By Jim Yong Kim
Too
often, the conventional wisdom in diplomatic or scientific circles is
that the general public doesn’t know what’s good for them when it comes to
foreign policy or tackling global threats. It’s too complicated, the experts
say; the public wouldn’t understand. Yet new polling suggests that many in the
public understand very well how global infectious disease outbreaks pose a
serious threat to their lives and economic security – and they know what should
be done about it.
A
opinion research survey commissioned by the World Bank Group with 4,000 respondents across
five industrialized countries - France, Germany, Japan, the United Kingdom and
the United States - found that most people are not convinced the world, or
their own country, is prepared for the next global epidemic. Twice as many
respondents think the world will experience another global epidemic in the next
decade as will not, and fewer than half are convinced that their own country is
prepared. They rank “global health and epidemics” as one of their top global concerns,
after terrorism and climate change.
These
findings come nearly a year since the World Health Organization (WHO) declared
the Ebola epidemic a “public health emergency of international concern,” its
highest level of alert. This triggered a massive global response, but only
eight months after the first identified case in West Africa. Yet after more
than 11,000 deaths, millions of lives disrupted and billions of dollars in lost
income, the threat is not over; new Ebola cases continue to emerge. We’ve also
seen the recent spread of the highly infectious MERS virus to the Republic of
Korea, which has contributed to a decline in the country’s GDP growth to a
six-year low.
Both
the Ebola and MERS viruses have been largely confined to a few countries
because they are transmitted through close contact. But what would happen if
the world faced a fast-moving, airborne disease such as the Spanish flu
outbreak of 1918-19? Modelling suggests a Spanish flu-like outbreak today would
kill more than 33 million people in 250 days. And the cost of such a severe
outbreak has been estimated at 4.8 percent of global GDP – or more than $3.6
trillion.
The
public is right: the world is not prepared for the next epidemic. We’re no
better equipped to respond quickly to an outbreak than we were a year ago. But
we can be – and at a fraction of what it would cost if we don’t act urgently.
Here are three things we need to do:
First,
let’s ensure that all countries invest in better preparedness. This starts with
a strong health system that can deliver essential, quality care; disease
surveillance; and diagnostic capabilities. We should expand successful efforts
such as those by Ethiopia and Rwanda to train cadres of community health
workers, who can expand access to care and serve as the frontline response to
future disease outbreaks. The
goal must be universal health coverage – both to ensure
everyone can get the care they need, and also because those areas without
adequate coverage put everyone at risk.
The public gets this: Strong majorities believe that investing in doctors,
nurses and clinics in developing countries helps prevent epidemics from
breaking out in their own countries and saves lives and money. But Korea’s
experience shows that even the most advanced health systems need to step up
their epidemic preparedness.
Second,
we need a smarter, better coordinated global epidemic preparedness and response
system that draws upon the expertise of many more players – including a
better-resourced WHO. The early months of responding to the Ebola
epidemic fell disproportionately upon the heroic Médecins Sans Frontières.
Outbreaks will happen, but they can be contained before they turn into much
more deadly and costly global epidemics. This requires pre-set arrangements and
close coordination between national and local governments, international
bodies, the private sector and non-governmental organizations, with a supply
chain that can be up and running in no time. The private sector, which was
largely shut out of the initial response to Ebola, can bring market discipline,
innovation and additional resources to the fight.
Third,
we must be able to get emergency funding out the door and deploy rapid response
teams at the first sign of a crisis. If a fast-moving epidemic hits, the
traditional approach of issuing fundraising appeals just isn’t good enough. The
World Bank Group is working with the WHO and other institutions on one part of
the solution – something we call a pandemic emergency financing facility.
Endorsed by the leaders of the Group of 7 in Germany in June, the facility aims
to make sure adequate and timely financing is available to countries and
international responders to effectively contain a pandemic threat. The facility
is developing innovative financing arrangements such as private sector
insurance and public sector contingency pools that can disburse rapidly to
support a surge in health workers or the setting up of emergency response
operations centers. Governments have already used this model to successfully
manage climate and natural disaster risks.
Two years ago, a survey of 30,000 insurance executives showed that
a global epidemic was their greatest worry. But the executives’ alarm was
ignored – as were the previous warnings from SARS and avian flu. Today, with
the painful reminder of the latest epidemic and public support strongly in
favor, it’s time to tackle epidemic prevention and response. We must break the
cycle of talk and no action.
Jim Yong Kim is the President of the World Bank Group.
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