PandemicsThree reasons the U.S. is not ready for the next pandemic

By Christine Crudo Blackburn, Andrew Natsios, and Gerald W. Parker

Published 20 August 2018

In the midst of a pandemic, decisions must be made quickly. Quick decision-making can often be hindered by the absence of high-level leadership. The need for high-level leadership, coordination and a new strategy are essential to mitigate the threat of pandemics, but these fundamental pandemic preparedness gaps persist. The next great pandemic is coming. The true question is: Will we be ready when it does? Right now, that answer is no, because the country lacks the sufficient safeguards we have outlined. But if the United States chooses to elevate the issue of pandemic preparedness and biosecurity as a national security priority, we could be. Outbreaks are inevitable, but pandemics are not if we take action now.

One hundred years after the Great Influenza pandemic of 1918, global health leadership stands at a crossroads. The United States continues to expand its policy of isolationism at a time when international cooperation in health could not be more important. The state of pandemic preparedness and the necessary steps for protecting the people throughout the world was the topic of The Scowcroft Institute for International Affairs’ 2nd Annual White Paper.

As pandemic policy scholars, with two of us spending the majority of our career in the federal government, we believe that it is essential to prepare the country and the world for the next pandemic. It is not a matter of if, but when, the next disease will sweep the world with deadly and costly consequences.

There are many topic areas that national leaders must address to create better preparedness and response capabilities, but we believe three are most urgent. These include targeting the resistance to antimicrobial agents that has come about because of overuse and misuse of antibiotics; ensuring continuity of supply chains; and improving and strengthening leadership.

Overuse of a wonder drug
Prior to Alexander Fleming’s discovery of penicillin, even the smallest scratch could be deadly. Its discovery, however, helped contribute to the perception that man had conquered disease, despite Fleming’s warning that “the thoughtless person playing with penicillin treatment is morally responsible for the death of a man who succumbs to infection with the penicillin resistant organism.” Now, 70 years later, society is quickly reaching the precipice of that reality.

The problem of antibiotic overuse and misuses is extensive. In fact, in the United States, 80 percent of all antibiotic use occurs in the agricultural sector and the majority of this use is nontherapeutic, meaning it is not medically necessary. Misuse of antibiotics also occurs frequently in the human health sector, however. The Review on Antimicrobial Resistance estimated that if changes are not made, the world could witness 10 million deaths annually due to antimicrobial resistant infections.