Respondents felt that the
efforts that could be addressed by private sector is well placed to harness
Pandemic Fund investments. the potential of these more innovative
financing mechanisms, particularly when
In light of complex regulatory pathways compared to governments and public
and long approval timelines for key sector bodies where procurement and
technologies, regulatory systems were public financial management rules are
suggested as a priority area for investment. more rigid and risk-averse.
Respondents highlighted several examples
where limitations in the capacity of global Given the multifactorial and complex
or country-level regulators had delayed nature of PPR, respondents suggested
or slowed their participation in PPR. fund investments should include a mix of
For instance, although industry rapidly short- and longer-term financing options.
developed point-of-care diagnostics for Those respondents involved in the
COVID-19, lengthy and resource-intensive research, development, and production
prequalification requirements, as well of medical countermeasures valued the
as the requirement for diagnostics to go predictable, longer-term, larger-scale
through different approval processes investments from institutional investors
in each country, significantly increased (like the National Institute for Health) in
the cost and burden of bringing these helping them bring life-saving products
technologies to the front-line, thereby and technologies to the marketplace. To
delaying access. Investment could focus on complement longer-term investments,
increasing regulatory harmonization across respondents suggested that shorter-term,
countries or regions. more flexible funding options should
be available to help the private sector
Financing mechanisms: respond to the dynamic and unpredictable
maximizing the value of every threats posed by emerging pathogens
dollar spent including, for instance, catalytic
financing to support the prototyping
Respondents considered the Pandemic and development of new diagnostic or
Fund an opportunity to look beyond therapeutic technologies.
‘business-as-usual’ and try innovative
ways of financing, implementation, and
delivery. Examples of innovative financing
mechanisms mentioned by the private
sector as of relevance to PPR included

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V. Recommendations
We propose seven recommendations for Recommendation 1: Allocate seats for
the Board of Governors and Secretariat private sector representation on the
of the Pandemic Fund, organized across fund’s Technical Advisory Panel (TAP).
the three themes of governance, funding
priorities, and financing mechanisms. Private sector representation on the
In making these recommendations, fund’s TAP would provide the Board of
we acknowledge the World Bank FIF Governors with ready access to private
Management Framework4 and Governance sector expertise and perspectives. Such
Framework for the FIF for PPR3, which representation would be in line with the
give the Board of Governors a high degree proposals made in the White Paper for a FIF
of autonomy in how the fund operates in for PPR and would align fund governance
support of its objectives, and call attention with the practices of similar multilateral
to the White Paper for a FIF for PPR which financing mechanisms like the Global Fund.
supports evolution in FIF governance
and operations: ‘Once established, FIFs Recommendation 2: Establish a group
naturally evolve in response to new of Board Observers, including private
opportunities, lessons learned and other sector participants.
changes in the environment.’5
Private sector representation in a
Governance group of Board Observers would follow
established precedents for private sector
To ensure that the private sector can be engagement in FIFs and create further
the best possible partner in delivering opportunities for the Board to solicit the
on the potential of Pandemic Fund input and perspectives of the private
investments, we recommend that the sector. Representation should reflect the
Board of Governors and Secretariat: diversity of industry contributions to PPR.
As a practical example, the governance
structure of the Global Infrastructure
Facility (GIF), a FIF for which the World

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Bank is also trustee, includes a group of Funding priorities
Board Observers (‘the Advisory Council’)
which has representatives from the To unlock the capabilities and expertise
private sector including commercial and of the private sector across the broadest
investment banks, infrastructure finance range of critical PPR activities, we
organizations, and developers. recommend that the Board of Governors
and Secretariat:
Recommendation 3: Explore
opportunities for shared country- Recommendation 4: Support a mix of
level funding calls with those of other longer-term investments to support
financing institutions involved in PPR. systems strengthening and shorter-
term investments to support rapid
The objectives of the Pandemic Fund response to emerging threats.
align closely with those of the other
multilateral response mechanisms for The operating framework for FIFs gives
pandemic response, including COVAX, the Board of Governors flexibility in how
AVAT, the Global Fund C-19RM, and investments are structured, including
others. Shared funding calls, whereby their duration. In determining how
a single application from a potential fund contributions are best allocated
beneficiary is used to assess eligibility to deliver on PPR goals, the Board and
across multiple funding sources would implementing entities should consider
reduce the administrative burden on investments that use longer-term
country-level beneficiary recipient entities financing instruments, necessary to
and help reduce the risk of duplication of allow for broad-based health system
effort across financing mechanisms. strengthening efforts, as well as shorter-
term financing instruments that can be
quickly deployed to support beneficiaries
to respond to emerging threats.

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Recommendation 5: Ensure that Financing mechanisms
implementing agencies of the Pandemic
Fund take a holistic approach to To ensure that investments are structured
investment, engaging the broadest range and financed in a way that maximizes
of private sector capabilities in PPR. private sector contributions to PPR, we
recommend that the Board of Governors
A key principle of the fund’s design and Secretariat:
is that it should fill gaps in the global
financing architecture for PPR. Given Recommendation 7: Engage with the
that successful multilateral financing private-sector arms of MDBs to explore
mechanisms exist to support the opportunities for co-design and co-
delivery of medical countermeasures, for financing of PPR investments in the
instance – COVAX and AVAT - the Board private sector.
is urged to ensure that the fund supports
PPR functions beyond the clinical and The private sector arms of MDBs have
biomedical including, for example, well-established processes and systems
investments in supply chain and logistics, for engaging the private sector and for
data systems, and information technology. establishing the additionality and risk
of investments in this sector. The use of
Recommendation 6: Support MDBs to facilitate financial transactions
investments that address regulatory was explored in the White Paper for
barriers to PPR. the FIF for PPR and offers an efficient
avenue for low-risk engagement of private
The Board of Governors has broad sector enterprises in fund investments.
autonomy in setting the strategy and Furthermore, MDBs are experienced in
priorities for fund investments. Given the design and facilitation of innovative
the cross-cutting impact of regulation financing mechanisms which, when
on all aspects of PPR, the Board is combined with the private sector’s
urged to consider investments that can capabilities, agility, and risk tolerance,
help streamline regulatory pathways, offer tangible pathways to catalyzing
including at a regional or global level, improved PPR.
and strengthen the capacity of those
regulators involved in PPR.

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Annex 1: Timeline of the development of the Pandemic Fund

Timeline Event Description


Jan. G20 members establish the The Panel, proposed by the Italian G20
2021 High-Level Independent Presidency, is tasked with assessing the global
Panel (HLIP) on Financing financing systems for PPR and proposing viable
the Global Commons for solutions for the longer term.6
Pandemic Preparedness
and Response
May The Independent Panel for The IPPR recommends significant mobilization
2021 Pandemic Preparedness of funding for PPR, including a mix of longer-
and Response (IPPR), term and emergent funding.7
established by the WHO,
releases a report calling
for a global fund for PPR
May WHO Director’s Report on The Director’s Report calls for predictable
2021 Global Health Financing funding for preparedness and rapidly scalable
Architecture for Pandemic financing for response, including through the
Preparedness establishment of a FIF for PPR.8
June The HLIP reports findings The HLIP proposes a global fund for PPR,
2021 on PPR financing to a suggests a global funding gap of at least $10
meeting of the Finance billion annually, and notes ‘significant scope for
Ministers and Central Bank governments and the MDBs to mobilize private
Governors (FMCBG) sector resources for PPR’.9
Oct. The G20 establishes the The JFHTF is created with a mandate to
2021 Joint Finance-Health Task design a financing facility for PPR to ‘ensure
Force (JFHTF) adequate and sustained financing for pandemic
prevention, preparedness and response’.10
March The World Bank and WHO World Bank and WHO identify an annual funding
2022 co-author two reports gap of $10.5 billion (supporting the findings
further establishing the of the HLIP) and note the potential of a FIF
case for a FIF to be complementary to existing financing
mechanisms.11,12
April The proposal to establish The Chair’s Statement from the meeting states
2022 a FIF for PPR is approved ‘given the support among many members to
at the 2nd meeting of the set up a FIF, the Presidency concluded that the
G20 FMCBG World Bank should begin exploring the process
to develop and set up a FIF’.5

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May The World Bank publishes Suggests the possibility of private sector
2022 a White Paper on the case participation (i) on the Governing Board (as
for a FIF for PPR Observers), as well as in (ii) the Technical
Advisory Group.5
May A two-week global A wide range of input and feedback is received
2022 consultation is held on the in response to the White Paper, including from
White Paper national Governments, NGOs, philanthropic
organizations, and academic institutions.13 The
Pandemic Action Network and others mobilize
significant feedback and input from CSOs
involved in PPR, including recommendations for
the board on governance, CSO engagement, and
investment priorities.14,15
June World Bank Board Board Report further highlights the potential for
2022 approves the private sector participation as (i) observers on
establishment of the FIF the Governing Board, and (ii) in the Technical
Advisory Group.16
Aug. A further extended In consultation sessions attended by more
2022 global consultation is than 350 civil society and non-governmental
held with CSOs stakeholders from more than 40 countries and
regions, global CSOs make recommendations
for the FIF, including seats for civil society on
the FIF governing board.1,2
Sept. The FIF Governance The Governance Framework includes
2022 Framework and Operational representation for CSOs in the Technical
Manual are approved by the Advisory Group of the FIF but with no clear
Governing Board mechanism for private sector representation.3
Nov. The FIF for PPR is The Pandemic Fund is launched with more than
2022 launched by the G20 $1.4 billion in financing commitments made
Presidency of Indonesia, by 24 donors from G20 countries, non-G20
called ‘the Pandemic Fund’ countries and philanthropic institutions.17

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19 | U.S. Chamber of Commerce

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