Preventing the Next Global Health Disaster
This op-ed originally appeared on RealClearWorld on April 11, 2018.
Each year in April, the World Health Organization celebrates World Health Day, an opportunity to raise awareness of global health issues. This year, it is also a chance to observe the centennial of the deadliest global health disaster of the 20th century—and the deadliest event of the century, period.
One hundred years ago, on March 11, 1918, at Camp Funston, Kansas, a U.S. Army cook by the name of Albert Gitchell fell ill as he and his fellow soldiers prepared to go to war in Europe. He thought he had a bad cold. Soon after, Corporal Lee Drake went to the infirmary showing the same symptoms. By that afternoon over a hundred others joined them, and eventually, this influenza virus would circle the globe.
Over the next two years, the 1918 influenza pandemic, also known as the Spanish flu, infected nearly a third of the global population, killing more than 50 million people worldwide. At the time, the United States and the world were ill-prepared to combat a pandemic. Influenza viruses had not yet been discovered, there were no vaccines to prevent infection and no medicines to treat it, and the field of public health was in its infancy.
Today, influenza pandemics remain one of our top infectious disease threats. We have a growing set of increasingly advanced tools to detect the emergence of a new strain of influenza virus domestically and abroad, but much work remains to be done.
When it comes to the threat of pandemic flu, as well as other infectious threats, preparedness cannot be confined within borders. The world must work together to focus on the prevention and mitigation of pandemics that pay no mind to borders, and focus the work of institutions like the World Health Organization (WHO) on that threat.
Our almost universally interconnected world makes it easier for serious illnesses to spread faster than ever before, and we saw this threat when the 2014 Ebola outbreaks that threatened to spread that illness throughout and beyond West Africa. That is why the Trump Administration strongly supports the Global Health Security Agenda to prevent, detect, and respond to infectious disease threats in collaboration with our partner countries.
The United States also supports reforms to WHO to ensure that future epidemics are handled more effectively than Ebola was. We are committed to investing in infectious disease preparedness at home and across the globe, including through the Global Health Security Agenda, and these tasks must be the focus of our global health work.
On flu, for instance, the Centers for Disease Control and Prevention (CDC), in collaboration with WHO and the National Institutes of Health (NIH), has built global flu surveillance networks with partner countries that help to detect and respond to new and known influenza viruses. This network provides an early warning system to detect new flu strains and increases the likelihood that partner countries can effectively combat and contain the virus before it spreads to our shores.
As we work around the world, we are investing at home as well. When I was at HHS in 2005, for instance, we formulated the first Pandemic Influenza Plan, a comprehensive blueprint that outlined how federal, state, local, tribal and territorial partners would respond in the event of a flu pandemic. A few years later, the experience of the 2009 H1N1 influenza pandemic showed the value of those preparedness activities, but also revealed remaining gaps. At the time, we did not have the domestic capacity to manufacture enough influenza vaccines to protect the entire American population.
Since then, through HHS’s Biomedical Advanced Research and Development Authority, we have worked with partners in the private sector to expand our ability to manufacture influenza vaccines domestically. Our manufacturing capacity has increased ten-fold since the 2000s, while we have worked to reduce the time it takes to develop a new flu vaccine in the event of a pandemic and invested in research toward a universal flu vaccine.
Our international work extends to many other disease outbreaks and threats. U.S. health agencies, including CDC, NIH, and the Food and Drug Administration (FDA), have helped lead the ongoing response to Zika throughout the Western Hemisphere. And just last year, HHS agencies helped the Democratic Republic of the Congo in responding to Ebola; the Republic of the Congo and Nigeria in responding to monkeypox; Zimbabwe in responding to typhoid fever; and Namibia in responding to anthrax. Right now, CDC, NIH, and FDA are assisting WHO and the government of Nigeria in responding to a Lassa fever outbreak.
The world has come a long way since 1918, but we are still vulnerable, not just to the flu but a range of infectious threats. The United States will continue to work with our partners around the globe to build preparedness for these threats and to strengthen our preparedness at home.
Infectious diseases remain a serious threat, but with the right level of cooperation and focus, we can look forward to marking many more World Health Days before we see another pandemic like the Spanish flu.
Alex Azar is the U.S. Secretary of Health and Human Services. The views expressed are the author's own.