Reframe pandemic preparedness as global health insurance

The headlines over the past few weeks have been about a frightening pathogen, concerns about vaccine availability, and what policymakers are doing to prepare should this become a widespread pandemic. No, these are not revisiting the news three years ago. Rather, the recent headlines about H5N1 Avian influenza circulating in mammal populations are more reminders that novel pathogens, pandemics and biothreats are here to stay. 

The new Congress has an opportunity to reinvest in the nation's health infrastructure and better position the country for the next pandemic. This means, first, putting politics aside and, second, looking to strengthen pandemic preparedness. While the former may be challenging, looking to advance the latter may provide a vehicle to achieving better preparedness outcomes for our national security, economic prosperity and the country as a whole.  

According to the International Monetary Fund, the COVID-19 pandemic could cost the global economy upwards of $12.5 trillion dollars through 2030 — a simply staggering amount of money. With the world heading towards more “zero sum” outcomes as The Economist suggests, finding smart ways of investing at home and ensuring economic resilience will lead to not just better growth, but stronger growth. 

It is fitting that policymakers speak of pharmaceuticals and biotech now in the same breath as semiconductors and other high-tech supply chains. They too are fundamental drivers of economic strength, while also key to our national security. For pandemic preparedness, this means looking at critical investments not as sunk costs, but as an insurance policy that will, inevitably, be drawn upon in the future, whether manmade or natural in origin.  

Too often Congress has seen pandemic preparedness as a luxury at best or simply a sunk cost at worst — something that can be eliminated when the risk or threat is reduced or gone. This has seen our country lurch from crisis to crisis, accelerating spending in the face of an emergent disease only to reduce the rates or even zero out spending once the threat has passed. This inconsistent funding is reflected in our response to novel diseases — little is done at first and then everything is done all at once. This is a costly and risky approach to disease management. Even worse, if we start to see pandemic preparedness and response through a political lens, we become divided on an issue related to the fundamental health of our nation — and our ability to defend ourselves. 

As a starting point, poor policy provokes scattered responses and — despite significant efforts to the contrary — uncoordinated responses. We have the lessons learned, whether from SARS, Ebola, Swine Flu, H5N1, and now COVID-19 — the issue isn’t a shortage of smart ideas, it’s a shortage of political will and a necessary framework. We need to look at pandemic disease not as a series of isolated incidents or accidents but as a long-term management challenge that does, from time to time, demand an increased response.  

The start-stop, all-in or all-out pandemic preparedness approach sends the wrong signals to the private sector which, while not wholly reliant on the government, does look to the government for direction and consistent investment for stockpiling and manufacturing. We are not suggesting that the government subsidize commercial expansion, but that commitments are made to preparedness around which the private sector can plan, compete and innovate. Here, all can learn lessons from the Trump administration’s Operation Warp Speed to the Biden administration’s subsequent vaccine and booster rollouts.  

Ultimately while resources can come from Washington, we have to remember that care will be provided by state and local authorities and doctors, nurses, and EMTs on the pandemic front line. The federal government with its scale and resourcing is the metaphorical 800-pound gorilla in the room — it can do things companies and even state and local governments cannot.  

Yet, it lacks the agility, flexibility and local/subject matter knowledge that the private sector, states and localities have. By investing in pandemic preparedness at this level we can reduce the burden on the federal government, and empower those at the point of care. This means encouraging stockpiling at a local level and augmenting local health care systems and networks. Here the federal government can use its size and scale to get better rates from private sector companies, provide guidance for state and local communities and provide a coordinating function in the event of a crisis.  

While we may feel long removed from COVID-19 the virus, its effects and its legacies are very much with us. Putting the acrimonious politics to the side, we are still registering infections, albeit at much-reduced rates and with much less virulence and lethality. 

Now is not the time to become idle or complacent simply because the immediacy of the threat has ebbed. Rather, it is the time to reflect on what worked and what didn’t, to double down on needed reforms and prepare for the next disease.

Glenn Nye is the president and CEO of the Center for the Study of the Presidency & Congress (CSPC). Dan Mahaffee is the senior vice president & director of Policy at the Center for the Study of the Presidency & Congress, where he leads its Geotech Program.