Two Regions, One Future: Financing Pandemic Prevention, Preparedness and Response to Build Global Health Security

Excellencies, distinguished delegates, our meeting is about to start, so can I ask you to please take your seats? Can you hear me? Maybe before we start, let me share a few brief logistical notes. We have simultaneous interpretation available in English, French, and Spanish. Please select your preferred language. For Spanish, it's channel 5, and for French, it's channel 6. This event is also being broadcast live through UN Web TV, and you can also choose your preferred language there. We want to extend a warm greeting to those participants following us online. And if you just give us a few minutes, we are going to start really soon.

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English channel is there's no it's the same we're all going to be in English so it's only that that's Spanish Excellencies, ladies and gentlemen, before our program begins, I would like to request the distinguished members of this first panel to please gather in front of us for a photo. Excellencies, distinguished delegates, I am Cecilia Munda Kasha, Vice President for Global Health Strategy at the United Nations Foundation, and it is an honor for me to welcome you all and open this important session entitled, Two Regions, One Future, Financing Pandemic Prevention, Preparedness, and Response to Build Global Health Security. I like to begin by acknowledging the presence of His Excellency, Dr. Muhammad Irfan Ali, President of the Cooperative Republic of Guyana, and His Excellencies, Evariste Ndiichimye, President of the Republic of Burundi and Chairperson of the African Union. On behalf of the UN Foundation, I want to thank the Cooperative Republic of Guyana and the Republic of Burundi, as well as the African Centers for Disease Control and Prevention and the Pan American Health Organization for their leadership and partnership in organizing this event. The coming together of these partners is itself a symbol of this kind of multilateral collaboration needed to confront threats that know no borders. Excellencies, distinguished guests, today we meet on the margins of the UN General Assembly in New York. In just a few days, countries will convene for a high-level meeting on pandemic prevention, preparedness, and response, also known as PPPR. Meanwhile, in the DRC, the Bundibugyo Ebola epidemic is expanding geographically. In Yemen, a chronic cholera epidemic continues to take hundreds of lives every year. And across Asia, we see how avian influenza continues to jump from poultry to people. These are different pathogens affecting regions in different ways, but together, they carry the same warning. The cost of responding to large crisis is always higher than the cost of preparedness. At the high-level meeting this Friday, governments will take stock of the existential threat posed by pandemics. They will also consider the recent progress that has been achieved and forge new commitments to a more durable and equitable approach to pandemic threats. This is a significant moment, but declarations alone do not drive change. Countries do. The policy gains secured in New York will only become life saves when they are reading into legislation and national action plans, when ministers of health and finance jointly budget and allocate the resources to implement them, and when neighboring countries commit to facing shared threats together rather than alone. As pandemic risk accelerates, so does the case for investing in this agenda. not as a health expenditure, but as an urgent cross-sectoral investment in economic resilience, national security, and sustainable development. From Georgetown to Gitega, Latin America and Africa are proving what a regional approach to health security can look like, collective responses that extend across sectors and across borders. And country ownership is at the center of that progress. Through consistent investments in preparedness and current UHC and primary care, countries have reduced the scale and the cost of emergency response, have protected essential services, and also strengthened everyday systems. Many governments are also opening fiscal space for the health sector by looking outside it, through taxation, debt swaps, and reprioritizing existing budgets. At the same time, real infrastructure is what turns individual resilience into collective strength. Shared surveillance and laboratory networks mean risks are caught earlier and evidence moves across borders and continents in a matter of routine, not exception. Full procurement allows them to secure medical products faster and cheaper, while regional manufacturing capacity shortens the distance between production and the populations who need these tools the most. This is the model that the world is now looking for as it rethinks global health architecture. and Africa and Latin America are building it themselves. That is why today we will hear from leaders and experts about successful strategies, key lessons learned, but also about the urgent need to accelerate investments in PPR. We're confident that these two panels of heads of states, ministers, and financing institutions will stimulate our debate and renew our advocacy efforts for improving capacities for PPR and for a future in which a regional approach becomes part of the blueprint for global health security. And with that, it is my privilege to introduce Ambassador Anne-Claire Ampoux, French Ambassador for Global Health and Chair of the Executive Board of UNITAID. Ambassador, it is wonderful to see you back in New York. Ambassador Ampru has, as you well know, an extensive experience in global health diplomacy, having co-chaired the intergovernmental negotiating body on the WHO Pandemic Agreement. We're very grateful for your willingness to join us today and to participate as a moderator of this high-level panel. Ambassador, the floor is now yours.

Thank you. Thank you, Cecilia, and thank you to the United Nations Foundation for your partnership in bringing G7 to life. Your Excellencies, distinguished delegates, we meet today at a consequential moment. The adoption of the WHO Pandemic Agreement last year, as mentioned by Cecilia, was a hard-won milestone, proof that multilateral cooperation on health security is possible, even in a fragmented geopolitical landscape. The topic of this panel is particularly close to my heart, not only as an ambassador, given my involvement in the pandemic agreement, but also as a chair of UNITAD, given the significant investments made by this organization in this area, which support the implementation of the pandemic agreement on many regards. But an effective implementation of the pandemic agreement depends on sustained political will combined with adequate financing. That is the work before us today, not to re-litigate the case of PPR. That case is made every time an outbreak crosses a border, every time a health system buckles under a surge it was not resourced to absorb. The work before us is to ask How we move from crisis-driven funding to strategic, predictable investment. How do Africa and the Americas, two regions that have paid an outside price in the face of both outbreaks and pandemics, lead that conversation together? The leaders and experts in this room have concrete answers, and I look forward to drawing them out. So to open our dialogue, I'm honored to invite His Excellency, Dr. Mohammed Irfan Ali, President of the Cooperative Republic of Guyana. President, you have been a consistent and credible voice for the proposition that pandemic preparedness is not a health expenditure, but a cross-sectoral investment in economic resilience, national security, and sustainable development. This matters, especially for countries and economies that are especially exposed to external shocks. So we are very grateful for your presence and for Guyana's commitment to this agenda. Mr. President, the floor is yours.

Thank you very much, colleagues, distinguished ladies and gentlemen. The COVID-19 pandemic was one of the most tragic developments in modern human history. It took millions of lives, disrupted economies, interrupted education, and exposed the extraordinary fragility of our interconnected world. We can only hope that humanity will never again endure a crisis of such scale and gravity. The best tribute to those We lost is to ensure that we act consistently and with sustained purpose to prevent, prepare for, and respond to any future global health crisis. The pandemic exposed crucial fault lines within and between countries. Those must be repaired before the next emergency finds them. For developing countries, five lessons deserve particular attention. First, preparedness must begin before the emergency. COVID-19 taught us that the real test comes when ordinary capacity is overwhelmed. We therefore need to build strength throughout the health system, from community care and disease surveillance to labs hospitals, and trained personnel so that a surge in demand does not result in a collapse in capacity. Second, resilience requires alternatives. The pandemic showed what happens when countries depend too heavily on distant sources for essential medicines, vaccines, diagnostics, and protective equipment. Every country must ask, what happens if the supply stops? The answer must include diversified suppliers, strategic reserves, and greater domestic and regional capacity. Third, the global South must become a producer of solutions, not merely a consumer of them. Our countries possess scientists, engineers, doctors, researchers, and institutions of considerable talent. Yet, that knowledge remains too fragmented. We must connect our scientific and technical capacities across borders, share research, pool investment, and build regional capabilities to develop and manufacture vaccines, medicines, diagnostics, and other lifesaving technologies. Science should know north or south, but access to its fruits must never depend on geography. We must build a world in which the global south has a scientific capacity, not simply to receive life-saving innovation, but to help create it. Fourth, resilience requires room to maneuver. When the pandemic struck, Governments needed resources immediately at precisely the moment when revenues were falling and economic activity was contracting. Fiscal prudence, therefore, has a human dimension. Reserves, sustainable debt, and sound public finances give governments the freedom to act when circumstances leave no time for deliberation. Fiscal space is emergency space. Fifth, a health crisis quickly becomes a crisis of livelihoods. The pandemic reminded us that for millions of people, particularly those dependent on informal employment, the loss of income can be immediate and devastating. Protecting lives, therefore, requires protecting the means by which people live, jobs, food, education, small businesses, and essential services. A resilient society is one that can absorb a shock without allowing the most vulnerable to fall through the floor. These lessons point to a larger truth. Pandemic preparedness cannot be the responsibility of health ministries alone. It belongs to finance, science, education, agriculture, trade, technology, and foreign policy. It belongs to governments, regions, and international community. The next global crisis may come from a virus we know, or one we have never encountered. What matters is whether we meet it with the vulnerabilities of yesterday or the preparedness of tomorrow. We cannot prevent every outbreak, but we can prevent an outbreak from becoming another catastrophe. That is the responsibility we carry from the pandemic, and a promise we owe to those who will come after us. Guyana anticipates that the outcome of this discourse we are having today will not be merely for academic purposes, but will be translated into a program of action. I thank you.

Thank you. Thank you very much, Mr. President, for this clear, very clear message and commitment.

I now have the honor of presenting Mr. the Minister who's representing the President of Burundi. Thank you very much for joining us as the representative of the President, of the chairperson of the African Union. You are bringing us that's a perspective that's both national and continental. and you are witnessing the means that the continent is putting in place to face these issues. We are grateful to Burundi for its partnership. Mr. Ambassador, you have the floor.

Thank you for giving me the floor, Excellencies, Mr. President of the Republic of Guyana, His Excellency Dr. Mohamed Iffran Ali, Excellencies, distinguished participants. Good afternoon to all. I would like sincerely to sincerely thank the organizers for having us, having brought us to this important parallel session happening on the on the on the at the edge of the 91st General Assembly, I have the honor of speaking with you today both on a national level and also as a representative of a country that is now at the head of the African Union. When it comes to the continental role, I would like to bring to this meeting the collective voice of African leaders, of leaders of the African continent, that the preparation for pandemics is for each member state.

For which it is a second question of security, of stability, economic stability, and also a question of their sovereignty. Excellencies, what we have learned from COVID, and at a great cost, is that what happens when there is a shock to the healthcare system, lives are lost and trade is interrupted. Years of development are reduced to nothing. From that time, our members, both individually and through the collective instruments that we have established through the Africa CDC, have invested in monitoring in laboratories and have invested in healthcare personnel, emergency care centers, and in cross-border coordination. The current Ebola epidemic in the DRC reminds us forcefully of the urgency of investing in preparation, response, and the response to a pandemic with lower confinement time and a more coordinated response. Dear participants, what we have established in our continent is not dependence, rather it's security and the independence of the healthcare system in Africa, where all our members together show their ability to prepare and defend our populations based on our own institutions, our own resources, and depending only on our own decisions with the world at our side as partners and not as a substitute to our own efforts. As a leader in Africa, as African leaders, we accept the importance of increasing our investment in health security and the best use of those resources. However, and I underscore this, this cannot be the sole purview of Africa. The participants gathered here should shoulder this effort for a long time effort through mechanisms such as the Pandemic Fund, and its crisis financing instrument so that we can answer each future threat. With our friends from Guyana and Santa Lucia, we would like to express the fact that African solidarity extends far beyond our continent. Our nation and the nations of South America and the Caribbean face a number of similar structural threats, and we would like to welcome the deepening of South-South cooperation between our regions in terms of health, safety, and preparation. Excellencies, dear participants, Prevention is less expensive than response, and continued investment is less expensive than financing in a time of crisis. The countries of Africa are ready to show the way in this area, fully in charge of their own security and their own health care needs. What we would like from the international security, international community is simple, and that is to prepare with the same seriousness, because this is a pillar of the international system. It is an integral part of it. And to conclude, Africa is not going to wait for the next pandemic in order to act, being in full control if it's preparedness and it's planning, and we want to invest now when preparedness is available to us and affordable. Thank you.

Thank you very much, Your Excellency.

distinctive and essential that a small island developing state from whom the case for regional cooperation in health security is not theoretical, but deeply practical, shaped by the reality of scale, geography, and exposure to compounding shocks. So I'm pleased to welcome Her Excellency, Dr. Carla Nathalie Barnett, Secretary General of the Caribbean Community, CARICOM, Your Excellency, you have the floor.

Thank you very much, Madam Chair. Excellency, President Ali of the Cooperative Republic of Guyana, other distinguished members of this panel, ladies and gentlemen. I want to begin by thanking the governments of Guyana and Burundi and our partners at the Africa Centers for Disease Control and Prevention and the Pan American Health Organization and the United Nations Foundation for convening this important discussion, which reinforces the important and strengthening partnership on health between the regions of the Americas and Africa. I also thank the organizers for inviting me to share the perspective of the Caribbean community. As a region of small island and low-lying coastal developing states, our populations are small, our specialized health workforce is limited and highly mobile, our health systems are extremely vulnerable to shocks, our resources are constrained, and our supply chains depend heavily on the outside world. This inescapable reality shapes everything about how we approach pandemic prevention, preparedness, and response. When a health emergency strikes, these are the conditions within which we work. No single CARICOM member state on its own can reasonably maintain every specialized capability that modern PPR demands. For CARICOM, regional cooperation is therefore necessary if we are to effectively manage our circumstances. Through our regional institutions, in particular, the Caribbean Public Health Agency, CARPHA, our member states pool expertise, surveillance capacity, emergency coordination and procurement, achieving together what would be very difficult to realize individually. Member states and CARPHA have also strengthened laboratory capacity and outbreak preparedness, building on lessons learned and, most recently, best practices that we undertook on the response to the COVID-19 pandemic. This cooperative approach is also institutionalized in our partnership with PAHO, WHO, and WHO, In 2025, CARICOM and PAHO/WHO signed the Joint Subregional Cooperation Strategy for 2025-2029, which places the strengthening of all-hazard emergency preparedness and integrated surveillance under the International Health Regulations at the center of our shared work program. CARICOM Member States have also prioritized PPPR in global discussions. CARICOM's position on the 2025 WHO Pandemic Agreement emphasize equity, solidarity, and fair access to medical countermeasures. Member states advanced these priorities at the 79th World Health Assembly in 2026, calling for fair access to vaccines, treatments, funding, and other benefits, especially for SIDS, which need the capacity to act quickly when an emergency occurs. Excellencies, my request to you all today is to situate health security within the broader resilience agenda that is a daily reality for CARICOM and other small island developing states. Climate shocks, hurricanes, and pandemics tend to arrive together or in close succession, and each compounds the economic toll of the others. A small state cannot set aside one threat while it responds to another. Its health workers, public services, and national budget must carry them all at the same time. COVID-19 showed how quickly a health emergency disrupts travel, trade, and livelihoods. Any credible PPPR financing architecture needs to understand and provide for that compounding reality. The voice of small states must help to shape the global PPR architecture, including its financing. Linked to this is a recognition that the vulnerabilities of small states and the work of the regional institutions on which they depend are now being severely impacted by the decline in donor resources. This is but one critical example of why the architecture of global financing needs attention, as CARICOM advocates through the Bridgetown Initiative. Most Caribbean states are classified as middle income, a classification that limits access to concessional financing, regardless of how exposed we are to pandemics, hurricanes, and climate shocks, sometimes within the same fiscal year. CARICOM fully supported the development of the Multidimensional Vulnerability Index, which measures countries' exposure to a range of shocks that impact growth and development, rather than using only income per capita to determine access to and cost of resources. The MVI is intended to take into account the vulnerable circumstances faced by SIDS. We believe the same logic must inform PPPR financing to avoid overlooking those countries most likely to face concurrent compounding crises. As our member states prepare for the second high-level meeting and the adoption of a political declaration on PPPR, it is important that commitments lead to practical action, predictable financing, and accountability for progress. Of equal importance are international partnerships and platforms for action that can be shared and replicated across regions, including pooled financing mechanisms for procurement. We would be remiss to forget a lesson which COVID-19 taught the world at great cost, that solidarity and equitable access to medical countermeasures are essential to any credible preparedness strategy. For CARICOM, the lessons from the COVID-19 pandemic were particularly sharp when it came to access to vaccines. When the smallness of our markets sent us to the end of the line and we could not directly purchase what we needed from the global pharmaceutical companies, it was our partnership with the African Medical Supplies Platform which provided access to vaccine supplies. Excellencies, CARICOM stands ready to deepen cooperation with our partners across Africa and the Americas to build better health security. We bring the experience of member states that have chosen collective action because their health security depends on it. Let us match that collective action with political commitment, sustained and appropriate investment, and fair access so that when the next pandemic comes, our countries will be better able to protect our people, our economies, and our future as part of the global effort to equitably protect all people, economies, and the global future. Thank you very much.

Thank you. Thank you very much, Dr. Barnett. What we have heard from our panelists is a clear message. Sustained investment in preparedness is not a health sector question, as you mentioned, President. It is a question of economic security, national resilience, and political will. And that investment must be country-owned and country-led, grounded in nationally identified priorities, rather than externally defined templates. At the same time, as you mentioned, Dr. Barnett, No country can build alone. The regional infrastructure that makes national preparedness coherent, surveillance networks that cross borders, laboratory systems that share capacity, emerging workforces that can move where they are needed, these are collective goods and they require collective investment. These two regions, Africa and the Americas, are currently facing significant challenges, from Ebola to chikungunya and yellow fever outbreaks. These recurrent outbreaks continue to test health systems that have nonetheless grown stronger. More resilient infrastructure, more capable institutions, and deeper investment in prevention. The political frameworks to sustain that progress are taking shape. What remains is the operational question: which specific capacities, built and maintained at regional level, make every country safer when the next threat emerges? That is the contribution of Africa CDC and PAHO, the institutions at the forefront of translating political commitment into regional preparedness in practice. So I'm pleased to welcome Dr. Jean Cassayr, Director General of Africa CDC, the continent's premier public health institution and the operational backbone of Africa's collective preparedness architecture.

Excellencies, Dr. Mohamed, Mr. Ali, President

I would love today to be fluent in Spanish and Portuguese and to speak because these are the language of America, but I'm sorry, I just speak French and English. Then please allow me to continue in English. But before maybe making this speech, Mr. President, let me tell you that for the first time I met your minister, Frank Antony, who's here. He was board member of a pandemic fund we met in Kigali. He was so brilliant. Comment he was making were just appropriate. And I was asking myself, how can we have a brilliant minister like that? And the response came, my president is brilliant. Now I can confirm that. Let me also recognize President Nkurunziza in absentia, represented by the ambassador and all dignitaries here present. I want to say, Excellency, my brother, Jabas, and myself, we started to think about how to bring together these two continents. And then, having Guyana and the Republic of Burundi, Calling us for this meeting, it's really a moment of joy, and we are celebrating that. We meet an important moment. Last year, we approved the pandemic agreement, and currently, we are still negotiating the pathogen access benefit sharing framework. But the bad news is, if we don't manage to finalize that, we are facing the risk to nullify the pandemic agreement, and the world cannot accept that. Excellencies, the question today is no longer whether another major health emergency will occur. The question is whether we'll have invested sufficiently before it occurs to protect our people, our economies, and our societies. This is why Africa CDC developed the vision that we are calling Africa Health Security and Sovereignty. Listening from you, Excellency President Irfan Ali today, listening from the Prime Minister Mia yesterday, and I see the minister representing the Prime Minister, listening from African leaders, including President Mamadou yesterday, I can confirm that the agenda of health security and sovereignty is bringing the two continents together. Across Africa and America, we are experiencing the enormous human, social, and economic consequences of inadequate preparedness. Health systems are overstretched. Supply chains are severely disrupted. Trade and tourism are suffering. and our economies are contracted significantly. Today, as it was shared, the Ebola outbreak is a stress test for our systems. More than 7,500 confirmed cases, more than 3,600 deaths. This outbreak that started with one province is now across seven provinces, in terms of area, it's larger than the UK territory. The message from Africa CDC is then clear. Pandemic prevention, preparedness, and response is not simply a health expenditure. It's an investment in our national security, economic resilience, and sustainable development. When countries invest in surveillance, laboratory and genomic sequencing capacity, emergency operation centers, immunization, digital systems, and strong public health institutions, they can detect earlier, they can respond faster, and they can reduce both the human and economic cost of emergencies. Excellencies, our people are flying every day We are in your region, in the American region. We came here with a long team, a very large team of African people. This is showing that the world is very well connected. And we need to work together to avoid transmission of disease across not only the two continents, but across the planet. We cannot continue financing preparedness as an emergency project. We need predictable, sustainable, and long-term financing that build capacities before crisis occur. First, we need countries who must remain in the driver's seat. Preparedness must respond to nationally identified risk. priorities and capacities. Countries should make decision on what they need to strengthen, where the critical gaps are, and how domestic, regional, and international resources can be aligned around those priorities. This is fundamental to national ownership and to ensuring that investment are sustainable. Second, National investment must be complemented by strong regional public goods. This is why regional institutions like Africa Science and Power are essential. Our role is not to replace countries. Our role is to enable and to strengthen them, to provide technical cooperation, to facilitate cross-border coordination, to strengthen regional networks, to promote knowledge exchange, and to help translate preparedness into actionable investment priorities. For Africa and America, this means continuing to strengthen the systems and institutions that allow the two continents to detect, prevent, and respond to threat. And this is even the main reason that Power and Africa CDC signed the MOU that we are implementing for our two continents. Third, we need financing that is available before day one of emergency, not after. Excellency, you will see the moderator of this session is not from Africa and not from America. This is what is showing us that we are all linked and we are working together. And we want them to continue to support us because countries cannot afford to spend those days searching for financing, negotiating emergency arrangement, or waiting for resources to be mobilized. Fourth, preparedness must be understood beyond the health sector. Today, we have ministers of finance, ministers of health, together with our development banks, international financing institutions, and global partners. We are preparing what can be the next move together. Excellencies, Africa and the America must work together. Our two regions share important experiences. We face cross-border health threat. climate-related risk, emerging zoonotic diseases, inequities in access to medical countermeasures, and the challenge of building resilient health systems while responding to competing development priorities. Excellency, let me share with you that we need your voice. One year ago, you renewed your second term. It was in September 2025. It means we still have you for the next four, five years. This is why, speaking with my leaders in Africa, we believe that we can use also your capacity as the chairman of CARICOM region in the past to bring the strong voice of the region to the Conference of Public Health in Africa that will take place in Addis Ababa from the 22 to the 27 November. I take a strong commitment to make sure that your invitation will land to Guyana very soon and will welcome you to Africa and will be so happy to celebrate the success that we are bringing to your region with your African brothers and sisters. It's also opportunity to invite all colleagues here to attend this meeting that will bring together 35,000 people in person and more than 100,000 people virtually. It will be also opportunity for Africa, a continent that is having more than 54 countries that represent 30% of the WTO membership to organize for the first time the dialogue, we don't want to talk about interview, of the WTO DG candidate. They will come to convince us that they have a vision for Africa and for America before we go to vote for them. This is why, Your Excellency, maybe when you will come to our continent, you also bring some ministers, because we want this candidate to know that we are serious with this agenda. Excellency, I will not stop. by also convening a personal message from my mother who was born the 25 April, like you. And because I love my mother and because she believed that all good people are born the 25th of April, this is why I wanted to send you greetings. Thank you so much, Excellency.

Thank you, Dr. Casella, and thank you for the invitation. I understand the president was personally invited, but everybody is invited, so that's great. So see you there, and that will be a great moment. Thank you very much. To close this panel, I'm now delighted to welcome Dr. Jarbas Barbosa, director of the Pan American Health Organization, which serves as a regional platform connecting national preparedness with shared capabilities across the Americas. Dr. Jarvas Barbosa, you have the floor.

Thank you. Thank you, Ambassador. Ambassador Ampru. Excellency, President Mohammed Irfan Ali, it's a great pleasure to have you here. I had the opportunity to visit Guyana. and to witness the revolution that we that you are doing with your leadership with the leadership from our good friend Minister Anthony they strengthen strengthen the national health system changing completely the access of the people of your country to the health services in in Guyana uh Ambassador manira taganda representing the president of Burundi Excellency Dr. Carla Burnett from the Caribbean community, Minister Cummings and other ministers that are present here, my good friend, my brother, Jean Cazaya, distinguished colleagues and partner Cecilia Mundaco, that is a very strong partner that allow us to have this very important meeting today. It's an honor to join you today, and I want to extend my sincere gratitude to the government of Guyana and Burundi for bringing Africa and America together around a question so vital to our collective future. Six years from the onset of COVID-19, what was the hardest truth to emerge from that crisis? For months, the Americas stood as the global epicenter of the pandemic. Our region endured the profound, devastating human and economic cost of a world caught unprepared. We lived through a reality we can no longer ignore. Preparedness cannot begin when a crisis is already at our doorstep, nor can it depend on emergency funding that arrives only after livelihoods and entire economies are already breaking. Preparedness is not a cost we pay during an emergency. It's an investment we make before one strikes. An investment in public health, certainly, but equally in our economic resilience, our social stability, and our collective security. In the Americas, our ongoing battle with epidemic-prone threats, whether influenza, dengue, yellow fever, or emerging pathogens, have shown us precisely where sustained investment changes the course of a crisis. It boils down to three core pillars. First, early detection. Countries must have the tools to spot a threat the moment it emerges and translate that insight into rapid action. That requires strong surveillance systems, interconnected laboratory networks, and cutting-edge genomic tools that convert raw data into immediate public health decisions. Second, operational readiness. Real preparedness means having systems that are alive and functioning before the siren sounds. Trained emergency teams ready to deploy, functional emergency operation centers, and resilient supply chains capable of delivering lifesaving resources. exactly where they are needed, when they are needed. And third, equitable access. COVID-19 exposed the tragic consequences of a world in which vaccines, diagnostic, therapeutic, PPEs, and medical oxygen are distributed inequitably. Mechanisms that pool demand and strengthen procurement, like PAHO's Regional Revolving Fund, Proved that you can break these vulnerabilities when we leverage collective purchasing power and strengthen regional production capacity in Africa, in Latin America, closer to the countries that you needed these pharmaceutical measures to respond not only to a future pandemic, but the current public health threats and challenges that we face. Yet perhaps the most fundamental truth from our region is this, no country, no matter how wealthy, can prepare entirely on its own. Pathogens do not respect borders, passports, or sovereign lines. Early warning data from one nation is the key that protects its neighbors. It stays alive with the infrastructure, like our regional genomic surveillance network for respiratory virus, provides high-level capabilities that would be inefficient and costly for every country to build independently. These are regional public goods. They not replace national preparedness, they supercharge it, making every national dollar spent vastly more effective. This is particularly important for smaller nations, including the small island developing states of the Caribbean, where maintaining every specialized capacity is simply not feasible. This is precisely where a regional institution like the African CDC and PAHO step in. For more than 120 years, PAHO has provided a platform for the countries of the Americas to confront shared health threats together. Our job is to help countries build their own strengths while weaving them into regional networks that achieve collectively what no single country can accomplish alone. And that is why today's dialogue between Africa and the Americas is so significant. Africa CDC and PAHO operate in different regions with unique contexts, but we are driven by a single shared objective: stronger countries, supported by stronger regional architectures, contributing to a safer world. The challenge before us today is not a lack of technical knowledge. We already have diagnostic tools, the risk assessments, and the action plans. The real challenge is sustaining financing. We must translate priorities into predictable long-term investments nationally, regionally, and globally, and maintain those investments during the quiet periods between crises. Ultimately, preparedness cannot be measured by the elegance of the plans we write on paper. It will be measured on day one of the next emergency by whether we can detect the threat share the intelligence, mobilize the expert teams in critical supplies, and act fast enough to stop an outbreak before it becomes a pandemic. That is the commitment we must make today. Thank you very much. Merci beaucoup.

Thank you. Thank you very much, Dr. Barboza, for your words. We are running out of time, so I will be very short, I understand. Mr. President, you have to leave. Thank you very much for your strong commitment. We need that. Thank you. Thank you, President. Just to conclude, a few words. Across this segment, the five speakers from the two regions have pointed us towards the same conclusion arrived at from different directions. The first is that preparedness is a political and economic choice. The second and perhaps most urgent conclusion, these capacities cannot be improvised once a crisis has begun. The third and last conclusion for today is that national investment alone is not sufficient. It requires sustained financing across borders aligned with regionally defined strategies. On that note, and to conclude, I'd like to emphasize that complementarity to what need and should be done at national or regional level, access to medical countermeasures should be also operationally considered at global level. And all these consideration brings us naturally to the question of financing. And these are the questions for our next panel. And before welcoming the moderator of this second panel, I would like to thank your excellencies for your intervention. Thank you very much. And I think that we will hand over to the moderator of the second panel. Thank you very much.

Thank you, Ambassador. Minister, your presentation was very good. How are you? Je ne sais pas.

Okay.

Thank you, excellencies. Can we have members of the second panel session join me on stage? We have Ghana, Rwanda, Guyana, Barbados Pandemic Fund. Thank you so much. Okay, Ghana. We are.

Yeah.

Ghana is over there.

I think they have-- yeah, yeah, no problem.

Ghana.

Barbados is over here.

I've seen Rwanda there. A bit of musical chairs.

Oh, OK, sorry.

Movement is good. After you.

We got some exercise.

Yeah.

All right. Your excellencies, colleagues, ladies and gentlemen, can we take our seats? I understand that we have 13 minutes for this particular panel session. So as much as possible, I would like to crave the distinguished indulgence of the panel members to go straight to the answer to be more brief, more concise, and keep it within two to three minutes so that we can really do it in 30 minutes. So, Excellencies, colleagues, ladies and gentlemen, we've heard from our political leadership, we've heard from our head of state and government, we've heard from our regional health organizations, so it's now time to listen to our ministers, our development finance institutions, our able and capable pandemic fund, you know, on how do we better finance pandemic prevention, preparedness, and response. And to set us going, as far as this panel session is concerned, I'll go straight to Guyana. And the question here is, what practical lessons can other countries draw from Guyana about turning identified preparedness gaps into prioritized, costed, and finance-ready investment. Over to you, Your Excellency.

Thank you very much, Mr. Chair, and to my colleagues on the panel. First of all, I would say that as a country, what we did was we started out by doing state party assessment, but we thought that if we are assessing ourselves, then maybe we might give ourselves very good marks. So we decided to bring in an external group that would do an external evaluation. And having done that external evaluation, we saw the gaps that we had in pandemic preparedness. And having found that, we thought that we needed to do something about it. And so we came up with a national health security plan. And fortunately for us, we took aspects of it and we went to the pandemic fund. And we were very fortunate as one of the countries to be able to get a 15 point something million dollars grant from the pandemic fund. And we got co-financing because we were able to do that, put this project together, we got co-financing from the World Bank and that package of about $22 million, then the government itself with the investments that we were making in the health sector, we were able to catalyze the money that we got both from pandemic fund and the co-financing from the World Bank, we were able to catalyze that so that we can undertake the transformation that is happening in Guyana. So it's not just about doing the assessment because somebody wants us to tick off a box. We did the assessments because we want to use this as a tool to know where the gaps are and to fix the gaps. And I think that is the important lesson here. And if each country can do similar things, I think the world would be a better place. So we have to take that step in knowing and understanding our weaknesses and then work with partners such as the Pandemic Fund to be able to ensure that we can fix those gaps.

Thank you so much. Honorable Frank Anthony, Minister of Health from Guyana. So we had assessment, identification of gaps, and of course, I mean, grant from pandemic fund, co-financing from World Bank, and much more importantly, domestic resources from the government of Guyana. Thank you. So, next is Honorable Yvonne Butera. I know you've done a lot in terms of bringing the Marburg outbreak under control in record time. You're also doing a lot to keep the ongoing Ebola outbreak in the Dr. Congo, you know, from coming to Rwanda. So, my question to you, Your Excellency, Minister Yvonne, what lessons from this crisis should fundamentally change our country's finance preparedness before the next outbreak? And how can we ensure that emergency investment strengthens sustainable national preparedness capacities rather than being lost when the emergency ends? So in essence, we are saying, how do we move away from the vicious cycle of we panic, when there's an outbreak and when the outbreak is gone, neglect it. Over to you, your honorable minister.

Thank you, Raj. That's a very loaded question, but I will try in a minute. As you rightly pointed, the world has been tested with different outbreaks. Maybe as of most recent, you have COVID, Mpox, and Lassa, and others. What we learned from Rwanda is that Number one, preparedness doesn't start when an outbreak is already there. You need to set the systems in place to be able to activate them if and when an outbreak will come. So let me just use, because we have limited time, the most recent outbreak that we had, which is Marburg, fatal disease among the top three most deadly viruses in the world. When it hit our shores in Rwanda, the capacity that we had built over a number of years came in handy. We were able to detect it very fast. We were able to track its source, its zoonotic source, in a very limited number of days. We were able to cut the transmission chain. In fact, we only had one transmission chain. That was very important to zero in and you control. So all the tools and knowledge that we have globally, we just need to apply them. Number two is to be able to scale your capacity of surveillance. We have a large community of community health workers. They went door to door, assessed risk. Those who might have been thought to have contact to that, you know, early testing, scale your testing. Three is, you know, deployment of innovative tools. I don't know if you know, but when Marburg hit, it was the first time from when an outbreak is declared to when an investigational product is put on a patient. We did it in 10 days. So from when the diagnosis was made of the first case to when the first patient received the investigational vaccine, it was 10 days. We were able to also deploy a monoclonal antibody. And all that contributed to having a case fatality rate of Marburg of 22.7%, the lowest ever recorded anytime and anywhere in the world. We are talking about a disease that usually around 70, 80% of case fatality rate. So in a nutshell, you get ready before the outbreak. We need to get out of the cycle of doing things when the outbreak is there. That's one of the issues that we face. But number two, we also see instances when there's a firefighting happening And as soon as the outbreak is controlled and people leave, the next thing that will come in two years will find as if there was nothing again. So one, prepare ahead of time. Two, when you build capacity during an outbreak, we should make sure that that capacity stays and strengthens at the national institution. I think by doing that, we can be able to ensure that countries are safe at a national level, if you extend to a regional level, and by extent to a global level. Thank you.

Thank you so much, Your Excellency, Minister Ivan. So we need to invest in preparedness well ahead of time and you do not wait until there's an outbreak before we start running around looking for support. So let me shift gear and go to Barbados. Let me invite Senator Honorable Lisa. to tell us about how preparedness financing should be designed for small island developing states.

Thank you very much. I'd like to congratulate my colleague from Guyana and Burundi as well for anchoring this important conversation along with PAHO and our colleagues bringing our regions together. I think that most of the colleagues, if not all of the colleagues, have already identified what the issues are, so there's no need for me to rehash many of the things that could potentially be said here, but what I will say is that Prime Minister Motley has led on the Bridgetown initiative for a reason, and the reframing of the development finance space for a reason. And one of the key things that she's kept saying is we need to be able to design financing solutions that cater to countries like ours. and we need to also move beyond measuring the ability to repay or to have access to that capital. And I'm going to come to health in a minute by measures like GDP and what a country looks like, countries like ours that may appear to be prosperous because resilience can be wiped out in countries like ours by a single pandemic or by a single climate event in 48 hours, as we've seen in some of our jurisdictions. And if you live in a region like the Caribbean, where the countries are just a few hundred miles away from each other, several countries could be taken out in one single event. So for us, what do financing solutions look like and what does resilience and preparedness financing look like? I want to make five simple points in two minutes. One, we have PAHO, and I'm happy our colleagues are here, and I want to perhaps start by making a call for us to finance the institution. as well as to finance the institution's work that is taking place across the Caribbean region. We need to be able to have strong, well-functioning institutions, and much of the things that many of us can recommend are already functioning under the umbrella of PAHO. And so my first call is for us to adequately fund and finance the work of PAHO as an institution, and secondly, to finance the work that is being done across the Americas through PAHO. That's my first call. The second point is for us to look at the way in which we are financing the various types of interventions across the region. There is such significant work that can be done through different levels. So we have PAHO, and to my left, we have the Inter-American Development Bank, and I'm sure we'll hear from them in a minute. But I want to make a call for four levels of financing to evolve. One, Institutional development financing through parties like PAHO and the Inter-American Development Bank, helping to work with countries like ours to finance infrastructure to help us to be prepared for outbreaks and health systems resilience. Governments, of course, too. Governments having access in our own budgets to be able to put a stake in the game to financing what is important to us. Some countries have different priorities, and so countries must take the wheel in programming into our country annual budgets. what is necessary. The third layer that I would put in here is the introduction of two additional components. One, philanthropy. In many of our countries in the Caribbean region, we are too small or seem to be too small for philanthropy and for social impact investment to make its way into our region. But there is a space for resilience, preparedness for health, to have our philanthropic institutions support entities and work, there's no reason why things like vaccines and so on need to be supported by certain types of institutions, but there is a rate of return that investors expect that philanthropists do not. And so it is space for philanthropists to come together with MDBs, with governments, and then finally a role to be played by private sector financing to support the development chain and the resilience financing for health resilience in our regions. If we were to bring all of them together and we frame it under the broad umbrella of the Bridgetown Initiative and the kind of work that we heard in the Accra Reset earlier this week, that is the kind of transformation that I believe can give rise to the issues that many of us have identified and are still raising as part of our resilience funding, our health sector preparedness financing, but our overall ability to respond before the fact, during an event, and after the fact. Thank you very much.

Thank you, honorable. Minister of Health of Barbados, I think you've really, I mean, outlined what financing should look like, especially for small island developing states and by extension for other countries. You did mention the criticality of financing regional health organizations. how Africa CDC, the Gov CDC, and so on and so forth. And you also brought, I mean, into the discussion, the aspect of public, private, philanthropic financing, you know, for health. So thank you. And you did mention Accra Reset, and this is a perfect opportunity to bring on board Ghana. So, Honorable Dr. Kwabena, represented by the Director General of Ghana Health Services, Dr. Samuel Kaba. So what would make pandemic preparedness compelling enough to be treated as a core national investment rather than an additional health expenditure? And what role should domestic financing play alongside international support? Over to you, Dr. Kabba.

All right, thank you so very much, and good afternoon, everybody. As you said, I'm actually representing my minister, so I'll try to do what I'm here to do. So, Your Excellencies, distinguished colleagues, ladies and gentlemen, let me begin with a simple proposition. Pandemic preparedness must be treated as a core national investment, not as a discretionary health expenditure. For many countries, particularly those operating within tight fiscal constraints, preparedness is often discussed in terms of what we can afford to spend today. I believe we should ask a different question. What can we afford to lose tomorrow if we do not invest today? The experience of COVID-19 gave us a very clear answer. The cost of preparedness may be significant, but the cost of an unprepared pandemic is vastly greater. Beyond the immediate loss of lives, pandemics can disrupt economies, interrupt trade, and supply chains. factorism and employment, place enormous pressure on public finances and reverse years of development gains. In that sense, preparedness is not simply about preparing the health sector for the next outbreak. It is about protecting the resilience of the entire economy. This requires us to change the way we think about preparedness. Investment in surveillance, laboratories, emergency operations, health workforce, capacity Supply chains and local manufacturing should not be seen as investments that benefit only during a pandemic. These are capabilities that strengthen health system every day. A strong laboratory system detects an emerging pathogen, but it also improves routine diagnosis. resilient supply chain protects essential medicines in normal times, but becomes critical during crisis. A well-trained workforce delivers routine services, but can also be mobilized rapidly when an emergency occurs.

This is why pandemic preparedness should be understood as a dual-purpose infrastructure.

It strengthens everyday's health system while giving countries the capacity to absorb and respond to extraordinary shocks.

There is also an important economic argument. Pandemics do not respect the boundaries of government ministries. Once an outbreak becomes significant, it becomes a concern for finance, trade, agriculture, education, transport, national security, and the private sector. Preparedness, therefore, needs to move beyond Ministry of Health and become part of the broader national development and economic security agenda. I will draw an analogy with insurance. We do not maintain insurance because we expect disaster every day. We maintain it because the consequences of being without protection when disaster occurs can be devastating. Pandemic preparedness should be approached in much the same way. We may not know when the next pandemic will occur, where it will emerge, or how severe it will be, but we know that infectious diseases threat will continue to emerge. The challenge, of course, is that preparedness has a visibility problem. When preparedness succeeds, the crisis that was prevented is invisible. What is visible is the investment required to build that capability. We, therefore, need to demonstrate its value through tangible outcomes. early detection, faster response, stronger local production of vaccines, diagnostics and essential supplies, resilient health system, and the ability to keep essential services running during emergencies. We should also consider more predictable and sustainable financing arrangements, including multi-year commitments. So that preparedness is not something we have to renegotiate only after a crisis has begun. Sustainable preparedness requires sustained financing. Ultimately, the choice is not between investing in pandemic preparedness and investing in our economies. Preparedness is an investment in our economies. It protects lives, safeguards livelihoods, preserves development against and strengthens the fiscal resilience of the state. If COVID-19 taught us anything, it is that the question is not whether preparedness costs money. It's whether we are prepared to pay a predictable cost today or unpredictable cost and potentially catastrophic cost tomorrow. That is why pandemic preparedness must be regarded not as an optional program, but as part of the essential infrastructure of a resilient nation. Thank you.

Thank you. Thank you so much, Dr. Kerber. Consequences of lack of investment, I think the COVID-19 pandemic has clearly laid bare what will happen if we fail to invest in preparedness. So at this junction, allow me to now shift gear and go to pandemic fund. Prayer. How can global financing mechanisms, such as the pandemic fund, best support country-led investment in PPPPR while helping to mobilize domestic sustainable and international financing over time? Thank you.

Thank you. Thank you so much. And it's a real honor to be here on stage with such an eminent panel. Much has already been said, so I won't repeat it. I think your question is an excellent one, and I would like to highlight three key messages. So firstly, I think, you know, just to highlight that the Pandemic Fund really offers a distinctive platform We are country led, we are catalytic, we are collaborative. Our grants are used to mobilize additional resources from international partners and incentivize recipient countries and institutions to put their own resources, right? So we're already in a way built fit for purpose. We are built in a way we We deliver financing in a way that seeks to make every dollar of grant money go as far as it can. And using this catalytic model, we've already achieved a leverage ratio of one is to seven. So for every dollar of grants that we've awarded so far, we've managed to mobilize seven additional dollars. And very importantly, of those seven additional dollars, three are coming from the recipient countries themselves. So you can see strong commitment here, commitment in action. Indeed, I'm pleased to say that all the countries here represented, as well as the regional organizations, have partnered with us, and we've seen very strong co-investments coming, uh, from Guyana, from Rwanda, from, from Ghana. Um, I also want to emphasize that, uh, uh, you know, our, our model is country driven, regional driven, so we're not telling, um, countries what they need. We're asking them what they need, what their priorities are. We're here to fund those priorities in the areas of surveillance, laboratories, health workforce. And similarly, we're asking regional organizations such as Africa CDC and PAHO and so on, you know, what the demands and needs are. And we are working through partners such as the IDB, I see UNICEF there, here, a range of multilateral organizations, you know, are our implementing entities. Maybe secondly, just, you know, very quickly, while our reach is global, we are already in 128 countries with a portfolio of $11.5 billion worth of investment projects across these 128 countries, our mandate is local and regional, strengthening the countries and institutions on the front lines. So we partner with global institutions, draw upon their tools, offer this platform. But at a time of competing global priorities, it's never been more important to build PPR capacity where it matters the most, which is in countries that are most at risk and have the greatest needs, and across countries, and then across regions. And about 50% of our portfolio of investment projects are in Africa, and about 20% are in Latin America and the Caribbean. And then maybe, you know, thirdly, I just want to highlight that four years ago, we were a concept. And, you know, today we are a reality. We have very strong results already, tangible results in terms of what we've produced in across 128 countries. You know, over 300 laboratories already strengthened through our investments. You know, about 150,000 workers around those countries. already supported. I'm talking here not just doctors, nurses, field epidemiologists, lab technicians, also veterinarians, because we see the connection between animal health and human health. We take a one health approach in what we do. And surveillance, you know, very innovative surveillance tools, many of which deployed by the countries represented here on the panel. So, you know, from proof of concept, we are now proof of delivery, and we look forward to scaling up more with the support of all of you and our important donors that are also represented here in the room. So, thanks so much, and looking forward to the next chapter.

Thank you, thank you so much, Priya, for all you do to support member states and to support the regional institutions. Four years ago, you were just a concept. Today, you are a reality. Congratulations. So, at this juncture, let me bring on board our colleague from the Inter-American Development Bank, the Chief of Health, Nutrition, and Population. So, Mr. Javier, what innovative and cost-efficient regional solutions do you see emerging in the Americas to integrate pandemic preparedness, prevention, and response into broader development financing? And how can regional development banks help countries achieve greater impact through shared investment and regional public goods? Thank you.

Thank you very much. It's a pleasure to be here with you all. I just want to make three points. The first one is we believe in the interdependence of preparedness, universal health coverage, and economic resilience. And that basically means that we must build health systems that are resilient, resilient to pandemics, but also to disasters, and resilient to change and shocks. And that is moving from being reactive to being proactive. And that means also leveraging the co-benefits of PPI investments. In other words, we believe in mainstreaming the investments into pandemic preparedness, into strengthening health systems, and strengthening primary health care, strengthening laboratories, digital transformation, and everything else. The second point is the comparative advantage that we bring as multilateral development banks. I want to highlight the importance of financial innovation and the importance of having instruments that are fit for purpose. For preparedness, I want to highlight a very interesting initiative that we're working with my colleague from Barbados. And it's the Caribbean Mult guarantor debt for resilience joint initiative. We are basically finalizing the design of the first operation in Barbados. It's a debt swap. It's the first time that it's a debt swap done for resilience. $500 million operation working with the World Bank, CAF, the Caribbean Development Bank, leading by the IDB. And we expect to have $160 million in savings that will be invested into the resilience of the health system in Barbados. So this is money that was not available before for the health sector, and we're very happy to bring this innovation to reality. The second, of course, is the work that we're doing with the pandemic fund. And here, you asked me about regional public goods. And we have two main regional projects, one in the Caribbean with CARPHA and one in Central America with CECOMISCA. And that is a very powerful combination of leveraging funding, but also using regional platforms and delivering on what countries really need. So that is for us very important. Now, in terms of other instruments, I have to say the bank learned a lot after the pandemic. We were not ready when the pandemic hit. And this year, we updated, upgraded our instruments, and now we have several new instruments that we are basically working with, uh, our member countries on. including expanding contingent credit facility. Now 15 countries now do have that facility, but also an emergency component on all our investment operations. So every investment loan has an emergency component when a crisis hits that we don't need to go to the board to ask to have flexibility to mobilize the funds. But we also have other investment instruments like investment financing to strengthen the health system and cost deferred drawdown options, which is a complementary to the initial contingent credit facility. So all I'm saying, I guess, is We have learned the lesson and we now have better instruments. Now the challenge is to deploy them all and make them useful for all countries. The final point is about, I think, the importance of partnerships. And I want to highlight here the partnership that we have with the Pan American Health Organization. We signed an agreement in 2024 that has allowed us to work differently and will allow us to work differently in country and regionally. We're working with the Pan American Health Organization on ALERTO in Central America, working hand in hand, leveraging their expertise and our expertise. But also, you know, the partnership with the pandemic fund, the World Bank, CARPHA, and other important regional platforms. Last but not least, I would say regional public goods are one of the key benefits of, you know, having a multilateral development bank. We could work with countries and produce these goods that otherwise would have underinvestment. So we're working to strengthen regulatory authorities. For instance, we have a regional public good to strengthen regulatory authorities in Central America, but also, you know, digital transformation with the Pan American for Health Highway. What I'm saying is we're ready to keep working with our member countries. We think we've made a lot of progress together, and we continue to be committed to strengthen pandemic preparedness and response and health systems overall. Thanks.

Thank you. Thank you so much, Mr. Javier. I think one key takeaway message from your submission is the importance of partnership between the MDBs and the regional health organizations, and by extension, partnership with the member states. Really, thank you. So colleagues, ladies and gentlemen, I think if you look at our time, we're already 28 minutes past the allocated time for this discussion. I will not attempt to summarize what we've had so far, but we share the report of this meeting to all of us. So at this particular juncture, allow me to invite Dr. Barbosa, the director for PAO. and Excellency Dr. John Kaseya, the DG of Africa CDC, to join us on stage for a group picture with the panelists, then we can bring the meeting to a close. Please, a round of applause for the panelists here.