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Picture: 123RF/LIGHTWISE
Picture: 123RF/LIGHTWISE

In a world that feels increasingly post-pandemic, the reality is that another pathogen more deadly and infectious than Sars-CoV-2 could arise at any time. To break a historic cycle of “panic-and-neglect” in health security, the time to bolster our ability to detect and respond to such biological threats is now.

Doing so will require sustained investment from governments, private corporations, philanthropies and multilateral organisations in sectors of the global bioeconomy crucial to pandemic preparedness and response, such as laboratory infrastructure for testing and genomic sequencing, research & development (R&D) for vaccines and therapeutics, medical equipment supply chains, and training a resilient healthcare workforce.

The effects of a poorly functioning global bioeconomy were seen during early responses to the Covid-19 pandemic as countries either lacked or failed to leverage existing laboratory and healthcare infrastructure. At first arrival of the virus many nations were hindered by insufficient testing capacity, depleted or nonexistent personal protective equipment and ventilator reserves, and chronic failure by many leaders to mobilise resources and expertise in place expressly for pandemic response.

Surveillance of emerging biological threats and the implementation of early response capacities are priorities of the Global Health Security Agenda, a multilateral initiative focused on global preparedness for pandemics and biological attacks. It is of immediate importance to sustain and grow investments that will generate and maintain the technical and laboratory infrastructure necessary for rapid detection and response to biological threats before they pose a widespread risk to the public.

Equitable distribution of resources is imperative to global health security as underinvestment in any one country has the potential to lead to the endemic spread of disease.

As a recent example of the benefits of doing so, genome-sequencing technology, made fast and cheap by investment from the public and private sectors, played a crucial role in the rapid development of Covid-19 vaccines and in tracking the evolution of the Sars-CoV-2 virus.

While funding for surveillance and early-response measures was lacking at the onset of the Covid pandemic, decades of progress in biotechnology and the streamlining of R&D processes helped compensate for early shortcomings of the global response, demonstrating the importance of investment in preventive infrastructure.

Though the rate of vaccine and therapeutic development doubtless helped attenuate the devastating effects of the pandemic, an even quicker pace for developing and distributing vaccines and therapeutics globally is necessary — and possible — to prevent the millions of deaths that future pandemics will cause.

The World Bank’s board of executive directors has unanimously approved a global health security fund tailored to pandemic preparedness and response, and the recent global Covid-19 summits have raised nearly $1bn in initial investments. As this fund is developed it is important that revenue be directed towards developing regional and local infrastructure for epidemic prevention and response in both wealthy and lower- and middle-income countries.

This can be achieved by aligning the fund’s goals with those of the Coalition for Epidemic Preparedness Innovations’ 100 days mission, and by ensuring regional organisations such as the Africa Centres for Disease Control & Prevention, the Caribbean Public Health Agency and the Association for South East Asian Nations health secretariat are at the table as investment decisions are made.

Equitable distribution of resources is imperative to global health security as underinvestment in any one country has the potential to lead to the endemic spread of disease, which places a significant burden on the affected country while also increasing the risk to the international community.

The World Bank facility is a catalytic force around which to rally in the short term. Over the long haul there is the enduring challenge of getting governments to put more money on the table for prevention, preparedness and building institutional resilience. Covid-19 no doubt highlighted the importance of investing in preparedness, but governments typically respond to catastrophic events after the fact.

Politicians come out to mobilise emergency services and support community recovery while — not wishing to sound too cynical — making every effort to be seen to be doing so, always with the eye on re-election. Public servants are thanked for their diligence. By contrast, successful prevention means the crisis is averted, no-one is thanked, there is no publicity, and politicians run scarce. To invest in preparedness is an act of forward-leaning wisdom; it is rarely an act of politics.

The Covid-19 pandemic has exposed severe gaps in health security response systems around the world. It also demonstrated that a strong bioeconomy is an effective safeguard against biological threats. But even in the absence of threats investing in the bioeconomy is a good thing to do as it generates jobs, enhances trade and stimulates innovations that can be leveraged to deal with larger spectrum of challenges, including climate change.

We now have the momentum to make lasting change and strike while the iron is hot to sustainably develop the technology and infrastructure necessary to protect the future of our physical and economic health.

• Dr James is chair of the Centre for Pandemic Research, College of Arts & Sciences, Columbia University, and honorary professor of public health at the Wits University. Rubin Thompson is a medical student at the University of Rochester.

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