Ahead of the crisis: Building a more strategic approach to prevent, detect, and be ready for the next pandemic. An independent evaluation

This evaluation reviews more than USD 20 billion in World Bank Group support for epidemic preparedness between 1991 and 2024, examining how investments have strengthened countries’ capacities to prevent, detect, and respond to infectious disease threats before they become large-scale outbreaks. The report assesses financing, advisory services, and technical assistance across 145 countries. It highlights progress in workforce development, laboratory systems, disease surveillance, emergency health services, and regional preparedness initiatives. The evaluation also identifies persistent challenges, including limited integration of human, animal, and environmental health through a comprehensive One Health approach, uneven cross-sector collaboration, gaps in antimicrobial resistance and zoonotic disease prevention, and weaknesses in preparedness measurement systems.

 

The evaluation focuses on major epidemic threats—zoonotic, vector-borne, foodborne, and waterborne diseases, and antimicrobial resistance—and applies a framework aligned with Bank Group strategies and global initiatives. Using mixed methods and a systems approach, it identifies effective approaches and provides actionable insights to inform ongoing efforts (including scaling support through the Health Emergency Prevention, Preparedness, and Response Global Challenge Program) and strengthen how preparedness is designed and delivered across sectors and industries. Drawing on extensive portfolio analysis, case studies, and country evidence, the report offers actionable recommendations to improve strategic targeting, strengthen public-private collaboration, expand preparedness financing mechanisms, and enhance long-term outcomes. The findings provide important lessons for governments, development partners, and international financial institutions seeking to build stronger and more resilient preparedness systems.