A new report from the Scowcroft Institute of International Affairs at The Bush School of Government and Public Service at Texas A&M University identifies several weak links or “breakdowns in the system” that could increase risk of global pandemics.

The white paper, titled “The Growing Threat of Pandemics: Enhancing Domestic and International Biosecurity,” aims to create an effective plan for reducing the threat of global pandemics and reducing the need for costly emergency funding to react to outbreaks once they are out of control. 

Among several other concerns, the authors cite the interface between animal and human health, zoonotic disease and the need for a “one-health” strategy for public health.

The list of challenges includes:

1.       Leadership: The authors recommend that United States leadership in biodefense be centralized in the White House, specifically within the Vice President’s office, with a Biodefense Council overseen by the Vice President

2.       International Response: The authors endorse recommendations from a World Health Organization (WHO) advisory group to re-evaluate and reform pandemic response plans. They also note that WHO Regional Office Directors, currently operating independently, should report directly to the Director-General for more efficient communication and organization during pandemic response.

3.       The Anti-Vaccine Movement: Driven by misinformation, the anti-vaccine movement in the United States continues to grow. The authors note that non-medical exemptions to vaccination requirements in some areas are approaching levels below the threshold for “herd immunity.” They recommend that states re-evaluate acceptance of personal belief or philosophical exemptions and remove them as exemption options.

4.       Animal – Human Health: The majority of emerging diseases are zoonotic. Some recommendations include expanded animal vaccination programs, institutionalization of One Health, increased disease surveillance along wildlife/livestock boundaries, and education and training for individuals who live or work in high risk areas.

5.       Uniform Health Screening: There should be uniform health screenings for individuals seeking permanent or extended temporary residence in the United States,” the authors say.

6.       Public Health and Health Care Infrastructure: The authors recommend greater investment in host country institutions, restructuring hiring systems for health care professionals in developing countries, enhanced diplomacy and commitment to the Global Health Security Agenda. They also note that enhanced foreign aid investments in global health, specifically for pandemic prevention and preparedness, are essential to international security and U.S. national security.

7.       Effective Outbreak Response: Even in the United States, a cumbersome process of identifying the disease, predicting risk, and acquiring emergency appropriations slows response time when an outbreak occurs. The authors recommend Congress make funding for diagnostics and biosurveillance a high-priority budget item, and that the United States use USAID/Office of Foreign Disaster Assistance’s (OFDA) financial authorities and resources to fund emergency responses and affirm OFDA’s role as the lead coordinator of the United States’ international response for pandemic emergencies.

8.       Cultural Competency: Ebola demonstrated that disease control protocols and cultural rituals can collide with devastating results. The report suggests that cultural anthropologists and crisis communicators are consulted and included in U.S. public health missions to other countries.

9.       Academic Collaborations: The report suggests building university-based public health extension programs designed to work within local communities, communicate disease research to a non-academic audience and incorporate host country universities and their established, global academic collaborations into the overall disease response.

The paper also encourages the Trump administration and Congress to consider enhanced global health foreign aid and other related investments targeted at pandemic prevention as a national security priority that is economically advantageous in the long term.

“Emerging infectious diseases with pandemic potential are one the greatest threats to our national security,” says Gerald W Parker, senior fellow in the Scowcroft Institute. “We find ourselves in a war against microbes, and our defense must include unifying leadership and investments in global health security to prevent outbreaks from becoming pandemics.

The full white paper is available online.