In 2013, members of the National Security Council convened a meeting to bring together officials working on infectious disease prevention and response from the Departments of State, Defense, Agriculture, Health and Human Services, as well as from the Federal Drug Administration, the Agency for International Development (USAID), and the Centers for Disease Control and Prevention (CDC).
I worked at State at the time, and my portfolio focused on preventing the spread of weapons of mass destruction, as well as terrorism and biosecurity issues. We met because of a growing concern: that despite the work of the United States, other countries, a variety of international organizations, the non-governmental sector, and other institutions to combat infectious disease, there was a steady increase of infectious disease threats. It was clear that infectious diseases would continue to endanger the global community, and that something had to be done.
That discussion was followed by a range of additional meetings to include close engagements with other countries, international organizations, and the non-governmental sector. The result was the February 2014 launch of the Global Health Security Agenda (GHSA) by the U.S. and international partners. The GHSA is an effort to build countries’ capacities to prevent, detect, and respond to infectious disease threats (whether from an accidental, natural, or intentional causes). Over 30 countries, along with international organizations including the World Health Organization (WHO), joined.
Since the launch in 2014, the GHSA has grown to include 67 countries, international organizations, and non-governmental organizations. The GHSA’s long-term, often quiet effort to strengthen capacity continues, and new global pandemics since then have been a stark reminder of why such planning matters. A month after launching the GHSA, the world was hit with Ebola; since then, we have confronted the 2015 Middle East Respiratory Syndrome in South Korea, the 2016 Zika virus, another outbreak of Ebola in 2018, and now, COVID-19.
When new crises hit, there is often a knee-jerk reaction to reinvent the wheel in response. But the global public health capacity embodied in the GHSA provides a strong foundation for addressing the pandemic we face today.
THAT WAS THEN
There were many indications in 2013 that the global community was not ready for a pandemic.
We realized that most countries (possibly as high as 70%) were not compliant with the WHO’s 2005 International Health Regulations, a legally binding instrument that seeks to, among other things, strengthen country capacities and detail a public health response to the spread of disease. There was also rising global awareness at that time of problems posed by the increasing threat of antimicrobial resistance — in other words, when germs develop the ability to defeat the drugs designed to kill them.
The 2001 Anthrax attacks in the U.S. — which infected 21 people, killed 5, and cost more than $1 billion to clean up — were also still on officials’ minds. SARS in 2003 cost the global economy $30 billion in only 4 months. In 2009, the H1N1 influenza pandemic killed 284,000 people in its first year alone. We were acutely aware that with the ease of global travel, a disease could not be easily contained. We also took note of the fact that over 60% of human diseases come from animals, at a time when many people around the world were (and are still) living in closer in proximity to animals.
The importance of infectious disease prevention, detection, and response needed to be elevated globally. We sought to ensure government leadership, urging leaders to dedicate time and resources to the issue, and to work with other countries. We also reminded the global community that infectious disease threats are a national security threat and should be treated that way.
In 2018, the U.S. administration released a Biodefense Strategy that would help with “detecting and containing biothreats at their source.” Following a whole-of-government approach, Congress allocated $1 billion for the GHSA until 2019. In FY2019, funding for global health security was $504 million, which included a one-time transfer of $38 million in unspent emergency Ebola funding. President Trump’s FY2020 request for global health security totaled $482 million.
Source: Brookings
