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A 'cycle of panic and neglect' leaves the world vulnerable to pandemics, experts warn

Health workers lower the coffin of an Ebola victim in the DRC - the outbreak has killed more than 2,000 people since August 2018 - REX
Health workers lower the coffin of an Ebola victim in the DRC - the outbreak has killed more than 2,000 people since August 2018 - REX

The world is unprepared for the “very real threat” of a devastating global disease outbreak, experts have warned.

In a stark report, 15 public health leaders have criticised a “cycle of panic and neglect” which they say has characterised approaches to health emergencies and left the world at an “acute risk” of both regional and global pandemics.

The report highlights the danger of a lethal respiratory pathogen, which could kill between 50 to 80 million people, wipe out nearly five per cent of the global economy and lead to social chaos.

As the world has become more interconnected, such a pathogen could spread around the globe within 36 to 50 hours, the report says.

But the experts warn that governments only invest in preparedness systems when emergencies strike – for instance the West Africa Ebola outbreak in 2014-2016, or the H1N1 swine flu outbreak in 2009.

This approach is inefficient, costly and leaves the world vulnerable to future crises, according to the report – which is the first to be published by the Global Preparedness Monitoring Board (GPMB), a panel of experts convened by the World Bank and World Health Organization in 2018.

“For too long, we have allowed a cycle of panic and neglect when it comes to pandemics: we ramp up efforts when there is a serious threat, then quickly forget about them when the threat subsides,” the report says. “It is well past time to act.” 

The GPMB – which is co-chaired by Dr Gro Harlem Brundtland, former Prime Minister of Norway and former director general of the WHO, and Elhadj As Sy, secretary general of the International Federation of Red Cross – also warns that disease outbreaks are increasingly difficult to contain when they do emerge.

Climate change and urbanisation provide the perfect breeding grounds for fast-spreading outbreaks, while managing epidemics becomes much more complicated in the context of prolonged conflict, fragile states and forced migration.

Alex Ross, director of the GPMB secretariat, told the Telegraph that the current Ebola outbreak in the Democratic Republic of Congo was a “canary in the mine” as it brought these problems to the fore.

“We have a situation that is very different from Ebola in 2014-16 – we have an effective vaccine, breakthrough medicines,” he said. “But even with rapid deployment we have not been able to control the outbreak because of insecurity in the region and complete lack of community engagement and trust.

“And this is what has been coined as the new normal,” he added. “These outbreaks can no longer be controlled by medical interventions, but the ability to manage them is determined by ensuring community engagement, and working with different sectors to address the broader issues.”

Dr Ross said that in this context, investing in disease surveillance and preparedness was more important than ever.

“There needs to be a shift in paradigm in how we think about preparedness,” he said. “The only guarantee you have is [to contain outbreaks] is investing in a basic system in every country.”

Mr As Sy added: “The trust between communities and the institutions that serve them is at the core of an emergency response, but it is almost impossible to build trust in the middle of a crisis. Community engagement and trust cannot be an afterthought, it has to be earned.

“We can’t just show up once a health crisis hits. We need to be there before, during and after.”

The GPMB board highlights seven “urgent actions” that countries around the world must take to prepare for health emergencies – including committed investment from heads of government, improved international cooperation and building better health and surveillance systems.

“Preparedness is not a very costly investment,” said Dr Ross. “Something unique about investing in preparedness that’s very different preparing for militarily of natural disaster threats is you get an immediate return - essentially you’re enabling a system to deliver basic services to a community.

“That is immediate and has additional benefits of increasing trust,” he added.

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