## Toward better pandemic preparedness ## Source details **Canonical URL:** [Toward better pandemic preparedness](https://www.imf.org/en/publications/fandd/issues/2021/12/pandemic-preparedness-patel-sridhar) ## Other formats - [Markdown version](/en/publications/fandd/issues/2021/12/pandemic-preparedness-patel-sridhar/index.md) - [Structured JSON version](/en/publications/fandd/issues/2021/12/pandemic-preparedness-patel-sridhar/index.json) - [Bundle manifest](/en/publications/fandd/issues/2021/12/pandemic-preparedness-patel-sridhar/bundle-manifest.json) ## Bibliographic details - Authors: JAY PATEL, DEVI SRIDHAR - Published: December 2, 2021 --- ### Key observations: pandemic performance versus preparedness metrics - The Global Health Security Index in 2019 ranked the United States as best prepared and the United Kingdom as next best prepared; two years later the United States had endured the highest global death toll from COVID-19, with more than 700,000 deaths. - The United Kingdom recorded seven times more deaths than the 20,000 that its government chief scientific adviser suggested in March 2020 would be a “good outcome.” - Based on a 2018 WHO self-assessment of IHR implementation, 86 percent of countries in Europe were deemed at the highest levels of pandemic preparedness on paper. - In practice, Europe experienced the second highest death rate from COVID-19 of any region, at 1,294 per million people. - Conversely, WHO judged just 15 percent of countries in Africa to be adequately prepared, yet fewer than 205 deaths per million have been reported in Africa. - Predictive metrics failed to capture the value of prior outbreak experience, cross-country collaboration, and community-based response capacities (examples: Liberia, Sierra Leone, Senegal). ### What went wrong in seemingly resilient systems - Effective health care requires four elements: “staff, stuff, space, and systems.” - Example of mismatch: the UK built seven Nightingale Hospitals at a cost of $736 million that largely went unused because trained staff were insufficient. - Large health systems were overstretched: examples cited include Italy’s Servizio Sanitario Nazionale and Brazil’s Sistema Único de Saúde. - Routine essential health care provision remains fragile in these countries. ### Successful country practices and capacity building - Community-based, bottom-up approaches helped many countries avoid harsher measures in 2020: - Thailand: four decades of volunteer recruitment mobilized for logistics and remote area coverage. - Vietnam: use of existing local governance for community-based coordination of quarantines and self-isolation. - Japan: rapid training of public health nurses enabled thorough retrospective and prospective contact tracing to identify main clusters within weeks. - Senegal: Institut Pasteur de Dakar was one of only two laboratories in Africa able to test for SARS-CoV-2 in February 2020; free tests yielded results within 24 hours or less; by April 2020, 43 African countries had the capacity to effectively diagnose COVID-19. - Adaptations from Ebola responses (2014–16) in West Africa improved community-based care and quarantine measures. ### Economic case for prevention and preparedness - Estimates cited: by 2025, COVID-19 will have a global economic burden of $16–$35 trillion (McKinsey & Company and an independent G20 panel). - Even modest reductions in this cost from better preparedness would yield substantial absolute returns on investment. - Investing in health delivers two types of dividends: - Immediate: better responses to acute public health emergencies, including antimicrobial resistance. - Long-term: healthier and more equitable societies, which improve everyday health care and fiscal protection and speed economic recovery (example: Finland). ### Science, vaccine equity, and manufacturing - Rapid development of multiple safe and effective COVID-19 vaccines reflects decades of investment in scientific research. - Governments must continue support for science and technology, including during uncertain periods, to accelerate future responses. - The COVAX Facility has underdelivered: lacking financial power to lower prices, forced to the back of the queue and reliant on donations. - Example of hoarding: Canada ordered doses equal to 10 times its population. - Recommendation: build and scale up vaccine manufacturing hubs in low-income regions to end the acute phase sooner and provide infrastructure for other infectious diseases. ### Global governance, IHR, and WHO - The International Health Regulations (IHR) legally bind 196 countries to develop capacities to rapidly report and respond to disease outbreaks. - During the pandemic many countries complied only in part, due to incomplete awareness or deliberate flouting of the regulations. - A revamped IHR should: - Adopt a more nuanced alerting mechanism. - Empower WHO to continually review and improve member states’ compliance. - WHO needs adequate financial support, authority, and trust to ensure better compliance. - Specific funding suggestion: an increase in funding of $1 billion a year in assessed contributions for the WHO would be a start. ### Conclusions and imperative - Successes and failures in the COVID-19 pandemic clarify actions needed to be better prepared for the next pandemic. - Investing in prevention and preparedness, strengthening local public health capacity, supporting science, building regional manufacturing, and reinforcing global health governance are central priorities. - Quotation framing the article’s message: Benjamin Franklin—“An ounce of prevention is worth a pound of cure” and “By failing to prepare, you are preparing to fail.” *Source: Toward better pandemic preparedness, JAY PATEL and DEVI SRIDHAR, December 2021.* --- ## Content in this bundle - **نحو المزيد من التأهب لمواجهة الجوائح** - [نحو المزيد من التأهب لمواجهة الجوائح (Markdown version)](/-/media/files/publications/fandd/article/2021/december/ar/patel.pdf.md){rel="alternate" type="text/markdown"} - [نحو المزيد من التأهب لمواجهة الجوائح (PDF)](/-/media/files/publications/fandd/article/2021/december/ar/patel.pdf){rel="external" type="application/pdf"} - **Hacia una mejor preparación para pandemias ● Finanzas y Desarrollo ● Diciembre de 2021** - [Hacia una mejor preparación para pandemias ● Finanzas y Desarrollo ● Diciembre de 2021 (Markdown version)](/-/media/files/publications/fandd/article/2021/december/es/patel.pdf.md){rel="alternate" type="text/markdown"} - [Hacia una mejor preparación para pandemias ● Finanzas y Desarrollo ● Diciembre de 2021 (PDF)](/-/media/files/publications/fandd/article/2021/december/es/patel.pdf){rel="external" type="application/pdf"} - **Vers une meilleure préparation aux pandémies** - [Vers une meilleure préparation aux pandémies (Markdown version)](/-/media/files/publications/fandd/article/2021/december/fr/patel.pdf.md){rel="alternate" type="text/markdown"} - [Vers une meilleure préparation aux pandémies (PDF)](/-/media/files/publications/fandd/article/2021/december/fr/patel.pdf){rel="external" type="application/pdf"} - **Toward Better Pandemic Preparedness** - [Toward Better Pandemic Preparedness (Markdown version)](/-/media/files/publications/fandd/article/2021/december/patel.pdf.md){rel="alternate" type="text/markdown"} - [Toward Better Pandemic Preparedness (PDF)](/-/media/files/publications/fandd/article/2021/december/patel.pdf){rel="external" type="application/pdf"} - **完善疫情防范措施 ●《金融与发展》● 2021年12月号** - [完善疫情防范措施 ●《金融与发展》● 2021年12月号 (Markdown version)](/-/media/files/publications/fandd/article/2021/december/zh/patel.pdf.md){rel="alternate" type="text/markdown"} - [完善疫情防范措施 ●《金融与发展》● 2021年12月号 (PDF)](/-/media/files/publications/fandd/article/2021/december/zh/patel.pdf){rel="external" type="application/pdf"} --- _Source: https://www.imf.org/en/publications/fandd/issues/2021/12/pandemic-preparedness-patel-sridhar_