Middle-income countries faced significant hurdles in accessing vital medical countermeasures during the COVID-19 pandemic. To prevent a recurrence, policymakers must push multilateral development banks for immediate, at-risk financing when the next outbreak inevitably arrives. This proactive approach is crucial for global health security.
Six years after the initial outbreak of COVID-19, the world risks forgetting critical lessons learned and repeating past mistakes. The threat of another pandemic has not diminished; studies suggest an annual probability of a COVID-level event is between 2-3%. Experts estimate that future pandemics could cost the global economy more than $700 billion, on average, every single year.
These staggering figures underscore the urgent need for robust financial mechanisms, especially for middle-income countries that often fall between traditional aid categories and full market access. Their ability to respond swiftly to health crises is paramount not only for their own populations but for preventing widespread global transmission.
The imperative for proactive funding
During the COVID-19 crisis, many middle-income nations struggled to invest adequately in vaccines, therapeutics, and other essential medical countermeasures. This delay exacerbated health and economic impacts, highlighting a critical gap in global preparedness. According to a commentary published on Project Syndicate in January 2026 by Masyita Crystallin and Rachel Glennerster, this failure must not be repeated.
They argue that the existing financing structures are often too slow and restrictive, failing to deliver funds at the speed and scale required during a rapidly evolving health emergency. The delay in accessing resources meant that by the time financing was secured, the window for effective early intervention had often closed, leading to higher costs and greater loss of life.
Reforming multilateral development bank commitments
The solution lies in compelling multilateral development banks (MDBs) to commit to at-risk financing. This means making funds available immediately upon the declaration of a pandemic, without the typical lengthy approval processes. Such a commitment would allow middle-income countries to procure necessary supplies and implement public health measures without delay.
Policymakers from these nations must demand that MDBs integrate this pre-approved, rapid-disbursing mechanism into their operational frameworks. This shift would transform MDBs from reactive lenders to proactive partners in global health security, leveraging their financial power to mitigate future crises before they escalate. It’s a strategic investment in global stability.
Ensuring adequate pandemic financing for middle-income countries is not merely an act of charity; it is a fundamental component of global economic and health resilience. By establishing pre-arranged, flexible financing through multilateral development banks, the international community can build a more robust defense against future pandemics, safeguarding lives and livelihoods worldwide.
