There are several certainties in this world. Death, taxes (for most people at least), new boy bands emerging, and unless things drastically change, more pandemics occurring. Yes, you know this wonderful experience of the current Covid-19 coronavirus pandemic? It’s going to happen again, and the next time it could be even worse.
That’s why efforts like the Pandemic Action Network want to stop what’s been dubbed the “cycle of panic and neglect.” The first part of the cycle is what’s happening right now: the “oh bleep, what do we do now, maybe it will go away or people won’t notice, oh that didn’t happen, people are dying, business are falling, bleep, let’s find someone to blame for this or spread some conspiracy theories” part of the cycle. If you haven’t figured it out yet, we are currently in the “panic” part of the cycle.
The second part of the cycle may happen after the pandemic is over. It’s the “the pandemic is old news, so early 2020’s. What are the Kardashians wearing right now” part of the cycle. This latter “neglect” part cycle is what helped get our society into the current situation in the first place.
Gabrielle Fitzgerald, the founder and CEO of Panorama and one of the co-founders of the Pandemic Action Network, warned that this is the time to be thinking about how to prevent the next pandemic: “We have to push people to address the gaps and deficiencies.” Fitzgerald that people may be more willing to take action before the “neglect” cycle happens again. She added that the Pandemic Action Network has been helping create a policy agenda on “how pandemic preparedness can be done for the future. We have a small core team but a number of important partners.”
These partners include the Bill and Melinda Gates Foundation, the Centers for Disease Control and Prevention (CDC) Foundation, the Federation of American Scientists, the Gordon and Betty Moore Foundation, iHeart Media, PATH, Save the Children, the United Nations Foundation, and the Wellcome Trust.
“We are not starting from scratch and do have international health organizations,” explained Carolyn Reynolds, another co-founder of the Pandemic Action Network and former veteran of the PATH and the World Bank. “We need to make pandemic preparedness a political priority. This includes advocacy and building political will and a movement.”
It’s not as if the current Covid-19 coronavirus pandemic came without warning. As Jerry Seinfeld once said about relationships, “breaking up is like knocking over a coke machine. You can’t do it in one push, you got to rock it back and forth a few times, and then it goes over.” The same can be said about pandemics. They don’t occur overnight. There are warning signs. The key is to heed those warning signs and do something about them.
There have been plenty of warnings and opportunities to prevent or at least reduce the impact of the current Covid-19 coronavirus pandemic. For example, the 2002-2003 SARS outbreak made countries around the world go “uh-oh” and helped prompt an agreement in 2005 to strengthen the International Health Regulations (IHRs). This included requirements that each country take steps to enhance pandemic preparedness such as maintaining appropriate stockpiles of personal protective equipment, establish timely disease tracking and reporting systems, and putting rapid disease control measures in place.
Did all countries do such things? Not even close. The Global Health Security (GHS) Index is a score out of a 100 points that measures how well a country is prepared to deal with global health threats. In 2019, the average score GHS Index was a 40.2. High-income countries, you know the ones with all the moolah scored an average of 51.3. Low-income countries scored an average 30.0. No one runs home to their parents yelling with joy, “I got a 50% on my test, after studying for 14 years!”
As the country with the most moolah, the U.S. presumably should lead the way in pandemic preparedness. However, in many ways, in recent years, the U.S. has done the opposite, leading trends in the wrong direction. In the U.S., support for scientific research and public health efforts has been falling in the years leading up to the pandemic. For example, as a Federation of American Societies for Experimental Biology (FASEB) presentation showed, inflation-adjusted funding for the National Institutes of Health (NIH) has actually dropped since 2003. According to a 2016 article in the American Journal of Public Health, inflation-adjusted public health spending per-capita had fallen by over 9% since 2008. Since President Donald Trump took office in 2017, his administration has repeatedly pushed for cuts in both scientific research and public health funding.
Then there’s the mystery of what happened to the White House’s National Security Council (NSC) Directorate for Global Health Security and Biodefense after Trump took office. Beth Cameron, former Senior Director for Global Health Security and Biodefense in the NSC, wrote an op-ed in the Washington Post in March, saying that one year after Trump took office, “I was mystified when the White House dissolved the office, leaving the country less prepared for pandemics like covid-19.”
There’s been back and forth about whether a dissolution, a shrinkage, a re-org, or a streamline actually occurred. For example, John Bolton, former head of the NSC tweeted the following:
Nonetheless, arguing about the semantics of what happened is like arguing whether you fell off the roof onto the birthday cake because you were tipsy, dizzy, laughing at a meme of a cat, or simply on a slippery roof. The lack of coordinated and organized responses to the current Covid-19 coronavirus pandemic has shown that the White House’s pandemic preparedness efforts were far from where they was supposed to be.
Actions taken by the Trump administration since the pandemic started certainly haven’t helped either. Efforts to blame others for the pandemic have engendered discord, the opposite of what you want when the world should be united in battling a mutual threat. Trump’s announcement in May that he would terminate the U.S.’s relationship with the World Health Organization (WHO) drew fire in more ways than one:
Note that this is not actual video, but an artist’s rendering. A number of scientific and medical organizations came out strongly against Trump’s decision such as:
Wright emphasized, “The world needs a strong WHO. If we didn’t have a WHO we would have to invent it. Pandemics are global threats that requires global solidarity and cooperation.”
Bolstering the WHO was one the recommendations of the ”Break The Cycle Of Panic And Neglect: Preventing The Next Pandemic” report that came out in June. This was the result of a collaboration between the Pandemic Action Network, ONE, PATH, Nuclear Threat Initiative (NTI), Global Health Security Agenda Consortium (GHSAC), Management Sciences for Health, and Global Citizen. The title of the report is fairly self-explanatory and the content included recommendations that countries should:
- Measure their capacity to prevent, detect and respond to public health risks by undertaking a Joint External Evaluation every two years and making it public.
- Develop National Health Security Action Plans with time-bound targets and benchmarks for IHR compliance.
- Fund National Health Security Action Plans through national budgets with international financing to close financing gaps where needed.
- Implement: Improvements should result in improved scores on international health security assessments e.g. JEEs and/or Global Health Security Index, with the aim to reach IHR compliance by 2024.
- Ensure the WHO and other international organizations have the necessary resources and capabilities to guide countries on their preparedness efforts, monitor compliance and lead an effective global response.
There were also recommendations for regional bodies like the European and African Union and global institutions like the United Nations, the World Bank and international funding agencies. These included finding more ways to coordinate efforts, ensure that countries are more compliant with IHRs, and creating integrated real-time data systems. Of course, all of this requires money, otherwise known as moolah. So two of the recommendations for global institutions was to establish a Global Health Security Challenge Fund and ensure that other major global health initiatives and financing mechanisms are designed and in place.
Of course, all of this makes sense while in the middle of a pandemic. But what happens when the current pandemic has run its course and life returns to normal, whatever normal eventually becomes? Will everyone go back to being immersed in the minutia of every day life and forget what it’s like right now? Will panic then segue back into neglect?
Wright emphasized, “We need to treat pandemics as catastrophic. Just like there is with the military, there needs to be continuing investment in readiness. Outbreaks can happen at any time. Systems need to be in place to be prepared to respond these outbreaks and to scale up quickly.”
Both Fitzgerald and Wright emphasized that this needs to be “a movement and not just a campaign.” Campaigns can be like Snapchats. They can be momentary and fade quickly with time. Movements instead persist and even grow. They can shift the landscape and help break what can easily become a deadly and economically devastating cycle.