- The
coronavirus may feel like it came out of nowhere, but the world has faced several infectious disease outbreaks over the past decade, including MERS in 2012, Ebola in 2013, and the Zika virus in 2015. - Experts have been warning for years that the world is due for another
pandemic and that there needs to be more preparation. - "There's one area though where the world isn't making much progress,"
Bill Gates said in 2018. "And that's pandemic preparedness." - Business Insider talked to epidemiologists, vaccine specialists, and public health experts and asked them all the same question: "How do we protect the world from the next pandemic?"
- Read live updates about the coronavirus here.
Bill Gates warned for years that the world would experience a deadly pandemic.
He also warned — each time — that we were not ready to face such a trial.
At the 2017 World Economic Forum in Davos, Switzerland, the billionaire told CBS that the world should do a better job of readying for an outbreak of a novel disease. Vaccine development would be a good point of focus, he said.
In 2018, Gates rang the same alarm at a talk hosted by the Massachusetts Medical Society and the New England Journal of Medicine.
"There's one area though where the world isn't making much progress," Gates said. "And that's pandemic preparedness."
The Bill and Melinda Gates Foundation in 2018 said it would offer $12 million in grants to encourage the development of a universal flu vaccine and more recently dedicated $250 million in response to the current novel coronavirus pandemic.
Gates says now's the time to start thinking about the next pandemic. In a recent blog post, he said that "Governments and others will invest heavily in being ready" for the next outbreak
"We need to have the ability to scale up diagnostics, drugs and
The world is more connected than ever before and societies are expanding into territories that have long been home to new pathogens unfamiliar to humans.
—CBSNews (@CBSNews) March 19, 2020
Business Insider talked to epidemiologists, vaccine specialists, and public health experts and asked them all the same question: "How do we protect the world from the next pandemic?"
Experts told Business Insider that there needs to be more long-term investment in public health and in organizations like the World Health Organization that are designed to deal with outbreaks. There's also a need for more funding of biomedical research, including vaccine research.
Here's what they said.
'There's no slack in the system'
Dr. Emily Landon, an infectious disease specialist at University of Chicago Medicine, told Business Insider that the key to protecting the world from the next pandemic is to invest in public health and organizations like the World Health Organization.
Landon says a key issue that has played out in the past few months was the limited number of people who could help and the limited resources at hand, including the number of tests available especially near the start of the crisis in the US.
"The more smart people we have at the table, the more we can do," Landon said. "We can't constantly cut funding to public health and then expect that we're going to be prepared."
"There's no slack in the system," Landon said, pointing to the hospitals that were inundated with
"In the hospital, we staff only for what we see on a regular basis," Landon said. "You can't expand for any kind of threat that comes your way. You know you get really stretched thin when things go a little crazy."
Dr. Yvonne Maldonado, a professor of pediatrics and epidemiology at Stanford University said there isn't just one solution to preparing for future pandemics but agrees that improving public health infrastructure would be a key step to take.
A 'shortsighted' lack of investment in public health
"I think that our public health infrastructure is so poorly cared for and it's just something we don't think about," Maldonado said. "We really aren't driven, at least in the US to build up public health infrastructure. Even the World Health Organization battles constantly to get the resources that they need."
Calling the lack of investment in these areas "shortsighted," Maldonado added that "there are many things that we have learned in the past that we have not put into place and some that we have put into place."
"It's really clear to me that we need a better public health infrastructure and surveillance systems to be able to identify diseases when they come along, not just in the US but around the world," she said.
The world also needs more organizations like The Coalition for
"We need to understand how different organisms work and how to scale up potential therapeutics for all of these pathogens," she said.
We already know what we need to do to prepare for the next pandemic
Public health experts say we already know the steps we need to take to prepare based on what we've learned from previous pandemics.
"We know there will be future pandemics, but we don't know when they'll happen," Jeremy Youde, dean of the College of Liberal Arts at the University of Minnesota and a global health policy researcher, told Business Insider.
"On the one hand we're trying to figure out how we can try to learn from what's happened in the past and on the other hand, we have to have systems that are resilient enough that they can be really flexible and can be useful in situations that we may not even be able to conceptualize at this point," Youde said.
According to Youde, building out networks that can adequately handle future crises as well as running through potential scenarios and workshopping different responses is crucial.
Youde said that after prior pandemics, there has often been an acknowledgement that more preparation needs to happen. What there hasn't been, he says, however, is "a lot of emphasis on the follow-through."
Tolbert Nyenswah, a senior research associate at the Johns Hopkins Bloomberg School of Public Health and the former deputy minister of health in Liberia, where he led the Ebola outbreak response, told Business Insider that there are already key documents that are available that highlight what the world needs to do in order to prepare for future pandemics.
They include a UN report published after the Ebola outbreak, that outlines 27 recommendations that the world should take to prevent another such event, and a set of policy recommendations by an independent expert group headed by Bill Gates.
There is also the Global Health Security Index, Nyenswah said, which offers insight into the global health security capabilities of 195 countries around the world and offers recommendations to improve.
Nyenswah said that so far, countries have tended to ignore these documents once crises pass.
Nyenswah said he believes that after the current coronavirus pandemic slows, global organizations and countries may commit themselves to implementing some of the recommendations that have been suggested for years.
Though the documents vary in scope, suggestions include things like robust disease prevalence assessment and response, research and development of vaccines and therapeutics, and the establishment of global coordination to ensure efficient response.
Nyenswah said that he believes if these things were in place, the coronavirus outbreak would have stopped in Wuhan.
Vaccine scientists say we need to keep preparing vaccine candidates for future pandemics "even when the threat is not nipping at our heels"
Dr. Greg Poland, director of the Mayo Clinic's Vaccine Research Group, said there are three keys to preparing for the next pandemic.
The first is to acknowledge that "no country can do it alone."
The second is to understand that such an event could occur in the future. "We've had three novel coronaviruses jump the species barrier in 18 years to infect humans," Poland said. "Are we ready for coronavirus four and five?"
The third, Poland continued, is preparedness. "I have been part of tabletop exercises that have repeatedly shown the very things we are now suffering as a nation and as a globe," Poland said. "This is not a surprise. The only surprise was no one knew the timing."
"We are going to have to cooperate with each other. We need robust global surveillance and data sharing and we have to rethink preparedness," he continued. "Nobody wants to do it because of the cost, but I will posit to you that all of the savings from not having done this were wiped out in the first week or two of this pandemic."
According to Poland, the world needs a strategic stockpile robust enough to handle something like another pandemic, and to invest in vaccine research.
"Even when the threat is not nipping at our heels, we could have, should have had a coronavirus vaccine." Poland said.
Dr. Stanley Plotkin, a leading voice in vaccine development who helped discover the rubella virus vaccine in the 1960s, emphasized the importance of vaccine research as well.
"We know that there are viruses out there that could conceivably become epidemics and the idea is to prepare prototype vaccines so that if an epidemic occurs, one has taken the first steps to produce a prophylactic vaccine," he said.
Pointing to the Trump administration's recent announcement that it would cut funding for the WHO, Plotkin said, "one of the reasons for deploring the decision by Trump to reduce funding to the WHO is that it's just the sort of activity which should be fostered."
Dr. Maria Elena Bottazzi, associate dean of the National School of Tropical Medicine at Baylor College of Medicine, told Business Insider that there needs to be more long-term investment in pandemic-related research.
Bottazzi previously worked on a SARS vaccine candidate, but once the virus' threat declined, the funding for her research did as well. She said that when beginning research for vaccine candidates, there wasn't a guarantee that even if the data continued to be promising, the investments would continue.
At the end, she said, "there really was no path forward because nobody really has any interest anymore."
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