A Billion in Pandemic Prevention Is Worth a Trillion in Cure

The world is warned to prepare now for health crises such as the Ebola outbreak, or pay a lot more later.
Photographer: Waldo Swiegers /Bloomberg

In October 2000, an Ebola outbreak was detected in Gulu, Uganda. The virus spread across the country, infecting 425 people and killing more than half of them. It was a wakeup call for the African nation, though apparently not the rest of the world.

Uganda responded by creating systems to spot epidemics in the making. "Village health teams" were made responsible for monitoring a few dozen households apiece, as well as building labs so specimens could be tested in 24 hours. While an Ebola outbreak seven years later took weeks to investigate, by 2011 Ugandan authorities were responding in a day or two, keeping deaths to a minimum.

QuickTake Ebola

The world needs a similar transformation to prevent outbreaks of infectious disease that threaten security and economic stability, according to a report (PDF) sponsored by several major foundations. Pandemics—epidemics that spread across the globe—could cost humanity $6 trillion in the 21st century, or $60 billion a year, the authors estimate. They argued for investing $4.5 billion a year—or 65 cents for every resident of the planet—to prepare.

"There are very few threats that can compare with infectious diseases in terms of their potential to result in catastrophic loss of life," the report states. "Yet nations devote only a fraction of the resources spent on national security to prevent and prepare for pandemics."

The document, commissioned by such heavy hitters as the Paul G. Allen Family Foundation, the Ford Foundation, and the Bill & Melinda Gates Foundation, was written by 17 academics, policymakers, and nonprofit and industry leaders from across the globe. Threaded through its  acronym-filled bureaucratese is a politely scathing assessment of the World Health Organization, particularly its handling of the most recent Ebola outbreak in West Africa. That epidemic is only now coming to an end, after almost two years and 11,000 dead.

The authors say the WHO, the arm of the United Nations charged with protecting the world from disease, is unprepared for the task. Noting that "there is no realistic alternative" to the underfunded agency, the commission says the WHO "must make significant changes in order to play this role effectively. It needs more capability and more resources, and it must demonstrate more leadership."

The group argued that spending a few billion dollars a year globally to improve national health systems the way Uganda did would provide a small insurance policy against catastrophic risks. The flu pandemic in 1918-19 killed at least 50 million people and drained 5 percent from global gross domestic product, the authors noted.

In a statement, the WHO said on Wednesday that the "Ebola outbreak has taught us many lessons. In light of the Ebola experience, WHO is making major changes to the work we do in outbreaks and emergencies."

The organization is "transforming to become a fully operational emergency organization" and seeks to "enable countries to have key capacities in place, including leadership and coordination, logistics and human resources," it said. This initiative will be presented to member states at the WHO executive board meeting at the end of this month, according to the statement.

The thousands of Ebola deaths in West Africa over the past few years may have focused world attention on vulnerabilities in capacity. Then again, the report's authors acknowledge that we’ve seen this movie before.

"After every outbreak of infectious disease, there is a flurry of activity and reports, but political interest quickly wanes and other priorities dominate," the authors wrote. It’s unclear whether the rest of the world will learn what Uganda did.

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