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International Monetary Fund. Communications Department

seven times more deaths than the 20,000 that its government chief scientific adviser suggested in March 2020 would be a “good outcome.” The Global Health Security rankings, based on more than one hundred questions about dozens of indicators and sub-indicators, were no match for the novel coronavirus. Similarly, based on a 2018 self-assessment of implementation of its International Health Regulations (IHR), the World Health Organization (WHO) deemed 86 percent of countries in Europe to be at the highest levels of pandemic preparedness, making the region the most

International Monetary Fund. Communications Department

surveillance and alert systems; and rapid surge funding for (early) response activities. While there should be more domestic funding, it will not be sufficient for the needs of low- and many lower-middle-income countries, at least not in the foreseeable future. It must be bolstered by favorable financing options, supported by strong partnerships and investments in pandemic preparedness and response, and backstopped by a fund that can pay for surge expenses as needed. Regional institutions have an important role to play that goes beyond backstopping countries. Both the

Ruchir Agarwal, Ms. Gita Gopinath, Jeremy Farrar, Richard Hatchett, and Peter Sands

future threats. The conversation on the immediate global response to COVID-19 has become somewhat detached from the need to scale up pandemic preparedness and response capabilities more generally and from the broader global health agenda. Further mutation of the SARS-CoV-2 virus remains a key risk for the world, with coronaviruses (both SARS-CoV-2 and other emerging and reemerging sarbecoviruses) now retaining pandemic potential going forward. An unknown number of animal coronaviruses, of unknown transmissibility and lethality, could emerge in the foreseeable future