“You Can't Start Responding to a Pandemic When it's Already Here”

Why are pandemics increasing?

First, global urbanization and population growth has made us increase livestock production to feed people, and livestock production encroaches on areas inhabited by wildlife. This increases the probability of viruses jumping from wild animals to livestock to humans. Second, antibiotic resistance. Some microbes are not affected by the older antibiotics we have, and we don't have a lot of good medicines in the pipeline. Each new virus can threaten global health security.

What is global health security?

The term came into use after the Ebola virus crisis, since the disease was a threat not just to the health of populations globally but also to economic security and even peace. Global health security involves health systems. And when I think of health systems, I think of all the organizations, the institutions, the policies, the people whose primary purpose is to improve health.

What will be the impact of coronavirus globally, especially in low- and middle-income countries?

There's still a lot of uncertainty about how many COVID-19 cases are going to be experienced in developing countries. There've been very few cases so far reported in sub-Saharan Africa, for example. But it’s not clear if that's because there’s not enough testing or because these countries are in an earlier phase of the pandemic or if these countries are too warm for coronavirus. In any case, the current estimate by the UN is that the global economy will slow down by about 2 percent, which means losses of a trillion dollars or more, besides the unquantified costs of death and trauma. That will hit these countries hard since it will dry up foreign aid.

How ready are these countries to face coronavirus?

Uniformly, the low-income countries are very weak in health systems even before the pandemic. Right now, the most concerning issues are weak supply chains. You do get tests there, but do you get them out to the different places where they need to be? Also, not enough beds, ventilators, respirators.

What lessons were learned from the Ebola crisis?

During the Ebola outbreak, countries were late in raising alerts, testing, and tracking cases. Citizens also lacked trust in government. Some low- and middle-income countries now have stronger disease monitoring systems and have better relationships with public health officials. We have to protect health workers and get protective equipment. You can't start responding to a pandemic when it's already here.

How can we achieve global health security?

Global health security means being able to prepare, detect, and respond to pandemics like these. The global community implemented many of the recommendations made by a commission after the Ebola crisis, but some countries didn't follow the rules. So we need to have political leadership, at the global, national, and community levels, that appreciates the economic danger as well as the human costs of pandemics.