Financing global health security: estimating the costs of pandemic preparedness in Global Fund eligible countries

Investments to build country-level capacities in health security are critical to ensure that the global community is better poised to prevent, detect and respond to outbreaks.In a prior SUMMARY BOX ⇒ The costs, globally, to build country-level public health capacity to address gaps in global health security over the next 5 years have been previously estimated as US$96-$204 billion, with an estimated US$63-131 billion in investment required over the next 3 years.⇒ Research conducted prior to the COVID-19 pandemic indicated that over one-third of Global Fund's budgets in 10 case study countries aligned with health security priorities articulated by the Joint External Evaluation, particularly in the areas of laboratory systems, antimicrobial resistance and workforce development.⇒ We estimate that over 85% of investments needed to build country-level capacities in health security, globally, over the next 3 years are in countries eligible for Global Fund support.⇒ Areas of investment opportunity aligned with the Global Fund's core mandate include financing for surveillance and laboratory systems, combating antimicrobial resistance and developing and supporting robust healthcare and public health workforces.⇒ In aggregate, global-level data highlight areas of op-portunity for the Global Fund to expand and further develop its support of global health security in areas aligned with its mandate and programmatic scope.⇒ Such investment opportunities have implications for existing budgeting and allocation processes and for implementation models, partners, programming and governance structures should these areas of potential expansion be prioritised.⇒ This work emphasises a role for targeted, actionbased cost estimation to identify gaps and to inform strategic investment decisions in global health.