Six years on, are we better prepared for the next pandemic?

This week, exactly six years ago, as we were gliding cheerfully into the 2019 festive Christmas season, the Covid-19 virus was spreading in Wuhan, China. I was preparing for an important Asia-Pacific Economic Cooperation meeting in Australia in February (the last overseas trip I would make for three years), oblivious to the looming pandemic. The world in general had no inkling of the terrible three years that would follow, with death estimates ranging from 7 million to 36 million, over 700 million infections reported, an economic cost put at US$12.5 trillion and more than 100 million people globally pushed into extreme poverty. I was among those who grossly underestimated what the toll would be. Writing in April 2020, I had naively assumed it would all be over in a few months, like with severe acute respiratory syndrome (Sars) in 2003. Yet over two years after Covid-19 was brought under control, many worldwide are behaving as if the pandemic never happened and that such a health emergency is unlikely to happen again any time soon. Rather than focusing on the lessons that we need to learn, many have been preoccupied with blame-shifting arguments on how and why we allowed the virus to spread out of control – glossing over what is perhaps the single most important reality: faced with a pandemic threat, delays of even a day or two (well within the range of human fallibility) can have catastrophic consequences. The outbreak’s early chronology is as fascinating as it is sobering. While a smattering of cases emerged in November 2019, it was only on December 30 that Wuhan officials formally reported the unusual pneumonia. While many in the Western world were still on extended Christmas and New Year breaks, Covid-19 was likely extending its range beyond China’s borders, exploiting international “vector hubs” such as Hong Kong. The genome was decoded by January 2, but it was a further 10 days before the Chinese authorities released the genome internationally. It was January 30 when the World Health Organization declared a public health emergency. Given how bureaucracies work, delays are routine, but this can be catastrophic when pandemics can appear anywhere, any time and move at warp speed. With memories of the Covid-19 crisis fading rapidly, pandemic preparedness plans remain a work in progress and are seldom a government priority. Political leaders have diverted money that should go to health security budgets to more immediate needs like national security and defence, subsidies for people hurt by the US’ tariff war and debt servicing. This year, WHO members adopted a legally binding pandemic agreement to make the world more equitable and safer in future pandemics. An intergovernmental working group co-chaired by Britain and Brazil has convened four meetings since then to draw up a Pathogen Access and Benefit Sharing strategy. This will hopefully be delivered to next May’s World Health Assembly in Geneva, but there is one major hitch: in just about a month’s time, the United States will no longer be a WHO member. Given that the US provided around 14 per cent of WHO funds, we are facing a potential global health crisis that goes far beyond pandemic preparedness. The loss of US funding will not just hit the WHO’s important work on polio, HIV/Aids, malaria and tuberculosis. Importantly, it is likely to compromise essential collaborative efforts required to ensure health security worldwide. Equally threatening to health security worldwide is US President Donald Trump’s decision to dismantle the US Agency for International Development (USAID), whose 2023 budget of US$42.8 billion was equivalent to 42 per cent of global humanitarian aid. About a quarter of all international cooperation programmes are expected to be cancelled as a result. Studies point out the potential long-term harm of US withdrawal is not just for the WHO but for global health security more comprehensively. It includes work on pandemic preparedness, disease surveillance, research collaboration and emergency coordination. One study called the US decision to withdraw from the WHO “a pivotal moment in global health diplomacy”. Another study, noting the “interconnected nature of global health and the importance of international cooperation in safeguarding the health and well-being of all nations”, warned that “the disadvantages of this decision are profound”. So, despite how recent the Covid-19 trauma has been, the gloomy reality is we may still be no better prepared for the next pandemic than in 2019. If anything, commitments to international cooperation and coordination are weaker than they were. Oxford historian Peter Frankopan may be perfectly correct to say “pandemics are part of the present and the future, and not just the past”, and that “zoonotic spillovers did not end in Wuhan a few years ago”, but few policymakers worldwide are acting as if this were so. Scarred as we were by Covid-19, we should remember that our most recent pandemic could have been much worse. The flea-borne Black Death pandemic exploded across Europe from 1347, wiped out about half of the European population and persisted in cities like Constantinople (modern-day Istanbul) for more than 500 years. In the 16th century, as much as 90 per cent of the native population of the Americas died after the Europeans arrived and brought smallpox. Back then, pandemics were unexplained and uncontrolled. Today we have no excuse, even as we glide cheerfully into another Christmas.

Six years on, are we better prepared for the next pandemic?

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Preparedness plans remain a work in progress while health budgets have been sliced by urgent demands and US withdrawal weakens global coordination

Preparedness plans remain a work in progress while health budgets have been sliced by urgent demands and US withdrawal weakens global coordination