Pandemics, which are large disease outbreaks that affect several countries, pose major health, social, and economic risks. A severe pandemic can result in millions of deaths, and even the most conservative estimates suggest that pandemics destroy up to 1% of global GDP, which is comparable to other top-priority threats, such as climate change. Recent economic work estimates that the annual global cost of moderately severe to severe pandemics is roughly $US 570 billion, or 0.7% of global income.
The last 30 years have seen a steady increase in the frequency and diversity of disease outbreaks. With unprecedented mobility of people, products, and food, the myriad of disease-causing microorganisms are also increasingly mobile. No nation is immune to this growing global threat that can be posed by an isolated outbreak of an infectious disease in a seemingly remote part of the world. Most of these outbreaks are caused by pathogens of animal origin that are transmitted to people, such as Ebola and avian flu. While outbreaks are inevitable, strong health systems can allow countries to better detect and respond to diseases and prevent an outbreak from becoming a pandemic.
The world is still doing too little
It is not a question of if, but when we will face the next major pandemic -- yet we are still stuck in an unsustainable cycle of panic and neglect. While progress has been made since the recent Zika and Ebola crises, a report by the International Working Group on Financing Preparedness, established by the World Bank, finds that most countries are still not adequately prepared for a pandemic. Many countries chronically underinvest in critical public health functions like disease surveillance, diagnostic laboratories, and emergency operations centers, which enable the early identification, response, and containment of outbreaks. This is especially short-sighted given the low cost of preparedness relative to the devastating impact of a pandemic. In low- and middle-income countries that have calculated the cost of financing preparedness the investment required is up to $1 per person per year.
The purpose of robust pandemic preparedness is universal health security, protecting all people from threats to their health. Universal health security is an essential part of the World Bank Group’s (WBG) ultimate goal of achieving universal health coverage, where everyone can access the quality health services they need without suffering financial hardship, by 2030. Universal health security both depends on and complements broader efforts to strengthen health systems and make them more resilient. It is also critical to attaining the Sustainable Development Goals and the WBG’s twin goals of ending poverty and boosting shared prosperity.
What the World Bank is doing
The WBG supports countries in their efforts to prevent pandemics by strengthening veterinary and human health systems, as well as the bridges between them. IDA 18 includes a scaled-up commitment over three years, starting in July 2017, from the WBG to strengthen pandemic preparedness in at least 25 countries. The work has commenced with an initial focus on 11 countries, including Kenya, Senegal, Ghana, Sierra Leone, Myanmar, Vietnam, Cambodia, Afghanistan, Haiti, Sudan, and Tanzania. The WBG is also working on a series of pandemic simulation exercises. Aimed at global and country policymakers, these exercises are intended to raise awareness of the threat posed by pandemics, test the systems that are currently in place, and drive increased investment for pandemic preparedness.
As part of its efforts to strengthen health systems following the devastation caused by Ebola, the WBG and its partners launched the Regional Disease Surveillance Systems Enhancement (REDISSE) Program in Guinea, Senegal and Sierra Leone, and in a second wave added Guinea Bissau, Liberia, Nigeria, and Togo. The initiative is an interdependent series of projects working to strengthen national, regional, and cross-sectoral capacity for integrated disease surveillance and response in the region.
The WBG, with the support of Japan, Germany and the World Health Organization, has also developed the Pandemic Emergency Financing Facility (PEF), a quick-disbursing financing mechanism that provides a surge of funds to enable a rapid and effective response to a large-scale disease outbreak. Eligible countries can receive timely, predictable, and coordinated surge financing if affected by an outbreak that meets PEF’s activation criteria. The PEF breaks new ground by providing the first-ever insurance for pandemic risk, offering coverage to all low-income countries eligible for financing under IDA.
Strengthening health systems and investing in outbreak preparedness is also one of the best ways to contain antimicrobial resistance (AMR). This occurs when antibiotics and other antimicrobial drugs no longer treat infections. While AMR is natural, its spread has been dramatically accelerated by over-use and misuse of antimicrobials, including antibiotics, in people and animals.
If AMR continues to spread unchecked, not only will many common infections become untreatable again, resulting in prolonged illness, disability, and death, there will also be enormous economic losses globally. Research by the World Bank finds that by 2050 in a worst-case AMR scenario, low-income countries could lose over 5% of their GDP and up to 28 million people, mostly in developing countries, would be pushed into poverty.
To help prevent this, the WBG is supporting country efforts to tackle AMR by systematically including it in our health investments in the developing world. Together with partners, the focus is on developing more AMR-specific interventions like stronger antimicrobial stewardship that reduces overuse, increased infection prevention and control, and the appropriate use of antibiotics in animal husbandry. At the global level, the WBG is creating an investment framework for the existing AMR Global Action Plan to be used by policymakers to ensure that that AMR investments go where they are needed most.
The East Africa Public Health Laboratory Networking Project (EAPHLN) is an example of a regional laboratory network that may soon be able to support AMR surveillance capabilities. The WBG-funded project is establishing a network of efficient, high quality, accessible public-health laboratories in the East Africa to help strengthen diagnostic and surveillance capacity and disease outbreak preparedness.
Last Updated: Jul 18, 2017