When it comes to infectious disease outbreaks, we just haven’t learned.

It’s not as if we weren’t warned. Last year, a report by the Global Preparedness Monitoring Board, a body put together by the World Health Organization and the World Bank Group, said that there was “a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people and wiping out nearly 5 percent of the world’s economy.” A pandemic on such a scale would create havoc and insecurity; the world “is not prepared,” it said. Hopefully, the numbers never reach those levels, but what we’re witnessing is scary enough.

This is our world in 2020, after we’ve dealt with severe acute respiratory syndrome, Middle East respiratory syndrome, the avian flu and Ebola in close succession, and are now confronted with COVID-19. The Global Health Security Index report last year found that all countries, across income levels, weren’t ready to handle globally catastrophic biological events. Few countries have tested their emergency operations in case of a biological threat and most haven’t allocated much funding from their national budgets to be prepared.

The world spends far too little on being ready for rapidly spreading, unknown diseases.

Every time there’s an epidemic, experts study the damage and assess systemic failures. A common finding is that financing for preparation was inadequate, leading to slow, expensive efforts to deliver aid. Even though the World Bank mobilized $1.62 billion to help countries hit by Ebola, it was difficult to get the resources there on time. Reaction costs more than pro-action. Unprepared health systems see costs spike, and suffer time lags in acquiring and moving resources that they could have earlier purchased over time and had ready for rapid deployment. The annual cost from pandemics is estimated to be as much as $570 billion a year. That includes lost income and increased and early mortality. Taxpayers foot the extra bill along with the health risks from delayed reaction. Last week, Chuck Schumer, leader of the US Senate’s minority Democrats, asked for $8.5 billion in emergency funding. The Trump administration wants $2.5 billion, half of that being new. Within the first few weeks of the outbreak, China said it had spent $4.5 billion on fighting the coronavirus. It has since spent hundreds of millions more.

It doesn’t have to be this way. Globally, an incremental $4.5 billion a year would make the world much safer, according to a commission convened by the US National Academy of Medicine. That’s about 65 cents per person. Of this amount, around $3.4 billion would be for upgrading national-level pandemic preparedness and $1 billion for research and development around infectious diseases. This spending could save an estimated $6 billion.

It would help with the immediate needs that epidemics require, like testing and collecting data as the disease spreads so that vaccines can be developed and then produced on a large scale. A big challenge for vaccines is that traditional methods of manufacturing proteins “are too slow for responding to an epidemic,” Bill Gates wrote in a paper for the New England Journal of Medicine.

Several countries have pandemic preparedness plans. Many are outdated or aren’t frequently refreshed. But even for countries that have better readiness and funding, the challenges remain huge.

South Korea has the largest number of cases outside China. It’s one of the countries best equipped to handle outbreaks, drawing lessons from the avian flu in 2009, according to the Global Health Security Index ranking. Until Feb. 17, there were only 30 known cases of COVID-19 in Korea. Then it emerged that several members of a religious sect were infected. Two weeks later, the country was testing more than 30,000 people and confirmed over 4,000 cases. The country is now getting together a supplementary budget of more than 6.2 trillion won ($5.12 billion) to deal with the coronavirus.

Governments need to run mock pandemic drills. They result in stronger health surveillance systems for when an infectious disease arrives, which it inevitably will. If a government doesn’t adequately fund its public health system, then getting trained care workers to man hospital beds won’t matter, even if there are enough in the first place. Health care and security budgets need to allocate money to maintain stockpiles of anti-viral drugs, medical equipment and other supplies to fend off biological risks.

Nations spend astronomic sums preparing for war. World military expenditure rose to $1.82 trillion in 2018, with the US and China leading the charts. Consider, also, the billions that have chased Silicon Valley startups for dog-walking, autonomous vehicles or other futuristic and fanciful ideas. But military contracts are lucrative; private tech investments promise huge returns and big payouts.

Arguably, the threat is lower for war than pandemics. The clear and present danger of a virus -- as we face today with our masks on -- is far higher. It’s no wonder we’re living in a state of paranoia of infection.

No amount of spending will lead to outright containment. It comes down to reducing deaths and averting economic damage by slowing the spread and fatality rate. To do that, we need to be prepared.


Anjani Trivedi
Anjani Trivedi is a Bloomberg Opinion columnist covering industrial companies in Asia. -- Ed.

(Bloomberg)