Global health experts advise advance planning for inevitable pandemic

Source(s): Georgetown University

As director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, Anthony S. Fauci, MD, has worked with five presidents who all faced pandemics early in their presidencies. At “Pandemic Preparedness in the Next US Presidential Administration,” a gathering of students and global health experts from academia, government and advocacy at Georgetown on Tuesday, Fauci and other global health leaders encouraged the incoming Trump administration to plan accordingly.

“If there’s one message that I want to leave with you today based on my experience, it is that there is no question that there will be a challenge to the coming administration in the arena of infectious diseases,” Fauci said.

The event was organized by the Center for Global Health Science and Security (GHSS) at Georgetown University Medical Center in partnership with the Harvard Global Health Institute.

In addition to the upcoming inauguration of President Trump, the event’s timing coincided with leadership changes at major global health organizations including the UN, World Bank, WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria, making this an important moment for pandemic preparedness.

“It’s hard to think of a more important time for this kind of meeting and for activism and a willingness to speak out in the public health community and the global health community than it is right now on the eve of Donald Trump becoming our next president,”  said Ronald A. Klain, JD (C’83), general counsel for Revolution LLC and the Obama administration’s former Ebola “czar”.

Planning - and paying - for a pandemic

“If you think about all the things that could very quickly devastate a population, devastate a country, pandemics is really near if not at the top of that list,” said Ashish K. Jha, MD, MPH, director of the Harvard Global Health Institute. Significant progress towards pandemic preparedness has been made but a lot of work remains, he added. “I would argue that still today, in many ways, we are not ready for the next big pandemic, which is going to come at some point, and so the question is, how do we get ready?

Realizing that a pandemic is inevitable is a significant first step that the incoming Trump administration can take towards improving pandemic preparedness. “No matter how much an administration believes and wants to believe that the secretary of health and human services and other members of the cabinet on the domestic side will be totally focused on a domestic agenda, something will happen at an unexpected point that will change that thinking,” said Bill Steiger, PhD, chief program officer at Pink Ribbon Red Ribbon, an international organization dedicated to fighting women’s cancers. “So you might as well prepare for that from the beginning.”

Setting up a funding mechanism to pay for pandemic response in advance is another critical step the Trump administration can take to prepare for a pandemic, said Amy E. Pope, JD, deputy assistant to the president and deputy homeland security advisor on the National Security Council staff at the White House. There are resources that can be quickly deployed when a community is devastated by a hurricane but not a pandemic, Pope said. “That means we are negotiating with Congress every time we need resources to address an emerging infectious disease and you all know that is a terrible way to do business and does not leave us in a very safe place,” she said.

Fauci faced that situation during last summer’s Zika outbreak. “We need [a public health emergency fund] because of what we had to go through for Zika,” he said. “I mean, it was very, very painful when the president asked for the $1.9 billion in February and we didn’t get it until September. That was a very painful process.”  

Hamid Jafari, MD, principal deputy director of the Center for Global Health and acting director of the division of global health protection at the Centers for Disease Control and Prevention, concurred. “What we are learning is that public health preparedness goes hand in hand with financial preparedness,” he said. “You cannot prepare for public health and not have financial preparedness.”

Laying the groundwork for a new initiative

“The threat of a pandemic is very real,” said Rebecca Katz, PhD, MPH, co-director of the Center for Global Health Science and Security at Georgetown University Medical Center and associate professor of international health at the School of Nursing and Health Studies. “And there are also a lot of gaps in our capacity to prevent, detect and respond. But there are also a lot of very exciting avenues to improve our approaches and to explore new initiatives.”

One such initiative is expected to launch later this year. The Georgetown Global Health Initiative will bring together research and education opportunities across the university, including the School of Medicine, School of Nursing and Health Studies, Law Center, McCourt School of Public Policy, School of Foreign Service and other institutes and centers, said Edward B. Healton, MD, MPH, executive vice president for health sciences and executive dean of the School of Medicine.

“The role of academic centers and institutions in global health is perhaps more important now than ever before,” Healton said. “Our overarching goal is to leverage our research and educational programs in a way that allows our institution, working in many cases with partners such as our colleagues at Harvard here today, to enhance the meaningful contributions and the real impact that we and other academic institutions can have on global health.”

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