Protecting Americans from infectious disease threats, today and tomorrow

As the COVID-19 pandemic expands, the U.S. Congress is drafting supplemental funding legislation to jumpstart our fight against this emerging threat. As with H1N1 influenza and Ebola, we can’t protect American lives and our economy without addressing global disease threats.

Because of good work done over the past six years, we now know, for the first time, where the life-threatening gaps in preparedness are, we have a clear path on how to close these gaps, and we know what it will cost to protect the world from health emergencies better. For just $1 per person per year in lower-income countries, we can drastically reduce the impact of this pandemic and the risk of future epidemics. 

If China had closed its “wet markets” after the 2003 SARS outbreak, this pandemic might not have happened. And if Guinea in West Africa had core public health functions in 2014, the Ebola epidemic could have been stopped in just weeks. If we don’t pay now to both mitigate the impending coronavirus pandemic globally and drive down the risk of future pandemics, we will spend a lot later — in American lives and dollars.

Unfortunately, what the world doesn’t have — yet — is the money necessary to close these gaps. The threat from the novel coronavirus is exponentially more significant than the risk of Ebola. In 2014, I said that widespread transmission of Ebola in the United States was not in the cards — and it didn’t occur. Unfortunately, there is a reasonably high likelihood that COVID-19 will spread widely, causing illnesses and deaths in our country.

COVID-19 is a sobering reminder that we’re only as strong as our weakest link and that the world is woefully unprepared for these health threats. The result is the immense health, economic, and social impacts that are beginning to unfold today, all of them preventable.

In addition to addressing the current health emergency, we need to look to the future. There will always be another health threat on the horizon, and another, and another. We must act today to prevent the next health crisis tomorrow. 

There’s a lot we still don’t know about how COVID-19 spreads, how deadly it is, and how to stop it. But what we need to do to protect the United States is clear. Congress’s supplemental appropriation must support vaccine development and the needs of state and local health departments in the U.S.

We must try to contain the virus wherever it appears and, if containment isn’t working, shift to mitigation to limit the harm. And we need to learn much more — fast — about how the virus spreads, how to treat it, and how to stop it.

But the supplemental appropriation will fail to protect our country effectively unless Congress also invests at least $1.9 billion over the next two years in global health security.

This commitment, as part of a global effort, would enable the world not only to tamp down the current pandemic but also to make rapid progress closing the many gaps in preparedness. Just 15 percent of countries have sufficient capacity to find, stop, and prevent outbreaks.

Here are some highlights of what that additional $1.9 billion can do to protect the U.S. and the world:

• Faster control of outbreaks of coronavirus and other health threats. This will require establishing or upgrading hundreds of laboratories around the world that serve as an early-warning network to prevent pathogens from spreading beyond areas where they emerge, disease tracking systems, and rapid response teams to nip outbreaks at the bud.

• Support some of the world’s most vulnerable countries to fill critical gaps. We can help dozens of countries close hundreds of specific, measurable life-threatening gaps. And we must do this because we can only be safer here when these gaps are closed around the world.
• Train more than 10,000 frontline disease detectives around the world to rapidly find, respond to, and control disease outbreaks. There are already excellent, practical, hands-on training programs across the globe with decades of experience developing technical experts and public health leaders, but there are far too few of them. These epidemiologists have been essential to controlling previous disease outbreaks, and the world needs this expertise now more than ever.

That $1.9 billion will be the U.S. contribution, approximately 25 percent of the total need. Other countries will need to increase their spending as well.

In recent years, the World Bank has committed more than $1 billion to improve preparedness. And other countries, including China, should also commit. But the U.S. — as we did with HIV, malaria, and pandemic influenza — should lead the global effort to close gaps in health preparedness and end the deadly, costly cycle of panic and neglect.

Supporting other countries isn’t just the right thing to do from an ethical standpoint — it’s the right thing to do to protect this country. Global health security is our nation’s health defense. It protects us from threats that are unseen and can travel around the world on a single flight, unnoticed. Investments now will save us billions and potentially trillions of dollars later.

This is not a “nice to have” component of the supplemental appropriation; it is necessary to protect our country.

By acting now, we can help control COVID-19 around the world, mitigate its effects here at home, and prevent future epidemics. We will be making a strong investment in our nation’s health defense by keeping Americans and the rest of the world safer from infectious disease threats, and we will protect the U.S. and global economies. 

Dr. Tom Frieden is a former director of the U.S. Centers for Disease Control and Prevention and former commissioner of the New York City Health Department. He is president and CEO of Resolve to Save Lives, a global nonprofit initiative funded by Bloomberg Philanthropies, the Chan Zuckerberg Initiative and the Bill and Melinda Gates Foundation and a part of the global nonprofit Vital Strategies. Resolve to Save Lives works with countries to prevent 100 million deaths by combatting epidemics. Follow him on Twitter @DrTomFrieden.