The aim of the Reimagining Multilateralism project was to “reimagine” the current multilateral health system through the lens of pandemic preparedness and response (PPR). In an ideal system, all nations would feel impelled to contribute toward the global good. Doing so would also be in their own selfish interest, ending the tragedy of the global health commons.
We used a mix of quantitative, qualitative, and game-theory methods to:
- understand the current landscape of financing of PPR;
- identify the barriers to collective action on PPR; and
- propose feasible transformations to the multilateral system to meet the challenges of PPR.
We began by tracking funding flows to PPR, in order to estimate the PPR “financing gap.” We then conducted a “global study” in which we conducted expert interviews with major multilateral health agencies, ministries of health in low-income countries and middle-income countries, civil-society groups, the private sector, and other key actors. The two aims of this qualitative study were to:
- understand in depth why multilateralism failed during the COVID-19 pandemic; and
- explore the key features of an equitable pandemic response in the next pandemic.
In parallel, we used game theory approaches to develop ways to help break the impasse over the Pathogen Access and Benefit Sharing (PABS) annex of the Pandemic Agreement.
Along with the global qualitative study, two national qualitative studies were conducted, led by the Public Health Foundation of India and the University of Ghana. These qualitative studies in India and Ghana explored the specific sub-national, national, and regional challenges to vaccine equity during the COVID-19 pandemic and the opportunities to ensure equity in the next pandemic.
Gavin Yamey, Center for Policy Impact in Global Health (Principal Investigator)
Ipchita Bharali, Center for Policy Impact in Global Health
Ayodamope Fawole, Center for Policy Impact in Global Health
Minahil Shahid, formerly Center for Policy Impact in Global Health (now a product management specialist at Marsh)
Siddharth Dixit, formerly Center for Policy Impact in Global Health (now an economist at the World Bank)
Osondu Ogbuoji, Center for Policy Impact in Global Health
Beth Boyer, Duke Margolis Institute for Health Policy
David McAdams, Duke Fuqua School of Business
Wenhui Mao, Duke Global Health Innovation Center
Kaci Kennedy McDade, formerly Center for Policy Impact in Global Health (now senior engagement lead, Kinaura Partners)
Marco Schäferhoff, Open Consultants
Preeti Kumar, Public Health Foundation of India
Rajna Mishra, Public Health Foundation of India
Genevieve Aryeetey, Department of Health Policy, Planning and Management, School of Public Health, University of Ghana
Adjeiwa Akosua Affram, Department of Health Policy, Planning and Management, School of Public Health, University of Ghana
Justice Nonvignon, Department of Health Policy, Planning and Management, School of Public Health, University of Ghana
Garrett Brown, School of Politics and International Studies, University of Leeds, UK
Tracking financing for global common goods for health: A machine learning approach using natural language processing techniques. Authors: Siddharth Dixit, Wenhui Mao, Kaci Kennedy McDade, Marco Schäferhoff, Osondu Ogbuoji, Gavin Yamey
How feasible is it to mobilize $31 billion a year for pandemic preparedness and response? An economic growth modelling analysis. Authors: Minahil Shahid, Marco Schäferhoff, Garrett Brown, Gavin Yamey
Policy Brief. Financing for future pandemics: implications that must be addressed. Authors: Minahil Shahid, Marco Schäferhoff, Garrett Brown, Gavin Yamey
Policy Brief. Is it feasible to mobilise $31 billion a year for pandemic preparedness and response? Authors: Minahil Shahid, Marco Schäferhoff, Garrett Brown, Gavin Yamey
Rethinking financial estimates for pandemic preparedness and response. Think Global Health, May 2, 2023. Authors: Minahil Shahid, Gavin Yamey
Three big questions facing the World Bank’s new pandemic fund. BMJ 2022:379 o2857. Kaci Kennedy McDade, Gavin Yamey
What are the key features of an equitable global vaccine strategy for the next pandemic? A qualitative study of pandemic control experts. Vaccine 2025 Aug 13:61:127377. Authors: Ayodamope Fawole, Beth Boyer, Minahil Shahid, Ipchita Bharali, David McAdams, Gavin Yamey
Policy Brief. What are the key features of an equitable global vaccine strategy? Gavin Yamey, David McAdams
Using Game Theory to Advance the Pandemic Agreement. Think Global Health, August 14, 2024. David McAdams, Gavin Yamey
How a “Club” of Countries Would Prevent Future Pandemics. Authors: Duke Fuqua School of Business.
Policy Brief. Advancing Global Public Health Surveillance and Emergency Preparedness: A Policy Dialogue Imagining Evidence-Based Prevention. Coralei Neighbors, Beth Boyer, Brian Canter, Molly Shields, David McAdams, Ipchita Bharali, Gavin Yamey
The project “Reimagining multilateralism: ending the tragedy of the global health commons” was funded by a grant from the Andrew Carnegie Foundation.