Governments and international institutions must take bold steps to manage the mounting threat of deadly disease outbreaks. This is the stark warning of a report released today by an international group of experts, which outlines concrete actions to prepare the world for health emergencies, recognizing that investing in preparedness before a crisis strikes saves lives and saves money.

Despite the increasingly dire risk of widespread epidemics, the world remains unprepared. The Global Preparedness Monitoring Board (GPMB) warns that epidemic-prone diseases like Ebola, influenza and SARS are increasingly difficult to manage in the face of prolonged conflict, fragile states, and forced migration. At the same time, the threat of a pandemic spreading around the globe is a real one – a quick-moving pathogen has the potential to kill tens of millions of people, disrupt economies, and destabilize national security. Climate change, urbanization, and a lack of adequate water and sanitation are all breeding grounds for fast-spreading, catastrophic outbreaks.

“For too long, world leaders’ approaches to health emergencies have been characterized by a cycle of panic and neglect,” said Dr. Gro Harlem Brundtland, co-chair of the GPMB. “It is high time for urgent and sustained action. This must include increased funding at the community, national and international levels to prevent the spread of outbreaks. It also requires leaders to take proactive steps to strengthen preparedness coordination mechanisms across governments and society to respond quickly to an emergency.”

The report emphasizes that although governments and international institutions have taken steps to increase preparedness for outbreaks since the deadly Ebola crisis in West Africa five years ago, current preparedness efforts are grossly insufficient. The current Ebola outbreak in the Democratic Republic of the Congo demonstrates how the lack of trust between communities and authorities can undermine the response during a health emergency. By contrast, after people infected with the virus crossed the border to Uganda this past summer, public health authorities, health care workers, and community volunteers were at the ready, with a preparedness plan in place. The cases were quickly detected and isolated before anybody else could be infected.

“The trust between communities and the institutions that serve them is at the core of an emergency response, but it is almost impossible to build trust in the middle of a crisis,” said GPMB co-chair Mr Elhadj As Sy, the Secretary General of the International Federation of Red Cross and Red Crescent Societies. “Community engagement and trust cannot be an afterthought, it has to be earned. Leaders and public health authorities must work as partners with communities to build that trust. We can’t just show up once a health crisis hits. We need to be there before, during and after.”

The report highlights that an outbreak equivalent to the 1918 influenza pandemic could kill an estimated 50 to 80 million people, spreading around the world in less than 36 hours and wiping out nearly five percent of the global economy. In the case of a pandemic, many national health systems would collapse, with low-resourced communities hit the hardest.

“Ebola, cholera, measles – the most severe disease outbreaks usually occur in the places with the weakest health systems,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “As leaders of nations, communities and international agencies, we must take responsibility for emergency preparedness, and heed the lessons these outbreaks are teaching us. We have to ‘fix the roof before the rain comes.’”

As noted in the report, some recent progress on scaling up in-country preparedness. As of July 2019, 59 countries developed a National Action Plan for Health Security, yet, none of have been fully financed. In order to be fully prepared, all countries must create a fully costed and financed action plan, with international funders stepping in to close gaps for the poorest and most vulnerable countries.

“Poverty and fragility exacerbate outbreaks of infectious disease and help create the conditions for pandemics to take hold”, said Axel van Trotsenburg, Acting CEO of the World Bank, which is a co-convener of the GPMB along with WHO. “Investing in stronger institutions and health systems will promote resilience, economic stability and global health security.”

In the report, the GPMB urges leaders to follow through on seven urgent actions (detailed below) to ensure the world is better prepared for the next health emergency. It calls on heads of state and governments to increase funding for preparedness and research into new technologies, strengthen response systems across sectors and follow through on international commitments. At the international level, the GPMB calls for intergovernmental organizations, donors and multilateral institutions to build preparedness into funding mechanisms, strengthen coordination and rapid communication systems, and monitor progress continually.


About the GPMB
As an independent monitoring and advocacy body, the GPMB urges political action to prepare for and mitigate the effects of global health emergencies. Co-convened by the World Bank Group and the WHO, the GPMB works independently to provide expert assessments and recommendations on the state of global preparedness. The opinions and recommendations contained in the GPMB report are those of the Board and do not necessarily represent the views of the World Bank Group and WHO.

The 15-member Board is made up of political leaders, heads of agencies, and experts, led jointly by Dr Gro Harlem Brundtland, former Prime Minister of Norway and former Director-General of the WHO, and Mr Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies.

Future work of the GPMB will include monitoring progress on this report’s recommendations and assessing the world’s preparedness for health emergencies caused by non-biological risks, including natural disasters. The GPMB aims to advocate at the highest levels so that commitments to preparedness remain high on the political agenda.

A full list of board members can be found on the GPMB’s website.

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