The world was less connected then than it is now when the 1918 pandemic of HIN1 influenza broke out. Even then, by the time the outbreak ended two years later, it killed at least 50 million people around the world, from eastern Europe to the South Pacific, to the Arctic, taking 675,000 lives in the United States alone. The economic cost of the outbreak was never pinned down.
Recent, smaller outbreaks give a glimpse of how those costs add up, though, with $5.4 billion from the U.S. alone to respond to and contain the 2014 Ebola crisis that began in West Africa and killed more than 11,000 people, and $1.1 billion from the U.S. in response to the outbreak of Zika and its impacts across the Western Hemisphere. Adding the costs of services, lost income and productivity, and the devastation to family, community and national economies caused by massive scale losses of life and health — impacts that also spread quickly in an increasingly connected world, makes the costs of equipping the poorest places in the world to detect, prevent, and stop infectious disease outbreaks look minuscule by comparison.
Still, after the next pandemic of H1NI flu broke out in 2009, examination highlighted public health preparedness gaps around the world. Only 20 percent of countries worldwide were in compliance with International Health Regulations that would ensure their capacities to notice and contain disease outbreaks within their borders before they became global disasters. The second H1N1 pandemic, the attention it drew to findings of global unpreparedness for future pandemics, as well as a growing incidence, recognition and spread of emerging infectious diseases, inspired the United States to initiate the creation of the Global Health Security Agenda, an international partnership to strengthen health and laboratory capacities that 60 nations have now joined.
With funding for the GHSA as well as funding allocated in response to Ebola, and since directed to filling health system gaps to enable future responses set to run out in 2019, a recently released analysis from the nonprofit PATH argues that continued United States leadership of investments and actions to build health capacities worldwide is critical to national as well as global interests. The analysis lays out a series of strategic and investment recommendations to maximize the impact of U.S. global health security leadership. In addition to continued strong support of the GHSA, they include the provision of dedicated and reliable funding for global health security efforts at the U.S. Centers for Disease Control and Prevention, USAID, the Department of Defense, and the Department of State, the establishment of emergency reserve funds at those agencies, the maintenance of strong support for the U.S. President’s Emergency Plan for AIDS Relief and other U.S. led programs that contribute to medical and laboratory capacity building, and sustained, predictable support for research and development both towards expanded knowledge of pathogens with pandemic potential and measures against them.