 The COVID-19 pandemic brought to light many deficiencies in health systems across the world. Even as it continues, discussions are on for a pandemic treaty that would address some of the pressing concerns that face the health systems of the world, specifically on the issues of pandemic prevention, preparedness and response or PPR. However, it's impossible to address these issues without talking about financing and the current models that are deeply skewed against developing and poor countries. It is in this context that Geneva Global Health Hub G2H2, a platform of over 40 civil society organizations, released a report titled Financial Justice for Pandemic Prevention, Preparedness and Response. Nicoleta Dentico, G2H2 co-chair and report co-author, talks about some of these issues. Well, the report is basically stemming from the Geneva Global Health Hub's recognition that COVID-19 has brought a new set of categories, a new set of approaches, a new set of ideas and notions that we need to really take into consideration when we talk about global health. And of course, the whole concept itself of global health needs to be profoundly questioned as it has been interpreted by the mainstream actors of global health. They have made it become a sort of a doctrine divided by diseases. So the idea is also to start reshaping this notion into perhaps global health justice or global public health. So it's in this kind of collective thinking that the idea to look at financing for health in the context of the pandemic treaty negotiation seemed extremely relevant because whatever the outcome of these negotiations on going at the WHO beat the pandemic treaty itself or the review of the international health regulations, financing will be a pillar, will be an indispensable element of whatever scenario the WHO and the international community are going to build. And we also wanted to challenge this notion of building back better because the idea is that we needed to build forward better. The back was the problem. And therefore the idea of looking at finance for health for us is a kind of an indicator of the honesty and the truthfulness of the international community on the one hand and the sense of direction that they want to take, meaning do governments or the international community or the WHO itself use this rhetoric basically to have a new stage, a new phase of the business as usual. This was the kind of initial inspirational light that gave us this idea that we needed to bring at this point a disconjuncture. Those unspoken topics that have been a kind of a taboo even when talking about financing because talking about financing at the WHO has been mostly talking about innovative financing mechanisms, always looking at the expenditure side of health budgets and hardly at the revenue side of health budgets. So this is what we actually have decided to challenge a bit, looking at the financial violence that exists in the world and the initial signs that we see with this pandemic fund venued at the World Bank that doesn't seem to be promising at all to us, both because it is venued at the World Bank that actually has a policy since 2013 of leveraging the private sector and also because this pandemic fund, it's a kind of an iteration of an old model that was specifically focused on specific diseases like the global fund for AIDS, TB and malaria but which will never really serve for pandemic prevention, preparedness and response and that is the first critique that this report highlights. A key focus area of this report has been the impact of austerity policies and commercialization. Throughout the pandemic, health workers went on strike across the world protesting the destruction of systems that would have helped them combat COVID-19 better. Due to pressure from bodies such as the IMF and the World Bank countries over the past few decades have considerably cut spending on public health and associated fields. A lot of the sector has been privatized. Why are these trends dangerous for the health sector? The problem of austerity and all that austerity brings which is privatization, it is commercialization, marketization of health is in itself one of those structural pathologies that has actually done so much harm to health rights and that have actually killed so many people, so many million people in the world and also, you know, basically broken life's desires, life's aspirations life's projects for many communities in the world. The report gives a bit of a political economy of this because, you know, our feeling is that many decision makers but also civil society actors act in a kind of constant presence. They don't have any sense of perspective, neither for where we come from and why we are here today. And therefore they have also a very restricted, very limited projection for a different future. So what we see and we are very concerned as G2H2 is the development also of a civil society working on global health that now claims that they want to be at the sit at the table in negotiating a treaty as if a treaty making where a kind of a new PPP, new public and private partnerships where civil society has to be there and who are really, you know, working within the given context and they try to only exclusively do damage control of the poor solutions that the international financial institutions or the G20 are providing to consider finance. No one is ever talking about the fact that austerity measures are not only a terrible legacy of the last 40 years. They of course started with the developing world in the late 70s and the 80s primarily. But then there was a kind of a third worldization of the whole globe for a lack of a better word to actually mention it that came over with the great financial crisis of 2007-2008 where also the northern countries started to learn the harsh lesson of austerity measures, which is a real reduction, a very serious extreme reduction of public spending and very net cuts of all the social expenditures that are those that actually make a society and that allow a society to live but which also allow a kind of a healthy relationship between governments and its own people. So these measures which have developed themselves in so many venues, not only with financial cuts but also then with the emergence, the mushrooming of so many modalities of a booming healthcare industry that has taken over in most countries to compensate for gaps in health and of course the democratization of health which is enhancing seriously health inequalities in this world. And as I said, this is of course a phenomenon that has different ways of expressing itself and different modalities of manifesting itself but it is a global phenomenon. It happens everywhere. Inequalities in health are occurring everywhere. This is something that is happening and it's a recipe that it has been administered during COVID and as the IMF projections and Isabel Ortiz who was one of the respondents at the launch of our report that told us very clearly, this is something that by 2023 is going to hit 148 countries which is about 6.7 billion people cutting on health and reducing the possibility for health rights to be met, to be satisfied. This is not a destiny. This is a situation that can be avoided and it must be avoided. So the report has quite a number of pages dedicated precisely to this terrible pathology of austerity measures, conditionalities, cuts, privatizations, policies and for example the public and private partnerships which the IMF and the World Bank occasionally recognize they don't work. They have said in several occasions that these policies have actually done harm to health but like men who beat up their women and occasionally they admit they have had a faulty behavior then they continue beating up their women and IMF is continuously then in a way suggesting that these policies are to be implemented the World Bank does exactly the same even if they claim that they want to abandon them. So this is something that we are experiencing now and this is really a pandemic that we need to prevent and to respond to very clearly. A deep structural question is one of debt and illicit financial flows. If the debt of the 76 most indebted countries had been waived in 2020, US dollars 40 billion would have been available for pandemic response. How have these factors affected the response to the pandemic and the health sector at large? This report has also another inner objective which is to have different communities of commitment, of engagement, talk to each other. We belong to the global health community and we have dealt with the finance certainly the PHM has done this in previous reports and activities but we definitely needed to link up much more to the financial crowd to the financial community constituency with those civil society entities that are working on the various manifestations of this functional financial architecture and to unite forces and unite voices in the cause that they are making for curbing illicit financial flows, canceling the debt, transforming reforming taxation system and bring financial justice. The report also had this idea of using health as a very important lens, as a crucial lens to give additional evidence of the wrongdoing of these policies and the urgent need to reform actually to transform, I would rather say the financial architecture as we have it today. So yes, debt of poor countries, of low income countries, middle and low income countries but also debt of countries in the north. The report when talking about debt cancellation brings a quote from a recent research of the London School of Economics which actually suggests debt cancellation also in the UK for solving a dire problem of the fact that one out of four households cannot have enough money for their essential expenditures by the end of the month. So there is an increasing poverty that needs to be tackled in the UK and debt cancellation could be the radical idea for re-establishing a new circulation of money and a new liberation of potential financial resources that are now kind of kept in the hands of the few because we need to remember that the world is awash in money. The narrative about the scarcity of funding is really a fake news and debt cancellation is for us a way to also redefine a narrative when it comes to financial justice but also an overall issue that should redesign the relationship between the north and the south. Of course, there was already a thriving debt crisis before COVID arrived. This is what the World Bank and the IMF are saying. The World Bank released a report in January 2020 already sending the alarm about a global debt crisis. This has become only worse after COVID-19 in which the pathogen arrived at a rather difficult time for indebted countries. The last annual meetings of the World Bank actually outlined the peril of this bomb exploding any time. So we needed to look at the debt issue and we needed to look at the new ways to address debt but it's not just procrastinating or postponing the payment of debt service which is more or less what the G20 proposed but it is really a major restructuring and now we are proposing that countries from the south should stop paying this debt because if we look at things really it is the north having a major substantive ecological debt towards the countries of the south. The global south is paying the highest price for the climate change and the global warming but it is actually as the Lancet planetary health disclosed in a very recent article the US and Europe that account for more than 50% of all the gas emissions and the devastation that has been produced and that we are confronted with today. Another report that came out in 2022 it is in fact the north that has to pay a colossal reparation to the south. So whose debt are we talking about? And we needed to tackle this issue even when we are discussing about health because health is the first victim of debt services and debt payment. If the 76 most indebted countries had been able to be exempted from debt payment in 2020 this cancellation of their debt in just one year would have liberated 40 billion dollars. It would have been 300 billion dollars if the debt cancellation had included also 2021, sorry when countries in the global south just as much as in the global north were still in the mid of the COVID crisis except that the north had the vaccines the south didn't. So these are some of the issues that we need to bring on the table when negotiating a pandemic treaty. It's not that because the WHO cannot deal with the financial architecture that we cannot bring these issues also in a negotiation about the future of the pandemic prevention preparedness and response.