WHO’s high-price pandemic plan (Originally published in The Australian)

The recent release of Anthony Fauci’s diaries, followed by his refusal to answer questions in an appearance before a US Senate committee by invoking the fifth amendment protection against self-incrimination 111 times, highlighted a stark divide in how the Covid pandemic was handled by public health authorities. This is as true of Australia as of the US.

Repeatedly, against certainty expressed in public to justify official statements on the origins of the virus and on lockdown, mask and vaccine policies, their private contemporaneous conversations confirm that even the top scientists were making decisions based on scientific uncertainty.

Consequently, one of the key legacies of the public-private gap is growing distrust of official claims. That scepticism should extend to the future pandemic agenda. We rely on the World Health Organisation to co-ordinate among countries to prevent scourges such as pandemics reaching our shores, or at least mitigate their effects. In doing so, we must defer to an army of international bureaucrats who work in such institutions. A deference that relies on trust.

Their salaries and careers depend on convincing us to part with more of our money to support their work. Yet, according to a new article on international pandemic financing in the Cambridge journal Health Economics, Policy and Law, the WHO and World Bank rely on dubious assumptions to calculate the return on investment case on which all major international efforts to mitigate future pandemics rely.

This should alarm governments. Mitigation is worth investing in, as pandemics will occur from time to time. But the article shows that current investments will have an overall detrimental effect on global health. Most starkly, it suggests a deep rot in the quality of institutions we rely on as stewards of this commonly accepted global good.

The WHO and World Bank report, produced at the request of the G20 in 2022, proposes an annual $US31.1bn budget for pandemic preparedness and prevention, about $US10.5bn of which would come through foreign aid (including Australia).

About $US26bn would come from low and middle-income countries already struggling with economic issues including burgeoning Covid debt. For context, the entire WHO budget for 2024-25 was just $US3.8bn a year.

The point of the WHO and World Bank’s argument is that if we spend such resources on preparing for pandemics, we will reap orders of magnitude greater return on investment down the road, more than a thousandfold in some wealthy countries – a bargain difficult to refuse if true.

The article from Leeds University shows the financial arguments are based on smoke and mirrors. They rely on assumptions on the quality-adjusted life years lost to pandemics as against the big three global infectious diseases of HIV-AIDS, tuberculosis and malaria; on the share of global funds to be devoted to pandemics in comparison to the other three per life saved in each case; and on the benefits to be gained from investments in vaccines and other pharmaceutical products instead of in the more basic determinants of health resilience in the population such as nutrition, sanitation, water and hygiene. These are the factors, along with antibiotics and gains in medical advances, that have reduced the mortality toll from pandemics since the Spanish flu of 1918.

Furthermore, the WHO and World Bank also discount the adjustments made to human behaviour to mitigate health risks as they become obvious, collateral costs of the pandemic response measures and the likely benefits of investing on those measures.

This matters because our government has signed on to the amended International Health Regulations, is expecting to sign the proposed WHO Pandemic Agreement and looks set to sign on to a UN political agreement in September advocating for yet more money for the authors and beneficiaries of the growing pandemic industry. They are promising a lot of money based on WHO’s costings.

It matters because most Australians assumed we could trust international institutions and that they valued rigour rather than false accounting and subterfuge.

Unfortunately, incentives without accountability are a poor basis for health governance. It matters because the diversion of funds to finance the pharmaceutical corporations, research institutions and bureaucrats who stand to benefit from the pandemic agenda are diverted from programs that work. International funding for the big endemic diseases and basic priorities such as nutrition is already falling, while the pandemic agenda expands. The Leeds authors call for simple transparency and honesty in assessing global health priorities, and in paying for them. Not a big ask. The Australian government has a choice to be constructive on behalf of its taxpayers and require better, or through blind acquiescence remain part of the problem.

David Bell, a graduate of the University of Melbourne medical school, is a former WHO medical officer, program head and director in international health agencies and a co-author of the Leeds review of WHO-World Bank costings. Ramesh Thakur, a former UN assistant secretary general, is emeritus professor in the Crawford School of Public Policy, the Australian National University.