A Letter to G20 Governments

In 2008-2010, the Great Recession could be surmounted when the economic fault line – under-

capitalization of the global banking system – was tackled. Now, however, the economic

emergency will not be resolved until the health emergency is effectively addressed, and that

requires coordinated global leadership – now.

LONDON – We are writing to call for immediate internationally coordinated action –

within the next few days – to address our deepening global health and economic crises caused by


The communique from the G20 Extraordinary Leaders’ Summit on March 26, 2020, recognized

the gravity and urgency of the entwined public health and economic crises, but we now require

urgent specific measures that can be agreed on with speed and at scale: emergency support for

global health initiatives led by the World Health Organization (WHO) and emergency measures

to restore the global economy. Both require world leaders to commit to funding far beyond the

current capacity of our existing international institutions.

In 2008-2010, the immediate economic crisis could be surmounted when the economic fault line

– under-capitalization of the global banking system – was tackled. Now, however, the economic

emergency will not be resolved until the health emergency is effectively addressed: the health

emergency will not end simply by conquering the disease in one country alone, but by ensuring

recovery from COVID-19 in all countries.

Global Health Measures

All health systems – even the most sophisticated and best funded – are buckling under the

pressures of the virus. Yet if we do nothing as the disease spreads in poorer African, Asian, and

Latin American cities and in fragile communities which have little testing equipment, ventilators,

and medical supplies, and where social distancing and even washing hands are difficult to

achieve, COVID-19 will persist there and re-emerge to hit the rest of the world with further

rounds that will prolong the crisis.

World leaders must immediately agree to commit $8 billion – as set out by the Global

Preparedness Monitoring Board – to fill the most urgent gaps in the COVID-19 response.

This includes:

$1 billion this year urgently needed by the WHO: This would enable the WHO to

carry out its critically important mandate in full. While it has launched a public appeal –

200,000 individuals and organizations have generously donated more than $100 million –

it cannot be expected to depend on charitable donations.•

$3 billion for vaccines: The Coalition for Epidemic Preparedness Innovations (CEPI) is

coordinating the global research effort to develop and scale up effective COVID-19

vaccines. In addition, Gavi, the Vaccine Alliance will have an important role procuring

and equitably distributing vaccines to the poorest countries and requires $7.4 billion for

its replenishment: this should be fully funded.

$2.25 billion for therapeutics: The COVID-19 Therapeutics Accelerator aims to deliver

100 million treatments by the end of 2020 and is seeking these funds to rapidly develop

and scale-up access to therapeutics.

Instead of each country, or state or province within it, competing for a share of the

existing capacity, with the risk of rapidly increasing prices, we should also be vastly

increasing capacity by supporting the WHO in coordinating the global production and

procurement of medical supplies, such as testing kits, personal protection equipment, and

ITU technology to meet fully the worldwide demand. We will also need to stockpile and

distribute essential equipment.

A wider group of central banks should be given access to the arrangements for currency

swaps and the International Monetary Fund (IMF) should enter into swap arrangements

with the major central banks. The IMF should use those hard-currency resources and

establish its own swap line facility to provide emergency financial support to emerging

and developing nations. But it is vital that if we are to prevent mass redundancies, the

guarantees that are being given in each country are rapidly followed through by banks via

on-the-ground support for companies and individuals.

The emerging economies – and in particular those of the poorest countries – need special

help, not the least in ensuring that support reaches all those affected by the drastic

decrease in economic activity. The IMF has said it will mobilize all of its available

resources. There should be an additional allocation of around $500-$600 billion in

Special Drawing Rights (SDRs). At the same time, to ensure sufficient funding for

individual countries, we encourage IMF members to allow lending quota limits to be

exceeded in countries most in need.

A further $35 billion will be required, as highlighted by the WHO, to support countries with

weaker health systems and especially vulnerable populations, including the provision of vital

medical supplies, surge support to the national health workforce (70% of whom in many

countries are underpaid women), and strengthening national resilience and preparedness.

According to the WHO, almost 30% of countries have no national COVID-19 preparedness

response plans; only half have a national infection prevention and control program. Health

systems in lower-income countries will struggle to cope; even the most optimistic estimates

from Imperial College London suggest there will be 900,000 deaths in Asia and 300,000 in


We propose the convening of a global pledging conference – its task supported by a G20

Executive Task Force–to commit resources to meeting these emergency global health needs.

Global Economic Measures

Much has been done by national governments to counter the downward slide of their economies.

But a global economic problem requires a global economic response. Our aim should be to

prevent a liquidity crisis turning into a solvency crisis, and a global recession becoming a

global depression. To ensure this, better coordinated fiscal, monetary, central bank, and anti-

protectionist initiatives are needed. The ambitious fiscal stimuli of some countries will be all the

more effective if more strongly complemented by all countries in a position to do so.

The World Bank and many of the regional development banks have recently been

recapitalized, but more will be needed. It is likely that – as in 2009, when the

International Bank for Reconstruction and Development’s (IBRD) spending alone went

from $16 billion to $46 billion – it (and the regional development banks) will need a

much larger expansion of available resources.

To meet its responsibilities for humanitarian aid, and for refugees and displaced people,

whose plight is likely to become desperate, and for the UN Sustainable Development

Goals, UN agencies have issued this week an immediate call for $2 billion of additional

resources that are urgently needed.

The international community should waive this year’s poorer countries’ debt repayments,

including $44 billion due from Africa, and consider future debt relief to allow poor

countries the fiscal space to tackle the health and economic impact of the COVID-19

pandemic. We ask the G20 to task the IMF and the World Bank to further assess the debt

sustainability of affected countries.

We agree with African and developing country leaders that given the existential threat to

their economies, the increasing disruption to livelihoods and education and their limited

capacity to cushion people and companies, that at least $150 billion of overall support

will be needed for health, social safety nets, and other urgent help.

These allocations should be agreed to immediately, coordinated by a G20 Executive Task

Force as part of the G20 Action Plan, and be confirmed in full at the upcoming IMF and

World Bank meetings. The two core economic institutions should be given reassurances

that additional bilateral funding will be forthcoming and the need for further capital

injections agreed.

The longer-term solution is a radical rethink of global public health and a refashioning – together

with proper resourcing – of the global health and financial architecture.

The United Nations, the governments of the G20 nations, and interested partners should work

together to coordinate further action.


Bertie Ahern – Taoiseach of the Republic of Ireland (1997-2008); Montek Singh Ahluwalia –

Deputy Chairman of the Planning Commission of India (2004-2014); Masood Ahmed –

President of the Center for Global Development; Nana Akufo-Addo – President of Ghana (since

2017); Edmond Alphandéry – Minister of the Economy, Finances and Industry of France (1993-

1995), Founder & Chairman of the Euro 50 Group; Abdulaziz Altwaijri – Director General of

the Islamic Educational, Scientific and Cultural Organization (1991-2019)3; Giuliano Amato –

Prime Minister of Italy (1992-1993, 2000-2001); Mohamed Amersi – Founder & Chairman, The

Amersi Foundation; Louise Arbour – UN Special Representative for International Migration,

UN High Commissioner for Human Rights (2004-2008); Óscar Aria – President of Costa Rica

(2006-2010)¹; Shaukat Aziz – Prime Minister of Pakistan (2004-2007)²; Gordon Bajnai – Prime

Minister of Hungary (2009-2010); Jan Peter Balkenende – Prime Minister of the Netherlands

(2002-2010)¹; Joyce Banda – President of Malawi (2012-2014)¹; Ehud Barak – Prime Minister

of Israel (1999-2001)³; Nicolás Ardito Barletta – President of Panama (1984-1985); José

Manuel Barroso – Prime Minister of Portugal (2002-2004, President of the European

Commission (2004-2014), Non-Executive Chairman of Goldman Sachs International¹; Kaushik

Basu – President of the International Economic Association, Chief Economist of the World Bank

(2012-2016); Deus Bazira – Co-Director of the Center for Global Health Practice and Impact &

Associate Professor of Medicine, Georgetown University Medical Center; Marek Belka – Prime

Minister of Poland (2004-2005), Deputy Prime Minister & Minister of Finance (2001-2002),

Director of European Department, IMF (2008-2010); Nicolas Berggruen – Chairman of the

Berggruen Institute²; Professor Erik Berglöf – Director of the Institute of Global Affairs,

London School of Economics, Chief Economist of the EBRD (2006-2014); Sali Berisha –

President of Albania (1992-1997), Prime Minister (2005-2013)³; Sir Tim Besley – President of

the International Economic Association (2014-2017), Professor of Economics and Political

Science, LSE; Carl Bildt – Prime Minister of Sweden (1991-1994), Minister for Foreign Affairs

(2006-2014)¹; Valdis Birkavs – Prime Minister of Latvia (1993-1994)¹; Tony Blair – Prime

Minister of the United Kingdom (1997-2007); James Brendan Bolger – Prime Minister of New

Zealand (1990-1997); Kjell Magne Bondevik – Prime Minister of Norway (1997-2000, 2001-

2005)¹; Patrick Bolton – Professor of Finance and Economics, Imperial College London,

Professor, Columbia University; Lakhdar Brahimi – Minister of Foreign Affairs of Algeria

(1991-1993), UN & Arab League Envoy to Syria (2012-2014), Member of The Elders; Gordon

Brown – Prime Minister of the United Kingdom (2007-2010); Gro Harlem Brundtland – Prime

Minister of Norway (1990-1996), Director General of the WHO (1998-2003), Member of The

Elders¹; John Bruton – Taoiseach of the Republic of Ireland (1994-1997)¹; Felipe Calderón –

President of Mexico (2006-2012)¹; Rafael Ángel Calderón – President of Costa Rica (1990-

1994); Mauricio Cárdenas – Minister of Finance of Colombia (2012-2018), Visiting Professor,

Columbia University; Fernando Henrique Cardoso – President of Brazil (1995-2002)¹; Hikmet

Çetin – Minister of Foreign Affairs of Turkey (1991-1994)³; Laura Chinchilla – President of

Costa Rica (2010-2014)¹; Joaquim Chissano – President of Mozambique (1986-2005)¹; Alfredo

Cristiani – President of El Salvador (1989-1994); Helen Clark – Prime Minister of New

Zealand (1999-2008), UNDP Administrator (2009-2017)¹; Emil Constantinescu – President of

Romania (1996-2000)³; Ertharin Cousin – Executive Director of the World Food Programme

(2012-2017); Herman De Croo – President of the Chamber of Representatives of Belgium

(1999-2007)³; Mirko Cvetković – Prime Minister of Serbia (2008-2012)³; Gavyn Davies – Co-

Founder & Chairman, Fulcrum Asset Management, Chief Economist & Chairman of Global

Investment Dept, Goldman Sachs (1988-2001), Chairman, BBC (2001-2004); Božidar Đelić –

Deputy Prime Minister of Serbia (2007-2011); Kemal Derviş – Minister of Economic Affairs of

Turkey (2001-2002), Administrator of UNDP (2005-2009), Senior Fellow Global Economy and

Development, Brookings Institution; Ruth Dreifuss – President of the Swiss Confederation

(1999), Member of the Swiss Federal Council (1993-2002); Mark Dybul – Executive Director of

The Global Fund to Fight AIDS, Tuberculosis and Malaria (2012-2017), Co-Director of the

Center for Global Health Practice and Impact & Professor of Medicine, Georgetown University

Medical Center; Victor J. Dzau – President of the National Academy of Medicine; Mikuláš

Dzurinda – Prime Minister of Slovakia (1998-2006), Minister of Foreign Affairs (2010-

2012); Gareth Evans – Foreign Minister of Australia (1988-1996), President and CEO ofInternational Crisis Group (2000-2009); Jeremy Farrar – Director of the Wellcome Trust; Jan

Fischer – Prime Minister of the Czech Republic (2009-2010), Finance Minister (2013-

2014)³; Joschka Fischer – Minister of Foreign Affairs and Vice Chancellor of Germany (1998-

2005); Franco Frattini – Minister of Foreign Affairs of Italy (2002-2004, 2008-2011), European

Commissioner (2004-2008)³; Chiril Gaburici – Prime Minister of Moldova (2015), Minister of

Economy and Infrastructure (2018-2019)³; Ahmed Galal – Finance Minister of Egypt (2013-

2014); Nathalie de Gaulle – Chairwoman & Co-founder of NB-INOV, Founder of Under

40³; César Gaviria – President of Colombia (1990-1994), Secretary-General of the Organization

of American States (1994-2004)¹; Ian Goldin – Professor, Oxford University; Felipe Gonzalez –

Prime Minister of Spain (1982-1996)²; Hamish Graham – Consultant Pediatrician & Research

Fellow at the Royal Children’s Hospital and Centre for International Child Health, University of

Melbourne; Bryan Grenfell – Kathryn Briger and Sarah Fenton Professor of Ecology and

Public Affairs, Princeton University; Ameenah Gurib-Fakim – President of Mauritius (2015-

2018)³; Sergei Guriev – Chief Economist of the EBRD (2016-2019), Professor of Economics,

Sciences Po; Alfred Gusenbauer – Chancellor of Austria (2000-2008)¹; Lucio Gutiérrez –

President of Ecuador (2003-2005); Tarja Halonen – President of Finland (2000-

2012)¹; Ricardo Hausmann – Minister of Planning of Venezuela (1992-1993), Professor at the

Kennedy School of Government, Harvard; Toomas Hendrik Ilves – President of Estonia (2006-

2016); Edward C. Holmes – ARC Australian Laureate Fellow, Professor, University of

Sydney; Bengt Holmström – Nobel Laureate for Economic Sciences (2016); Professor of

Economics, MIT – Osvaldo Hurtado – President of Ecuador (1981-1984)¹; Mo Ibrahim –

Founder of Celtel; Chairman of the Mo Ibrahim Foundation²; Ekmeleddin İhsanoğlu –

Secretary General of the Organization of Islamic Cooperation (2004-2014)³; Dalia Itzik –

Interim President of Israel (2007), President of the Knesset (2006-2009)³; Mladen Ivanić –

Member of the Presidency of Bosnia and Herzegovina (2014-2018)³; Gjorge Ivanov – President

of North Macedonia (2009-2019)³; Hina Jilani – Advocate of the Supreme Court of Pakistan,

Member of The Elders; Mehdi Jomaa – Prime Minister of Tunisia (2014-2015)¹; Ivo Josipović –

President of Croatia (2010-2015)³; Mats Karlsson – Vice President, External Affairs at the

World Bank (1999-2011)³; Caroline Kende-Robb – Executive Director of the Africa Progress

Panel (2011-2017), Secretary General of CARE International (2018-2020); Kerry Kennedy –

President of Robert F. Kennedy Human Rights; John Key – Prime Minister of New Zealand

(2008-2016); Jakaya Kikwete – President of Tanzania (2005-2015); Ban Ki-Moon – UN

Secretary General (2007-2016), Deputy Chair of The Elders¹; Frederik Willem de Klerk – State

President of South Africa (1989-1994); Horst Köhler – President of Germany (2004-

2010)¹; Jadranka Kosor – Prime Minister of Croatia (2009-2011)³; John Kufuor – President of

Ghana (2001-2009); Chandrika Kumaratunga – President of Sri Lanka (1994-2005)¹; Luis

Alberto Lacalle Herrera – President of Uruguay (1990-1995)¹; Ricardo Lagos – President of

Chile (2000-2006), Member of the Elders¹²; Zlatko Lagumdzija – Foreign Affairs Minister of

Bosnia and Herzegovina (2012-2015)13; Pascal Lamy – Director-General of the World Trade

Organization (2005-2013)²; Hong-Koo Lee – Prime Minister of South Korea (1994-

1995)¹; Mark Leonard – Co-founder & Director of the European Council on Foreign

Relations; Yves Leterme – Prime Minister of Belgium (2009-2011)¹; Enrico Letta – Prime

Minister of Italy (2013-2014); Justin Yifu Lin – Chief Economist & Senior Vice-President of the

World Bank (2008-2012), Dean of Institute of New Structural Economics, Peking

University; Tzipi Livni – Minister of Foreign Affairs of Israel (2006-2009); Minister of Justice

(2013-2014)³; Budimir Lonchar – Minister of Foreign Affairs of SFR Yugoslavia (1987-1991); Petru Lucinschi – President of Moldova (1997-2001)³; Nora Lustig – President Emerita

of the Latin American and Caribbean Economic Association, Professor of Latin American

Economics, Tulane University; Graça Machel – Education & Culture Minister of Mozambique

(1975-1986), Deputy Chair of The Elders; Mauricio Macri – President of Argentina (2015-

2019); Jamil Mahuad – President of Ecuador (1998-2000); John Major – Prime Minister of the

United Kingdom (1990-1997); Moussa Mara – Prime Minister of Mali (2014-2015)³; Giorgi

Margvelashvili – President of Georgia (2013-2018)³; Paul Martin – Prime Minister of Canada

(2003-2006)²; Ricardo Martinelli – President of Panama (2009-2014); Beatrice Weder di

Mauro – President, Centre for Economic Policy Research (CEPR), Professor of International

Economics, Graduate Institute in Geneva; Thabo Mbeki – President of South Africa (1999-

2008)¹; Péter Medgyessy – Prime Minister of Hungary (2002-2004)³; Rexhep Meidani –

President of Albania (1997-2002)¹³; Stjepan Mesić – President of Croatia (2000-

2010)¹³; Branko Milanovic – Professor at the Graduate Center, City University of New

York; Benjamin Mkapa – President of Tanzania (1995-2005)¹; Mario Monti – Prime Minister

of Italy (2011-2013)²; Amre Moussa – Secretary General of the Arab League (2001-2011),

Minister of Foreign Affairs of Egypt (1991-2001)³; Joseph Muscat – Prime Minister of Malta

(2013-2020)³; Dawn Nakagawa – Executive Vice President, Berggruen Institute; Andrew

Natsios – Executive Professor, Bush School of Government & Public Service, Administrator of

USAID (2001-2006); Bujar Nishani – President of Albania (2012-2017)³; Gustavo Noboa –

President of Ecuador (2000-2003); Olusegun Obasanjo – President of Nigeria (1999-

2007); Ngozi Okonjo-Iweala – Board Chair of the Global Alliance for Vaccines and

Immunization, Finance Minister of Nigeria (2011-2015); Jim O’Neill – Chair of Chatham

House; Djoomart Otorbayev – Prime Minister of Kyrgyzstan (2014-2015)³; Roza Otunbayeva –

President of Kyrgyzstan (2010-2011)¹; Leif Pagrotsky – Minister of Industry and Trade &

Minister of Culture and Education of Sweden (1996-2006); Ana Palacio – Minister of Foreign

Affairs of Spain (2002-2004)³; Geoffrey Palmer – Prime Minister of New Zealand (1989-90),

Chair of the New Zealand Law Commission (2005-2010); George Papandreou – Prime Minister

of Greece (2009-2011)³; Andrés Pastrana – President of Colombia (1998-2002)¹; P.J.

Patterson – Prime Minister of Jamaica (1992-2005)¹; Christopher Pissarides – Nobel Laureate

for Economic Sciences (2010), Professor of Economics & Political Science, LSE; Rosen

Plevneliev, President of Bulgaria (2012-2017); Romano Prodi – Prime Minister of Italy (2006-

2008), President of the European Commission (1999-2004); Jan Pronk – Minister for

Development Cooperation, The Netherlands (1989-1998), Professor Emeritus at the

International Institute of Social Studies, The Hague; Jorge Quiroga – President of Bolivia

(2001-2002)¹; Zeid Raad al Hussein – UN High Commissioner for Human Rights (2014-2018),

Member of the Elders; Iveta Radičová – Prime Minister of Slovakia (2010-2012)¹; Jose Ramos

Horta – President of East Timor (2007-2012)¹; Òscar Ribas Reig – Prime Minister of Andorra

(1990-1994)¹; Mary Robinson – President of Ireland (19990-1997), UN High Commissioner for

Human Rights, Chair of the Elders¹; Miguel Ángel Rodríguez – President of Costa Rica (1998-

2002); Dani Rodrik – President-Elect of the International Economic Association, Professor of

International Political Economy, Harvard University; Petre Roman – Prime Minister of

Romania (1989-1991)¹; Kevin Rudd – Prime Minister of Australia (2007-2010, 2013)²; Jorge

Sampaio – President of Portugal (1996-2006)¹; Julio Maria Sanguinetti – President of

Uruguay (1985-1990, 1995-2000)¹; Juan Manuel Santos – President of Colombia (2010-2018),

Nobel Peace Prize Laureate (2016), Member of The Elders; Kailash Satyarthi – Nobel Peace

Prize Laureate (2014), Founder of Bachpan Bachao Andolan, Global March Against Child