Should global financing be the main priority for pandemic preparedness? – Authors' reply

We agree with Carel IJsselmuiden and colleagues that research and development (R&D) systems of low-income and middle-income countries (LMICs) need to be strengthened for pandemic preparedness and response to succeed. Solving the financing challenge is central to closing what we called “the R&D equity gap”.¹ This task includes establishing research hubs on each continent committed “to equity of opportunity” for scientists in LMICs who must be central to all aspects of the R&D ecosystem.¹ A global financing system is essential to support the broad components of the R&D ecosystem of the future. Distributed modern manufacturing capacity, including in LMICs, and procurement and distribution of the products of R&D are integral to this. Eliminating the “immoral inequity” of vaccine access that IJsselmuiden and colleagues refer to depends on sufficient manufacturing capacity to address the needs of all countries simultaneously. We are heartened by the call of the Africa Centres for Disease Control and Prevention to establish more vaccine manufacturing capacity on the African continent.² LMICs also need to invest their own resources; indeed, in the Money & Microbes report,³ the World Bank's International Vaccines Task Force notes the importance of national investments to “motivate young investigators to pursue clinical research careers, and…to choose to use those skills in-country”. Providing the quality education and infrastructure cutting-edge scientists require will make it easier to retain talented young scientists and attract nationals who wish to return home after their education and training abroad. While the world cannot wait for these goals to be achieved to improve the R&D preparedness and response ecosystem, we can ensure that national and international investments and a solid financing system will leave us better positioned to achieve both equity of opportunity and equity of outcomes. We must use this time during the COVID-19 crisis to make solid progress towards that end.

GTK is a member of the Lancet Task Force on the Origins and Early Spread of COVID-19 & One Health Solutions to Future Pandemic Threats. NL and VJD declare no competing interests.