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© 2022 International Monetary Fund

WP/22/99

IMF Working Paper

Research Department

Financing vaccine equity: Funding for day-zero of the next pandemic

Prepared by Ruchir Agarwal and Tristan Reed*

Authorized for distribution by Pierre-Olivier Gourinchas

May 2022

IMF Working Papers describe research in progress by the author(s) and are published to elicit comments and to encourage debate. The views expressed in this Working Paper are those of the author(s) and do not necessarily represent the views of the IMF, The World Bank, their Executive Boards, their management, or any other entity mentioned herein. This paper is also published in The World Bank’s Working Paper Series.

ABSTRACT: A lack of timely financing for purchases of vaccines and other health products impeded the global response to the COVID-19 pandemic. Based on analysis of contract signature and delivery dates in COVID-19 vaccine advance purchase agreements, this paper finds that 60–75 percent of the delay in vaccine deliveries to low- and middle-income countries is attributable to their signing purchase agreements later than high-income countries, which placed them further behind in the delivery line. A pandemic Advance Commitment Facility with access to a credit line on day-zero of the next pandemic could allow low- and middle-income countries to secure orders earlier, ensuring a much faster and equitable global response than during COVD-19. The paper outlines four options for a financier to absorb some or all of the risk associated with the credit line and discusses how the credit would complement other proposals to strengthen the financing architecture for pandemic preparedness, prevention, and response.

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Title Page

WORKING PAPERS

Financing Vaccine Equity: Funding for day-zero of the next pandemic

Prepared by Ruchir Agarwal and Tristan Reeda

Contents

  • I. Introduction

  • Related Literature & Policy context

  • II. The benefit of day-zero financing for vaccine purchases in pandemics

  • III. Design of a pandemic Advance Commitment Facility with a day-zero credit line

  • IV. Conclusions

  • V. References

  • TABLES

  • 1. When low- and middle-income countries entered bilateral contracts for vaccines, they did so later than high-income countries

  • 2. Regressions of delivery data on purchase contract date and fixed effects

  • 3. Indicative features of a pandemic Advance Commitment Facility with contingent financing for rapid pandemic response in low- and middle-income countries

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A version of this paper has been accepted for publication by the Oxford Review of Economic Policy. Agarwal is an economist at the IMF and Reed is an economist at the World Bank’s Development Research Group. We thank Kathleen Beegle, Michael S. Bennett, Chad Bown, Nick Caroll, Mukesh Chawla, Deon Filmer, Shakill Hassan, Aart Kraay, Samuel Maimbo, Barbara McGowan, Traci Phillips, Karen Pillay, Shirmila T Ramasamy, Dirk Reinermann, Lakshmi Shyam-Sunder, Daniel Susskind, Darius Stangu, Daria Taglioni, Patricia Wycoco, the editors, and an anonymous referee for useful comments. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the IMF and World Bank or their affiliated organizations, or those of the Executive Directors of the IMF and the World Bank, their Managements, or the governments they represent.

Finance Vaccine Equity: Funding for Day-Zero of the Next Pandemic
Author: Ruchir Agarwal and Tristan Reed