Health Emergencies

Recent years have starkly highlighted the risk of major health emergencies and countries’ lack of preparedness to fight them. Between 2020 and 2023, the COVID-19 pandemic resulted in over 7 million confirmed deaths, an additional 70 million people living in extreme poverty, and well over $10 trillion in estimated economic losses.

The COVID-19 pandemic was particularly devastating, but disease outbreaks are not rare, and the risk of outbreaks is rising. At the same time, a proliferation of bacterial “superbugs” resistant to antimicrobials has emerged due to overuse of antibiotics in humans, animals and food systems and poses a risk to countries at all income levels. Antimicrobial resistance (AMR) has been named one of the top 10 global threats to public health, claiming almost 5 million lives every year.  By 2050, AMR could cut the global gross domestic product by 3.8% yearly and push 28 million people into poverty.

Stopping the Grand Pandemic: A Framework for Action | 3-pager (PDF)

Moreover, health emergencies are not just caused by pathogens; they are also brought on by natural disasters, climate-related events, and conflict. For example, between 2000 and 2019, there were more than 7,000 major disaster events claiming more than 1.2 million lives and affecting over 4 billion people.  Countries affected by fragility, conflict, and violence (FCV) face an increased risk of disease outbreaks due to overcrowding, poor sanitary conditions, and reduced access to health services.

Many of the key solutions are already known: the risk and impacts of health emergencies can be reduced if countries have the capacities across multiple sectors for prevention, preparedness, and response (HEPPR). Doing so will require increased, flexible, and sustained financing across multiple sectors.

A 2022 WHO/World Bank report to the G20 Finance and Health Task Force estimated that international financing needs to increase by between $10.5 billion to $15 billion per year while noting the need for increased domestic financing. While investment needs are significant, the devastating impacts of health emergencies means that returns are high.

These realities have prompted the expansion of concerted work on all levels. Advances in the global HEPPR architecture include: (i) the launch of the Pandemic Fund  in 2022 to support relevant work, particularly in lower- and middle-income countries; (ii) collaboration on improved and equitable access to medical countermeasures (MCMs), such as vaccines, diagnostics, and therapeutics (including the G7/G20-endorsed “100 Days Mission” to accelerate the development of safe and effective products); and (iii) the creation of the One Health Joint Plan of Action  to strengthen global collaboration.

The Pandemic Fund

The Pandemic Fund is a multilateral financing mechanism dedicated exclusively to strengthening critical pandemic prevention, preparedness, and response capacities and capabilities of low- and middle-income countries through investments and technical support at the national, regional, and global levels. It provides a dedicated stream of additional, long-term financing for investments in areas such as infectious diseases surveillance, laboratories and diagnostics, and health workforce strengthening.

As of November 2024, the Pandemic Fund had awarded two rounds of grant funding, totaling $885 million, which catalyzed an additional $6 billion in funding from international and domestic partners for 47 projects covering 75 low- and middle-income countries in six geographical regions.

Last Updated: Feb 18, 2025

Health emergency prevention, preparedness, and response has long been an important priority for the World Bank Group.  The International Development Association (IDA), the Bank’s fund for the poorest countries includes explicit policy commitments on pandemic preparedness since IDA 18, following  the Ebola outbreak in West and Central Africa (2014–16). 

Today, IDA21 continues that focus and includes commitments on building resilience to shocks, including pandemics and implementing the Global Challenge Program on Health Emergency Prevention, Preparedness & Response. Recent reforms, such as the World Bank's enhanced Crisis Preparedness and Response Toolkit (CPRT), help countries in their preparedness planning making them more resilient to shocks such as health emergencies.

In addition, the Bank developed a new health emergencies indicator in the new, streamlined WBG Scorecard and launched a new WBG Global Challenge Program for health emergencies. AMR is another important area of expanded work, including the development and operationalization of the Framework for Action on AMR in Bank operations.

Across all efforts, our work reflects three interrelated focus areas:

• strengthening and scaling core HEPPR capacities;
• enabling equitable access to medical countermeasures (MCM) including diagnostics, vaccines, pharmaceuticals, devices, and personal protective equipment;
• enabling rapid, scaled and coordinated surge financing from domestic and international sources while building emergency-ready public financial management systems.

The Global Challenge Program on Health Emergencies

The Global Challenge Program (GCP) on Health Emergencies is a critical platform for advancing the Bank’s ambitious agenda., working across our public and private sector arms through a coordinated approach to more effectively crowd-in public and private sector solutions and financing.  The GCP is designed to help partners to enhance capacity to prevent and prepare for health emergencies by strengthening health systems at country, regional and global levels.

To accomplish this, the GCP brings together resources and expertise from across the World Bank, the International Finance Corporation (the WBG arm dedicated to the private sector), and the Multilateral Investment Guarantee Agency (MIGA), (which offers political risk insurance and credit enhancement guarantees) to develop and advance to pressing needs of health emergency preparedness together with country partners.

This includes joined-up WBG programming, enhanced external partnerships, targeted concessional financing and incentives, systematic use of data and learning, and operational streamlining and process innovation.

Antimicrobial Resistance (AMR)

AMR is a problem that affects and is driven by interconnected factors related to people, animals, plants, and ecosystems across a range of sectors, including health, agriculture, food, water, sanitation, and the environment. These sectors are all relevant to mitigating the rising tide of AMR. The World Bank AMR Framework articulates key intervention across four priority sectors: (i) health; (ii) agriculture and food; (iii) water and environment; and (iv) multisectoral – all of  which are critical to prevent the emergency and spread of resistance.

Through its financing and policy dialogue, the World Bank also provides governments with technical assistance and implementation support for AMR-related investments and collaborates with international organizations, development - and country partners to support improved awareness and understanding of critical issues relating to AMR through global advocacy and facilitating knowledge synthesis and sharing. Read more on AMR.

Health Emergency Preparedness and Response Program

The Health Emergency Preparedness and Response (HEPR) Umbrella Program complements the World Bank’s efforts to provide further resources in response to health emergencies. The HEPR Umbrella Program provides upstream, catalytic financing to the most vulnerable countries, including those unable to access traditional World Bank financing. The program offers a flexible mechanism that makes resources available before a country accesses other funding sources or even when there is insufficient domestic funding. 

Since inception in June 2020, the HEPR Program has supported more than 42 countries and regional grants with a total of over $125 million.

Last Updated: Feb 18, 2025

Africa Centers for Disease Control and Prevention Regional Investment Financing Project (ACDCP)

The World Bank’s Africa Centres for Disease Control and Prevention Regional Investment Financing Project supports (with $250 million) Ethiopia, Zambia, and the African Union (AU) in combatting epidemics and advancing critical public health priorities. Launched in 2017, the project is linking existing public health institutions and pooling the capabilities of national health authorities. It is also financing the establishment of laboratories, transnational surveillance networks, emergency-response mechanisms, and other public health assets designed to manage diseases on a regional and continental scale. The project is supporting the implementation of Africa CDC’s flagship innovation RISLNET (Regional Integrated Surveillance and Laboratory Network) in the Eastern and Southern Africa regions.

It supports the development of guidelines and standards to improve coordination between the Africa CDC and national public health institutions across the African continent. The project facilitates the sharing of public health assets and the exchange of vital data on infectious diseases. It also aims to build the capacity of regional and continental public health institutions.

Regional Disease Surveillance Systems (REDISSE)

Currently in its fourth phase, the REDISSE Program leverages $657 million of World Bank financing to improve surveillance and laboratory capacity in 16 countries in West and Central Africa. Recipients include Angola, Benin, Central African Republic, Chad, Democratic Republic of Congo, Economic Community of Central African States (ECCAS), Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Republic of Congo, Sierra Leone, Senegal, Togo, West African Health Organization (WAHO).

REDISSE provides countries with financing that is under their direct control to address key priorities. It ensures that financing for emergency responses is in place to decrease response delays in the event of a disease outbreak. It also finances regional level policy dialogue to promote information exchange, collective action and efficient use of country and shared resources, training institutions and commodity stockpiles for disease surveillance and response. Through the program, participating countries have also benefited from an early and immediate access to World Bank financing for COVID-19 preparedness and response, while complementary country-specific financing was mobilized from the World Bank’s COVID-19 Fast-Track Facility. 

East Africa Health Laboratory Networking Project

The East Africa Public Health Laboratory Networking Project is a World Bank-funded regional laboratory network that includes Burundi, Kenya, Rwanda, Tanzania and Uganda. The project has significantly increased regional capacity to detect outbreaks and mount rapid effective responses, with access to quality diagnostic services expanded to vulnerable groups in border areas and serving over 10 million people (of which 60 percent are female). 

Through a network of 41 upgraded laboratories, access to services has improved for vulnerable groups, while boosting cross-border disease outbreak preparedness.  The project has allowed the creation of 10 cross-border committees across the five countries and one between Kenya/Uganda and South Sudan; screenings at selected border crossing points; enhanced diagnostic capacities for laboratory-confirmation of pathogens (from 8% to 100%); joint investigations on Ebola, Marburg, and yellow fever; continued strengthening of pandemic preparedness to address risks of cross-border transmission; and roll out of a mobile phone reporting system on disease outbreaks.

Health Security Program in Western and Central Africa

The Health Security Program in Western and Central Africa works in countries across the region to increase regional collaboration and health system capacities to prevent, detect, and respond to health emergencies. The project consists of five components including: (i) preventing health emergencies with a focus on strengthened planning and management of health security resources, as well as preventing and minimizing impacts of health threats such as zoonoses and antimicrobial resistance (AMR); (ii) detection of health emergencies focused on multisectoral surveillance systems and mechanisms for data sharing within and across borders, strong regional laboratory networks and multisectoral and integrated workforce required to enable early detection of health emergencies; and (iii) health emergency response focused on building and sustaining capacities that can prevent and prepare for an outbreak from becoming an epidemic or pandemic, through a focus on disease control and effective health emergency response.

During its first phase, the $500 million IDA-financed operation involves Cabo Verde, Guinea, Liberia, and the Economic Community of West African States (ECOWAS) to increase collaboration and improve health system capacities to prevent, detect, and respond to health emergencies in the region. It is focused on strengthening critical interconnected systems to improve health security for about 627 million people, targeting vulnerable groups such as infants and children, adolescents, mothers, and the elderly. The program is ramping up multisectoral preparedness and response capacities for health emergencies, relying on a One Health approach, and its interventions aim to address the intertwined nature of pandemics, AMR, and climate-related challenges persistent in the region.

Last Updated: Feb 18, 2025