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Global Health Security in an Era of Explosive Pandemic Potential

Abstract

Pandemics pose a significant risk to security, economic stability, and development. Annualized expected losses from pandemics are estimated at 60billionperyear.Despitethecertaintyandmagnitudeofthethreat,theglobalcommunityhassignificantlyunderestimatedandunderinvestedinavoidanceofpandemicthreats.Wecannotwaitorcontinuewiththestatusquo,inwhichwepayattentiontoinfectiousdiseasethreatsonlywhentheyareattheirpeakandthenarecomplacentandremainvulnerableuntilthenextmajoroutbreak.Toreinforceandsustaininternationalfocus,funding,andaction,itiscrucialthatpandemicsrisetothelevelofhighpolitics,becomingstandingagendaitemsforpoliticalactors.Inthisarticle,wemakethecaseforfundamentalreformoftheinternationalsystemtosafeguardglobalhealthsecurity.WebuildontheactionagendaofferedbyfourinternationalcommissionsformedinthewakeoftheEbolaepidemic,callingfortherecommendedpeacedividend(anannualincrementalinvestmentof60 billion per year. Despite the certainty and magnitude of the threat, the global community has significantly underestimated and underinvested in avoidance of pandemic threats. We cannot wait or continue with the status quo, in which we pay attention to infectious disease threats only when they are at their peak and then are complacent and remain vulnerable until the next major outbreak. To reinforce and sustain international focus, funding, and action, it is crucial that pandemics rise to the level of “high politics,” becoming standing agenda items for political actors. In this article, we make the case for fundamental reform of the international system to safeguard global health security. We build on the action agenda offered by four international commissions formed in the wake of the Ebola epidemic, calling for the recommended “peace dividend” (an annual incremental investment of 4.5 billion – 65 cents per person) to strengthen global preparedness, for the United Nations to play a greater role in responding to major global health and humanitarian emergencies, and for an effective and efficient R&D strategy with multiple stakeholders—governments, academics, industry, and civil society—identifying R&D priorities and leading a coordinated response. If our action plan were adopted, it would safeguard the global population far better against infectious disease threats. It would reap dividends in security, development, and productivity

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