How to avoid another pandemic? A World Health Organization with punch

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When you think about it, the idea that the breakout of a mysterious respiratory disease in one neighbourhood of a Chinese city could turn into a calamitous global pandemic is ridiculous.

Yes, international travel makes it more likely that an unaware person could carry a burgeoning zoonotic pathogen from one continent to another. But in this instantly connected age, one informed by similar recent pandemics, you’d expect that preventing that from happening would be a top priority in every country.

That is not the case. As a report released this week by an independent panel commissioned by the World Health Organization (WHO) bluntly put it, there were “weak links at every point in the chain of preparedness and response.”

“Preparation was inconsistent and underfunded,” says the report. “The alert system was too slow – and too meek. The World Health Organization was under-powered. … Global political leadership was absent.”

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The consequences have been enormous: unnecessary deaths and illness; overloaded hospitals; cyclical lockdowns that have cost children a year of their educations; economic misery; unprecedented government debt; fear, confusion, isolation.

The panel makes sensible recommendations for preventing future outbreaks from turning into global catastrophes.

For instance, it wants WHO to have complete independence and better funding, so that the United Nations agency can publish information about breakouts without getting permission from national governments, and its experts can investigate threatening pathogens on-site without interference from local officials.

The panel also wants countries to give their national pandemic response co-ordinators “a direct line” to government leaders, in order to avoid delays caused by unclear chains of command.

In Canada, provinces with more centralized health systems, such as British Columbia, were better at containing the first wave of COVID-19 in 2020, an investigation by The Globe and Mail found last year. In Ontario, with its public-health units that don’t report to the province’s Chief Medical Officer, and its siloed hospital and testing systems, the response was too slow to contain the virus.

But the panel’s most important recommendations are twofold.

First, when a new virus is detected and is spreading between people, as WHO confirmed the novel coronavirus was doing in January of 2020, countries must agree to work from the precautionary principle that the pathogen is being transmitted by asymptomatic carriers.

Doing so could have meant that Canada, among others, immediately closed its borders, enforced quarantines on returning nationals, tested widely and locked down hot spots, as countries such as New Zealand did so successfully. Instead, Canada and others adopted a wait-and-see strategy in early 2020, partly out of fear of angering China.

Second, governments everywhere must make pandemic preparation and response a permanent priority, in co-ordination with WHO.

Canada responded to the SARS outbreak of 2003-04 by creating the Public Health Agency of Canada, but subsequent governments bureaucratized the agency and reduced the role of Chief Public Health Officer to that of an adviser. As well, Ottawa silenced the country’s Global Public Health Intelligence Network, a widely respected early-warning system.

Ontario also dropped its post-SARS enthusiasm for better preparation in the years after 2004; its most infamous failure was letting millions of dollars worth of personal protective equipment rot in a warehouse, rendering it unusable when COVID-19 struck.

This can’t happen again. The world needs an agreed-to response system that makes it safe for a country to own up to an outbreak, because it knows that a well-funded and independent WHO will step up and help it contain the threat.

At the same time, countries must be able to take preventive measures, such as temporary border closings, without risking retaliation or accusations of xenophobia.

The world can prevent a repeat of the COVID-19 disaster if it works together. That’s never easy, and it’s certainly not a given, but it is the only way forward.

As the panel said in its report, “We have been warned.”

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