Our Global Health Frameworks in COVID-19 : Who Was Left Behind?

This article examines whether international institutions’ COVID-19 response funding aligned with well-established pre-pandemic measures of countries’ long-term health capacity and preparedness, and their anticipated ability to respond to emerging biological threats. In simpler terms, we explore whether COVID-19 funding allocations matched pre-pandemic assessments of countries’ needs, based on the WHO’s Joint External Evaluation (JEE) scores. We track global health financing provided throughout the SARS-CoV-2 pandemic by both national governments and by multilateral, nonprofit, and philanthropic organizations using the Global Health Security Tracking database. Across all of these funding streams, our descriptive analysis suggests no significant correlation between pre-pandemic assessments of country need and proceeding pandemic funding allocations. We find that countries for which global health institutions determined to have the lowest health capacities prior to the pandemic did not receive greater amounts of global health funding relative to higher capacity peer nations once the pandemic arrived. If we are not using existing rubrics of institutional capacity, then what factors are driving these financial decisions? These results ultimately ask us to consider how many more times our global health systems will have “watershed moments,” that reveal how unprepared, uncoordinated, and underfunded we truly are before we get it right