A break in key US support for global efforts to protect Americans and the world from pandemics could stall momentum that has been gaining steam in the wake of recent threats such as Ebola and Zika viruses, according to a new report from PATH, an international nonprofit group based in Seattle that advocates for innovations in medical countermeasures for improving global health.
The 36-page report, posted on the group's website, is titled "Healthier World, Safer America: A US Government Roadmap for International Action to Prevent the Next Pandemic." The analysis discusses progress that's been made, outlines the risk if efforts languish, and makes a set of recommendations for moving forward.
Carolyn Reynolds, PATH's vice president of policy and advocacy, said in a statement today that global security funding often comes as a reaction to a crisis rather than ahead of time when cost-effective and sustainable investments can help stop disease outbreaks at the source. "The US and the world are just beginning to reap the benefits of efforts made post-Ebola. Now is not the time to stop back."
GHSA meeting in Uganda
The report comes on the eve of a Global Health Security Agenda (GHSA) meeting that will take place in Kampala, Uganda, this week.
Over the past few years, United States has taken one of the lead roles in the GHSA, a partnership of nations, international organizations, and nongovernmental groups that works toward building countries' capacity to prevent and respond to infectious disease threats.
However, a change in White House administration has made it unclear what the US future role would be, given rhetoric that seems to turn away from global partnerships and mixed signals about global public health in President Trump's budget proposal.
Earlier this month, Secretary of State Rex Tillerson voiced support for US collaboration on global infectious disease issues and signaled the country's support for extending the GHSA to 2024.
In a blog post on the White House web site yesterday, Admiral Tim Ziemer, senior director for Global Health Security at the National Security Council, said he will lead a delegation of US government officials to the Uganda meeting to deliver a commitment to promote global health that President Trump recently made at a meeting with African leaders at the United Nations General Assembly.
He said the group expects to review and fine-tune the 5-year agreement that now includes more than 60 nations working to close gaps in preventing the spread of infectious diseases. "It's not hard to understand why these goals are so widely and eagerly embraced. The world remains under-prepared to prevent, detect, and respond to infectious disease outbreaks, whether naturally occurring, accidental, or deliberately released," Ziemer wrote. "We recognize that the cost of failing to control outbreaks and losing lives is far greater than the cost of prevention."
The United States' three objectives at the meeting are to ensure GHSA extension to 2024, urge partners to sustain and strengthen commitments, and foster partnerships to prevent the next outbreak, he said.
Analysis pushes for funding commitment
The report estimates that $450 million of the federal budget is earmarked for international health security programs, amounting to less than 0.1% of nondefense discretionary spending. However, it warned that fiscal year 2018 House and Senate budget proposals would cut the programs by about 10%.
Since fiscal year 2015, programs at the US Agency for International Development (USAID) and the US Centers for Disease Control and Prevention (CDC) have received $1 billion from the $5.4 billion allocated for the Ebola response to help address country health system problems that helped fuel spread of the outbreak.
PATH said the investments have already had a big impact on building key health capacities in some of the world's least developed countries, but there's more work to do, and the report's findings reveal a big opportunity cost to halting progress.
Reynolds said US support has relied heavily on supplemental funds that will soon disappear. "The US Administration and Congress must maintain its leadership position backed up by the necessary resources to ensure continued vigilance against emerging pandemic threats, both at home and abroad," she said.
The group said it welcomed GHSA commitments from Tillerson and other top government officials and calls to extend it to 2024, and urged the US to take several actions, starting with a GHSA funding commitment that reflects a US strategy to prioritize capacity-building in low- and middle-income countries where outbreaks are most likely to start.
Also, PATH said the plan should come with measurable indicators for progress and senior-level US government oversight and that the United States should keep leading in multilateral forums to encourage continued participation from other countries, health partners, and the private sector.
And finally, the analysis highlights the importance of the nation's investments in developing a strong pipeline of new drugs, diagnostics, vaccines, and other tools to prevent and battle pandemics—for example, through incentives to spur investment from the private sector.
Preparedness on World Bank radar
In related developments, the World Bank held a pandemic exercise during its annual meeting this month, the Washington Post reported today. The simulation involved a mysterious drug-resistant virus that spread quickly and often led to severe respiratory infections that required ventilator treatment.
The exercise is the fourth pandemic planning exercise the World Bank has held this year, according to the report, which it said reflects a growing awareness outside the global health sector about the increasing threats and economic disruption a global pandemic could pose.
Participants at its most recent exercise included ministers from about 12 countries and officials from global health groups and the International Air Transport Association.
Oct 24 PATH press release
Oct 5 CIDRAP news story "Secretary Tillerson lauds global health security agenda"
Oct 23 White House blog post
GHSA web site
Oct 24 Washington Post story