The microbes are winning and we are unprepared for the fight. Louis Pasteur got it right in the 19th century when he said
“Messieurs, c’est les microbes qui auront le dernier mot.”
(Gentlemen, it is the microbes who will have the last word.)
Admittedly we have had plenty of successes against the microbes. We’ve improved sanitation, hygiene and antimicrobials. We’ve eradicated smallpox, developed vaccinations for many diseases so they are now less of a threat then they were in previous generations and we have organizations like the Gates Foundation and the Carter Center working to end various infectious diseases. But if the 2014 West African Ebola epidemic has taught us anything, it’s that, as a global nation, we are so very unprepared for the next pandemic or plague.
A report titled “The Neglected Dimension of Global Security” from the National Academy of Medicine, highlights the fact that future pandemics are a huge threat to the world. As a consequence of increasing population, economic globalization, environmental degradation and ever-increasing human interaction around the globe, humanity should expect a growing increase of infectious disease threats to global security. According to Peter Sands, Chair of the Commission of Global Health Risk which put together the report, we have not done nearly enough to prepare for or prevent potential pandemics. Part of the issue is the way pandemics are perceived as a health issue, and building defenses for a potential future event falls by the wayside in the face of more immediate concerns, such as war, terrorism, financial crises, etc.
Past pandemics give us reason to worry about the scale of future pandemics. The 1918 influenza pandemic killed anywhere from 50 million to 100 million people, since 1900 only WWII killed more people. HIV/AIDS has killed 35 million people, no war or disaster in the last 50 years can compare to the loss of life caused by HIV/AIDS.
It has been calculated that the annual expected cost of potential pandemics is around $60 billion, compared to the Commission’s recommendation of incremental spending of $4.5 billion per year (65 cents per person per year). Even if these estimations prove to be incorrect, spending too much money on potential pandemics will reap rewards in other ares such as antimicrobial resistance and endemic diseases. However, if too little money is spent the potential of a catastrophic pandemic becomes even more likely.
The Commission recommends changes in three broad areas: first, reinforcing public health capabilities and infrastructure of health systems so individual nations can respond effectively as the first line of defense; second, reinforcing international leadership for better coordination and response; third, increasing research and development in the infectious disease area.
Pasteur’s comments highlight the difficulties of fighting infectious diseases. Although we have many tools to fight infectious diseases that we didn’t have in Pasteur’s time, there are still too many areas of the world without access to those tools. The Commission’s report provides a framework for addressing these disparities on the country level and on the global level. The challenge now is to make the recommendations happen. Humanity is unprepared for the coming pandemic or plague and we are running out of time to get prepared.