Thursday, July 18, 2013

Infectious Disease Preparedness for Cheap Countries

Pandemics are problems for nation-state legitimacy.  Strong states with mature public health programs can handle them well.  Weak states distracted by poverty, illiteracy, environmental degradation, social unrest, and insurgencies could destabilize or even disintegrate in the face of a pandemic.  States need early warning systems for disease outbreaks and road maps for consequence management.

Early warning systems already exist.  CDC's Morbidity and Mortality Weekly Report (MMWR) is a model for national organization of medical threat data.  WHO's Global Alert and Response (GAR) Disease Outbreak News (DONs) is free for any national health service to use as a monitoring tool.

The US already leads the way in pandemic mitigation.  The US National Intelligence Council published National Intelligence Estimate 99-17D, The Global Infectious Disease Threat and Its Implications for the United States in January 2000.  Analysis is the foundation for action.  The US Centers for Disease Control and Prevention followed up with its publication Protecting the Nation's Health in an Era of Globalization:  CDC's Global Infectious Disease Strategy in 2002.  Wealthy countries with strong central states can afford to make detailed plans.  Poorer countries are at a disadvantage but all is not lost.  Developing countries can follow the US's lead.

The US has been generous enough to suggest optimal funding levels and project directions for global health programs.  NIH published The Impact of Globalization on Infectious Disease Emergence and Control via the National Academies Press.  Developing countries that are too cheap to pay the $45 for a hard copy are welcome to download the PDF for free from the NIH's NCBI.  The opportunity cost of inaction is huge, as outlined in EMBO's "Pricing infectious disease." 

Weak states have all of these free resources courtesy of Uncle Sam.  Use them before the next sequester hits federal spending.  Poverty is no excuse for unpreparedness if developing countries wish to avoid destabilizing pandemics.