It is understandable at this time of crisis that a government’s first instinct is to look inwards to the urgent needs of its own people. Along with strict isolation policies, health investments are being increased and redirected to the COVID-19 threat and staggering amounts of public money are being pumped into economies at risk of collapse under the impact of necessary social distancing measures.
So far we are mainly seeing the impact of the COVID-19 pandemic in East Asia, Europe and North America. But an even more devastating epidemic is potentially unfolding in South Asia, Africa and Latin America, where there is far more limited access to protective measures and intensive care for the seriously ill (virtually none in some countries), and where staying at home could simply prove impossible for many families who rely on daily labour for income and food. It is possible that the early measures being taken may slow the onset of disaster, but unlikely that they will prevent it.
It won’t be long before governments around the world realise that this global crisis requires global solutions, as organisations and experts are increasingly insisting. Just as public money is required within the borders of each country, an effective pandemic response will require very large sums of public money at the international level backed up, of course, by as much philanthropic giving as possible (the World Health Organization and the UN Foundation have established a COVID-19 solidarity fund for charitable donations) and the right type of private investment.
As usual when we look beyond our own town and city limits, our national borders, the reasons to engage in joint solutions are a combination of self-interest and solidarity.
Self-interest because the COVID-19 virus is attacking everyone, no matter where they live in the world, rich or poor. It is, in that sense, a great equaliser (also it is also framing the great inequalities that characterise our modern world). Even if one country manages to get on top of it in the short to medium term, there is no way back to normality without most other countries doing the same. And in a globalised world, where intercontinental travel can be quicker than getting around your own country, it’s not just our immediate neighbours that we need to worry about – it’s the whole planet.
And solidarity because, in any case, could people in rich countries simply watch while COVID-19 tears countries apart and kills thousands of people, simply because they happen to be in regions less wealthy than their own? Hopefully, we have not reached such a breakdown of humanity and empathy.
This global ramping up of public spending would come in many different forms but all would support essentially the same three goals: to respond to the immediate urgency of producing and distributing the protective equipment, test kits, and treatment options needed at scale in all affected countries in the coming months; to invest in and fast-track the production of affordable and effective new drugs as well as a vaccine manufactured and distributed at scale and at pace; and to support poorer countries as they face unprecedented demands on their balance sheets, both in the immediate term, and in the aftermath of the crisis. This money has to be additional to current development spending, otherwise equally important, if less urgent, areas will become victim to this virus.
But long experience has shown that the way the world spends its money matters as much as the quantity it spends: how is as important as how much. The world of aid has as many failures as successes on its books. That’s why this is the time to push forward more modern and effective approaches to decision-making and budget-spending. The global effort to curb the coronavirus can’t be just another case of “the West helping the rest”. New principles must apply for a new era.
First, we need to move on from the “donor-recipient” mentality that characterises the “foreign aid” mentality. We are all in this together. All countries need to contribute what they can, whether financial or other resources, and all countries can benefit, according to need.
Second, decision making needs to be more democratic than ever to balance the inevitable competition for resources that is already occurring. All the best research shows that more participatory governance leads to better results right the way from shared governance at the global level through to local community response. While money will come mainly from governments, lessons from the AIDS pandemic demonstrate the crucial role affected communities and civil society in ensuring an evidence-focused, rights-based response.
Third, we mustn’t be limited in our ambition for what this money can achieve. Yes, we need to respond to the current crisis, but we need to look beyond the crisis as well, to a new world order that is both emerging and that requires shaping. For a start, global public money should help all countries ensure good public health systems. This is an opportunity to set a new bar in public health across the world.
Fourth, we need to change the language we use. We need to shift away from “foreign aid” thinking and rather imagine this as “global public investment” or “global contributions”, heralding a new approach to global cooperation.
Many institutions, instruments and funds already exist to channel the kind of money we are talking about, from the usual bilateral agencies (like DFID, USAID, the Chinese and Indian aid sectors) to multilateral stalwarts, like the World Bank and UN funds. The Global Fund to Fight AIDS, TB and Malaria, (“the Global Fund”) was created in 2002 to respond to global pandemics of and has been hugely successful in raising resources and saving lives. Other examples of pooled funding mechanisms to support health crises include GAVI (the Vaccine Alliance) and UNITAID.
If these funds, and others, can alter their mandates quickly, to respond to broader objectives and accommodate a broader governance structure, then they can lead the effort. If not, we might need a major new fund that embodies modern principles of global cooperation. No more “donor-recipient” – it’s time for “we’re all in this together”.
Huge challenges are always beaten through strong international cooperation – bringing together the vast intellectual, technological and financial resources available in our global village. Multilateralism is always under the spotlight and some of today’s avowedly nationalist political leaders may eschew the opportunity to work together. But we can’t allow the best ideas to be held back – those willing to engage should do so, and hope that others will join as they see the impact of solidarity in action.
COVID-19 may be the pandemic that showed us that global solidarity is not a nice idea – it is a necessity – and that Global Public Investment must be increased and improved for the 21st century. But we need to move quickly.