As the world mobilizes to contain the coronavirus and its fallout, we can’t lose sight of the bigger, equally alarming picture: The next pandemic is only a matter of time. The U.S. needs to start preparing for it as soon as possible.
The global outbreak of COVID-19 is in no way an anomaly. Today, infectious diseases are emerging and reemerging more quickly than ever before. Between 1980 and 2013, the number of annual epidemics has gone from fewer than 1,000 to over 3,000. Infectious diseases such as Zika, MERS-CoV, SARS, cholera, tuberculosis, HIV/AIDS, influenza, and Ebola kill millions every year, and their outbreaks have decimated economies and triggered aftershocks and panic around the world.
It’s a dire situation that highlights the disturbing reality about the fragility of our global economy, the insufficiency of America’s social safety net, and persistent underinvestment in U.S. public health preparedness. We have always known that the next crisis was only a matter of time. And yet time and again, we find ourselves playing catch-up, scrambling to react to these crises, having failed to prepare for them in the first place.
In the wake of every disease outbreak, we see a flurry of proactive public health measures in the form of funding, task forces, and renewed interest in vaccine development and other public health measures. But eventually political interest wanes, funding priorities change, and as the crisis comes under control, our attention shifts to other seemingly more pressing issues.
Look no further than the Ebola outbreak a half-decade ago, the deadliest one in history. All told, the epidemic killed more than 11,000 people. Hundreds of children were orphaned.
More than 40 reports were written in the wake of this tragedy, each of them outlining alarming vulnerabilities: overburdened local health systems, a lack of coordination between governments and NGOs, inadequate disease surveillance and alert systems, and a lack of trust between citizens and local and national authorities.
Even so, the tragedy quickly faded from the headlines, and the world let its guard down. In 2014, Congress appropriated $5.4 billion to fight the Ebola epidemic. Four years later, the Trump administration walked back that commitment, rescinding the remaining $252 million in funding that had been set aside to build up local capacities and prevent future outbreaks. That same year, the global health unit of the White House National Security Council was eliminated altogether.
It is that kind of short-term thinking that has led to the very predicament America finds itself in today. We have chronically insufficient and underfunded public health entities that have no surge capacity during times of emergency. We’re lacking the ability to engage in the transdisciplinary work required to effectively address the crisis. And widening socioeconomic disparities threaten to make future pandemics even deadlier.
The time to change this paradigm is now.
First and foremost, the U.S. needs stronger public health systems to detect and contain diseases. That means developing a central data surveillance system to link laboratory data with population data and clinical measures, so that organizations across our health system will have the necessary information to track and predict outbreaks. It means having sustained funding for discovery science, so that we can develop new vaccines, rapid diagnostics, and treatments. And it means investing in better health care delivery across the board.
Second, we need to bolster our communication and coordination. In addition to the Centers for Disease Control and Prevention (CDC), the U.S. would benefit from a new, nongovernmental organization that could guide our national response during public health crises and prepare evidence-based epidemic protocols and practices during times of peace.
Such an entity should be led by public health and policy experts who operate independently, outside the confines of the normal political landscape. A great model for such leadership is The Elders, the organization founded by Nelson Mandela that works both publicly and through private diplomacy to promote peace and human rights around the globe.
And finally, we need to address the underlying inequalities that make a crisis like this one so devastating for vulnerable people. In the short term, that means targeting the congressional stimulus package to the small businesses and workers who will be hardest hit, including those in fields like hospitality, retail, and the gig economy. In the long term, it means bolstering our social safety net—by expanding unemployment insurance, paid sick leave, health care access, small-business assistance, and food and housing security.
This may be a tall order, but public health now has everyone’s attention. Even in the throes of this crisis, we have an opportunity to break the familiar, dangerous cycle of panic and eventual neglect that inevitably follows every pandemic. And when we do, we will save countless lives.
Jane J. Kim is dean for academic affairs at the Harvard T.H. Chan School of Public Health and a professor of health decision science.
Michelle A. Williams is dean of the faculty at the Harvard T.H. Chan School of Public Health and the Angelopoulos professor in public health and international development.
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