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Gro Harlem Brundtland, Elhadj As Sy23 Oct 2019 00:00
We have developed many of the tools needed to prevent, treat and contain disease, including vaccines, diagnostics and drugs. But world leaders are not doing enough to scale them up. (Unicef)
Imagine the following scenario. In a matter of days, a lethal influenza pandemic spreads around the world, halting trade and travel, triggering social chaos, gutting the global economy and endangering tens of millions of lives.
Such a large-scale disease is an entirely realistic prospect.
A new report by the Global Preparedness Monitoring Board warns that humankind is stumbling toward the 21st-century equivalent of the 1918 influenza pandemic, which affected a third of the world’s population and killed about 50-million people.
A similar outbreak today would spread much faster and more widely, potentially resulting in a loss of 5% of the global economy. And yet, despite the threat that this and other health emergencies pose to global security, preparing for them is rarely a priority for political leaders. No government has fully funded or implemented the International Health Regulations, the principal international treaty for health security, to which all countries have committed. It is not surprising that the world is unprepared for a rapidly moving airborne pandemic.
We have developed many of the tools needed to prevent, treat and contain disease, including vaccines, diagnostics and drugs. But world leaders are not doing enough to scale them up. Investment is urgently needed to deliver life-saving health technologies to people most in need.
But outbreak preparedness is as much a social, political and security issue as it is a medical one, with factors like diminished trust in institutions and the spread of misinformation impeding effective action. This can be seen in the current Ebola outbreak in the Democratic Republic of the Congo (DRC).
The World Health Organisation and its partners have significantly improved their response capabilities since the 2014-2016 Ebola outbreak in West Africa, including by employing breakthrough vaccines, medicines and innovative technologies. But the outbreak in the DRC is unfolding in a far more complex environment, characterised by politicisation and little trust in authorities and health workers, and it is affecting people suffering from severe and longstanding insecurity. In such a context, top-down solutions are not enough.
National and international authorities rarely take the time or make the necessary investments to involve people most affected by an outbreak. A better approach would recognise local people’s needs and ensure that they are fully involved in planning and accountability mechanisms.
Of course, protecting against disease outbreaks will cost money — but not as much as one might think. According to data from the World Bank, most countries would need to spend just $1-2 a person each year to reach an acceptable level of health-emergency preparedness. That amounts to a return on investment of 10 to one, or even higher.
And the return on investment does not consider the benefits beyond health for the economy or social stability. In today’s interconnected world, if one group cannot prevent or manage disease outbreaks, everyone is at risk. Given this, all parts of society, including the security sector, must be involved in prevention and planning, and wealthier countries need to invest more in helping lower-income countries to reach adequate levels of preparedness.
This includes not only targeted initiatives, but also more broad-based investments that improve the quality, reach and sustainability of public health systems and the full engagement of local people. The world should be doing this anyway: the United Nations’ third sustainable development goal aims to deliver “universal health coverage, including financial risk protection, access to quality essential healthcare services, and access to safe, effective, quality and affordable essential medicines and vaccines for all” by 2030.
For too long, health emergencies have been met with a cycle of panic and neglect — an approach that is highly inefficient and expensive and that is putting all of us at growing risk. Governments worldwide must start thinking ahead and increase funding at the local, national and international levels to shore up health systems, improve capacity to respond to health emergencies, and prevent the spread of outbreaks, whether of known pathogens like Ebola or unknown ones, say, that spread from animals to humans.
We have the knowledge and the tools. There is no excuse for being caught unprepared. — © Project Syndicate
Gro Harlem Brundtland, a former prime minister of Norway and director general of the World Health Organisation, and Elhadj As Sy, secretary general of the International Federation of Red Cross and Red Crescent Societies, are co-chairs of the Global Preparedness Monitoring Board
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