Precisely how the “fiscal environment” could be a constraint ought to have been a mystery. Most governments around the world were engaged in unprecedented emergency spending that dwarfed the scale of the entire vaccine program. As Aylward pointed out, “This will pay itself off in 36 hours once we get trade and travel moving again.” But even in the midst of a ruinous pandemic, costing the world economy trillions of dollars, when it came to making the case for public health spending, global leaders were tongue-tied.
