One Health, Many Risks: World Bank’s Mission to Strengthen Global Health Defenses

The “Preparedness for Epidemics and Pandemics” evaluation by the World Bank Group (WBG), released in June 2025, provides a sobering assessment of the mounting global risks posed by infectious diseases and the institution’s role in helping countries prepare. Drawing on work by key international institutions including the Global Preparedness Monitoring Board (GPMB), World Health Organization (WHO), Food and Agriculture Organization (FAO), United Nations Environment Programme (UNEP), and the University of Notre Dame, the report underscores how interconnected human, animal, and environmental health systems are increasingly vulnerable. Since 2000, the number of global disease outbreaks has grown dramatically, and the likelihood of another pandemic on par with or worse than COVID-19 in the next 25 years is estimated at nearly 70 percent. The report reminds us that while COVID-19 cost the world over $13 trillion, the price of investing in prevention and preparedness is less than one percent of such damage. This economic logic underpins the call for stronger development financing and institutional reform. Fragile countries with weak health surveillance and infrastructure are most at risk, not only of health impacts but also economic and social breakdown.

World Bank’s Strategic Shift: From Reaction to Readiness

In response to these escalating risks, the World Bank Group has transitioned from a reactive model to a proactive, systems-strengthening approach. The launch of the Health Emergency Prevention, Preparedness, and Response (HEPPR) Global Challenge Program in May 2024 marks a strategic pivot. This initiative seeks to break the chronic “panic and neglect” cycle observed after past pandemics by embedding long-term readiness into country development programs. It prioritizes three pillars: strengthening One Health and public health capacities, improving emergency healthcare delivery systems, and ensuring equitable access to medical countermeasures such as vaccines and diagnostics. The program has encouraged multilateral collaboration among institutions such as the IFC, the International Development Association (IDA), and various global trust funds. Instruments such as the Pandemic Fund, the Global Environment Facility, and regional partnerships with African disease surveillance bodies also feature prominently. IFC, for example, supports the private sector's role in diagnostics, vaccine production, and health service delivery, a critical component, especially in developing nations where private entities often account for up to 80 percent of healthcare services.

One Health: The Cornerstone of a New Approach

Central to the World Bank’s pandemic strategy is the One Health framework, which acknowledges the interconnectedness of human, animal, and environmental health. Originally gaining prominence during the SARS epidemic in the early 2000s, this integrated model has now been formally institutionalized in the Bank’s operations. The 2018 One Health Operational Framework and the 2022 Joint Action Plan laid the groundwork for more coordinated approaches to zoonotic diseases, antimicrobial resistance, and ecological spillover risks. The evaluation describes how infectious diseases can spread via contaminated water systems, food supply chains, wildlife, and human migration, and it argues that environmental degradation, such as deforestation, habitat loss, and agricultural intensification, is a major catalyst. Despite this conceptual clarity, the report concedes that One Health implementation within Bank-supported projects remains limited. Most interventions still operate in siloed sectors, health, agriculture, and environment, with few demonstrating integrated design or execution. The document calls for more multisectoral lending and planning to unlock the full value of the One Health paradigm.

Measuring Impact and Overcoming Operational Bottlenecks

To determine whether its investments are translating into real progress, the evaluation uses a robust conceptual framework that assesses three areas of intervention: capacity-building (e.g., surveillance, workforce development, biosafety), emergency health services (e.g., mobile clinics, diagnostics, infection control), and countermeasure logistics (e.g., manufacturing, storage, and distribution of medicines and vaccines). The study spans over two decades of World Bank and IFC operations, using tools like portfolio reviews, alignment analysis, case studies, and outcome harvesting. A major conclusion is that although some countries have benefited from sustained, targeted support, implementation remains uneven. Challenges identified include limited flexibility in financing during crises, weak data and results monitoring systems, and inconsistent multisectoral coordination at the ground level. The World Bank’s Crisis Preparedness and Response Toolkit, introduced in 2024, was a step forward, but questions remain about its real-time effectiveness. Lessons from previous IEG evaluations, including during the Ebola, avian influenza, and COVID-19 responses, stress the importance of investing in local workforce scale-up, strengthening laboratory systems, and ensuring trusted community engagement, especially during crises where misinformation spreads rapidly.

Looking Forward: Toward a Sustainable Preparedness Architecture

Ultimately, this evaluation is not just a backward-looking audit but a forward-thinking blueprint. It makes clear that preparedness is not a luxury; it is a necessity with long-term payoffs in resilience, economic security, and lives saved. By covering 20 years of operations and including both active and closed projects, the report provides valuable insights for scaling the Bank Group’s efforts through the HEPPR program and beyond. The use of mixed-method evaluations, engagement with local and regional stakeholders, and consultation with experts from institutions like the Pandemic Sciences Institute at Oxford and the World Organisation for Animal Health lends rigor to its findings. The evaluation also encourages stronger partnerships with the private sector and more strategic use of data and innovation. As the world braces for future health emergencies, this report is a reminder that investment in preparedness is not just about the next outbreak; it’s about rethinking the foundations of health systems globally. If its recommendations are heeded, the World Bank could play a transformative role in ensuring that the next pandemic does not catch the world so catastrophically off guard.