Here’s what we know for certain: We are living the consequences of being underprepared for the next big global epidemic. If we act now, we can prevent or blunt future epidemics and save millions of lives. The question isn’t if another pandemic will emerge, but when.
We have successfully addressed serious public-health challenges. After the United States realized it was falling behind in biomedical research in 1998, we doubled the budget of the National Institutes of Health. When the world faced the unprecedented devastation of HIV, we created the President’s Emergency Plan for AIDS Relief (PEPFAR) and helped turn the tide on the disease, building bridges with governments and communities around the world.
But when it comes to avoidable health crises such as severe acute respiratory syndrome (SARS), Ebola and drug-resistant organisms, the U.S. and global response has been slow, haphazard and far too limited.
This coronavirus outbreak reminds us that humanity shares a common enemy: dangerous microbes. When Ebola struck between 2014 and 2016, Congress ultimately allocated $5.4 billion to control an epidemic — but the epidemic could have been nipped in the bud at almost no cost had basic systems been in place. The world needs a massive investment to protect against the next health threat. Where billions of dollars are needed to protect against future health threats, just a small fraction has been provided. Where thousands of staff are needed, far too few are deployed. And where long-term investments in new tools to diagnose, treat and prevent diseases are called for, investments are short-term and too small.
Investing in outbreak preparedness should be a no-brainer. China’s economy has already taken a big hit, with global ramifications, and its government has already committed billions of dollars to fight the outbreak. A global influenza pandemic could kill tens of millions of people and devastate the global economy.
Countries with the least resources are most at risk. Places without systems to detect and respond to outbreaks are like rooms that lack smoke alarms and sprinkler systems. We’re all connected by the air we breathe, the food we eat and the planes we fly in. When other countries are stronger, we’ll be safer.
After I stepped down as CDC director in 2017, I helped launched Resolve to Save Lives, which has a core goal of helping make the world safer from epidemics. The good news is that the world is making some progress. More than 110 countries have rigorously and independently assessed their epidemic preparedness. However, of the nearly 10,000 life-threatening gaps these assessments have identified, few have been closed.
Stepping up capacity will not be quick or easy. But a bipartisan coalition should invest for the long term in making the United States and the world much safer from epidemic threats. We’re nickel-and-diming a problem with solutions that could save tens of billions of dollars. It costs approximately an additional $1 a year per person to step up core preparedness in lower-income countries — or about $3 billion to $4 billion globally.
Focused research also needs to be funded, and U.S. preparedness needs to be strengthened, bringing the total need to approximately $5 billion to $10 billion a year, including funds from the World Bank, other multilateral organizations, bilateral donors and the United States. That may seem like a lot of money, but it could save many lives and many times that amount of money in years to come,.
The United States and other countries are more prepared today than in the past, but we’re not where we should be. Globally, we need accurate, timely and far-reaching laboratory networks, skilled epidemiologists who track and control diseases, early warning systems and rapid-response teams. And we need research to develop more rapid diagnostics, new treatments and vaccines, and improved health-care delivery.
We need to further support the World Health Organization for its work on the global response to pandemics. But we also need to hold it accountable for technical rigor, operational speed and excellence. We need to increase funding going to preparedness, including World Bank-funded projects. And we need all governments — donor countries and low- and middle-income countries — to invest in public-health systems that can save lives today and prevent a disaster tomorrow.
We don’t know at this moment how severe the coronavirus outbreak will be and whether it could have been prevented. But we do know that we are not doing what’s needed to prevent the next health disaster. Outbreaks are inevitable. If we don’t prepare for them, shame on us.