A report from the Scowcroft Institute of International Affairs at Texas A&M’s Bush School of Government and Public Service presents an overview of the systems and institutions in place for dealing with rapidly emerging pandemics at the national and international levels. The report highlights many of the shortcomings in our ability to respond to these crises, especially at the international level. The report identifies nine priority areas where national and international pandemic response can be improved, and offers actionable policy suggestions to improve them. these areas are leadership, international response, addressing the anti-vaccine movement, human and animal health, uniform health screening, public health and public healthcare infrastructure, effective outbreak response, cultural competency, and academic collaborations.
The report finds that the structure of domestic governmental and international organizations is fragmented and lacks coordination, leading to delayed responses and infighting when a pandemic arises. The Scowcroft report suggests establishing strong, centralized leadership within the federal government, particularly within the office of the Vice President, to coordinate biodefense and pandemic preparedness across federal agencies, and streamlining the process for funding these efforts.
Due to shortcomings in its response to the 2014 ebola outbreak in West Africa, the World Health Organization (WHO) received significant criticism and calls for reform. The Scowcroft report recommends adopting reforms suggested by the WHO’s internal advisory group, and to centralize power and authority toward the global WHO and away from the regional offices.
A significant obstacle to pandemic and bioterrorism response, particularly in Europe and the United States is the influence of the anti-vaccine movement. Driven by conspiracy theories or the belief that vaccination is the cause of autism, many communities are dangerously approaching non-vaccination rates that would compromise herd immunity, the protection of the non-vaccinated population by the immunity of the vaccinated population. The Scowcroft report suggests public health information campaigns to counter pseudoscience spread by anti-vaccine activists. They also recommend that states repeal personal belief exemptions that exist in many states’ requirements for children to be vaccinated before attending public school, as well as the promotion of research into the true causes of autism to assuage anti-vaccine sentiments.
The report calls to attention the importance of coordinating human and animal health policies. Most epidemic diseases are zoonotic, in that they are transferred to human populations from animal populations. These diseases can come from wild animals, domestic animals, or be transmitted from one group of animals to another before infecting humans. The report recommends the expansion of vaccination programs to protect livestock, domestic animals, and wildlife from disease, and an increase in the surveillance of animal populations for the emergence and spread of new diseases. The report also recommends that animal and human health officials collaborate in a “One Health” approach to global healthcare.
Also of concern is the screening system the United States uses to identify and quarantine disease in individuals entering the United States. Our current system, for instance, requires that immigrants be vaccinated before being allowed entry, but does not apply that rule to refugees. The Scowcroft report recommends implementing infectious disease screenings, requiring vaccination for refugees, and implementing infectious disease screening on travelers remaining in the US for more than three months.
The Scowcroft report also addresses the shortcomings in the public health and medical infrastructure in the developing countries where pandemic diseases are likely to emerge. The report recommends that NGOs and local governments direct funding toward improving local health and medical infrastructure, and recommends partnerships between USAID and developing nations, as well as supporting the Global Health Security Agenda.
The report details the importance of decreasing our response time to pandemic outbreaks. In situations involving infectious disease, the quicker we can respond, the easier it is to defeat the pandemic and the most lives can be saved. The report recommends that Congress designate biosurveillance and diagnostics high-priority budget items. It also recommends the US that draws on resources from the USAID Office of Foreign Disaster Assistance (OFDA) in dealing with all international pandemic response, as it is the agency best situated to do so.
The Scowcroft report identifies our cultural competency in pandemic response. Peoples in areas affected by an infectious disease outbreak may have cultural practices that are hostile to western medicine and health authorities, or which promote interactions with the sick or deceased which may facilitate the further spread of disease. The report highlights the role that cultural anthropologists and crisis communication specialists must play in ensuring that health authorities are taking the right approach when interacting with local populations.
Finally, the Scowcroft report recognizes the roll that universities must play in responding to pandemic. Universities are useful because they are local and on-the-ground repositories of information that can assist health authorities in responding to local disease outbreaks. The report recommends that universities be made responders to outbreaks alongside governments and NGOs.
The ability for the global community to respond to pandemic has been greatly increased compared to earlier times, such as during the 1918 flu pandemic that killed hundreds of millions. Nonetheless, the Scowcroft Institute’s white paper has identified myriad ways in which national and international response can be improved. Our ability to make the correct changes to our response systems will dictate the extent to which the next major disease outbreak will stopped early on, or will cause major disaster.
Convergence Ventures’ partner Greffex believes in the importance of shortening the response time to infectious disease outbreak. Their breakthrough plug-and-play vaccine design leads to incredibly short development and manufacturing times compared with other vaccines currently on the market. In situations where days and weeks count, getting vaccines to outbreak-effected populations quickly and efficiently is paramount.