MAY 18, 2018 UPDATE TO: To Prevent Disease “X”, Invest in America’s Health Security

This week, the Democratic Republic of Congo (DRC) announced that a deadly new outbreak of Ebola has spread to Mbandaka, a large city in the DRC with a population of over one million– after already killing 23 people and infecting another forty in rural areas.

As news of the outbreak spread, the White House announced its intention to rescind approximately $252 million in U.S. funding designated for the fight against Ebola and the National Security Council’s top global health security expert – Rear Admiral Tim Ziemer – left his position overseeing U.S. pandemic preparedness. These concerning developments followed reports that President Trump had been briefed by Bill Gates on the threat pandemics pose to the homeland , and despite the fact that the White House’s National Security Strategy clearly states that “We will work with other countries to detect and mitigate outbreaks early to prevent the spread of disease.”

Both the rescissions proposal and Admiral Ziemer’s departure raise serious questions about the Administration’s strategy for the Global Health Security Agenda – a global partnership of 64 nations and international organizations that aims to build resilience against infectious disease threats like Ebola. Prior to this latest outbreak, Congress had already intervened to reject the President’s proposed budget cuts for global health – ensuring level funding for America’s global health programs and sending a strong signal that America will continue to prioritize global health security. As the world confronts yet another Ebola outbreak, it’s imperative that both Congress and the Administration ensure that global health experts have the resources – and support – they need to wipe infectious diseases like Ebola off the map before they reach our shores.

Original blog post from March 23, 2018:

To Prevent Disease “X”, Invest in America’s Health Security

Recognizing how difficult it can be to predict epidemics, the World Health Organization recently declared that the unknown “Disease X” is likely the most deadly infectious disease facing the public today. Considering that it takes just 36 hours for deadly pathogens to spread anywhere in the world, “Disease X” could prove even more devastating than the recent Ebola and Zika outbreaks.

Investing in Other Countries

A recent progress report on the Global Health Security Agenda (GHSA), which the United States helped launch in 2014, notes that in 2017 alone there were over 25 reported public health emergencies in GHSA nations – including infectious diseases such as dengue fever, Marburg virus, Ebola, and cholera. The U.S. Agency for International Development (USAID) Administrator Mark Green highlighted the importance of these efforts at the launch of the 2018 Progress Report for the GHSA, stating that “The world is safer when countries have the local capacity to prepare for and respond to known and unknown health threats.”

Though pinpointing the next major health threat is difficult, investing in developing countries’ health infrastructure, disease surveillance, and rapid response capabilities has been proven remarkably effective at preventing outbreaks– and avoiding the need for massive, costly interventions. In the four years since its inception, the GHSA has overseen more than 3,700 disease detectives who have investigated and contained some 650 outbreaks before they could spread further.

The GHSA progress report highlights several powerful examples of rapid responses to emerging disease outbreaks across the globe. For instance, just last year, following a series of undiagnosed deaths in the Democratic Republic of Congo (DRC), USAID, CDC, and other GHSA partners sprang into action by providing medical supplies and facilities, and sending a team of U.S.-trained disease detectives to trace and contain the outbreak. Within just two days the disease was confirmed as Ebola virus and stamped out with only eight cases reported in the country and no spread beyond the DRC’s borders. The rapid intervention prevented a potentially devastating outbreak, and cost the U.S. just $400,000.

But despite the progress that’s been made, there is just as much left to do in order to prepare the world for “Disease X.” Last week, Bill Gates met with President Trump at the White House to make the case for continuing to invest in global health security and foreign assistance more broadly. He warned in a recent interview that, when it comes to threats posed by pandemic diseases, “we don’t have the tools, the preparedness, [or] the capacity to deal with that.” A looming pandemic today could kill more than 30 million people within a year, and he pointed out that “there is a reasonable probability the world will experience such an outbreak in the next 10-15 years.”

Will we fund it?

The White House recently released a statement noting that “The United States Government remains a strong supporter of GHSA and continues to demonstrate leadership through our engagement in multilateral efforts and bilateral capacity building programs.” Yet the President’s recent budget proposal seems to suggest the opposite. The Administration’s Fiscal Year 2019 budget proposes reducing Global Health Programs by 23% — or over $2 billion – compared to FY17 levels. More specifically, the budget proposes zeroing out funds for the Global Health Security Agenda – a steep reduction from the $143 billion provided in FY17.

Although the budget does request that $75 million in remaining Ebola funds be transferred to the GHSA, these funds were previously allocated and do not represent new funding. Without additional funding, U.S. contributions to the widely-lauded GHSA would end next year, by September of 2019. This uncertain budgeting outlook has even led the CDC to either scale back or end its work in 39 developing nations affiliated with the GHSA – leaving us all more vulnerable to “Disease X.”

Looking to Congress

Severe cuts of this nature would have immediate and long-term consequences for the health security of Americans and millions around the world. In recent years, we’ve seen several pandemics emerge without warning – from Ebola, to Zika, and various forms of Influenza – at tremendous economic cost. While the 2014 outbreak of Ebola in West Africa claimed the lives of over 11,000 people, it also had an estimated economic cost of nearly $3 billion. Similarly, the 2002 outbreak of Severe Acute Respiratory Syndrome (SARS) cost the global economy nearly $40 billion. Estimates indicate that the next severe pandemic could cost the world economy a staggering $6 trillion.

As Capitol Hill rushes to finalize its spending package for the remainder of 2018, look for Congress to restore critical funding for U.S. global health efforts. Congressional leaders from Lindsey Graham (R-SC), to Tom Cole (R-OK), and Chris Coons (D-DE) recognize the tremendous impact and long record of bipartisan support for America’s global health programs – from PEPFAR to the President’s Malaria Initiative, to the GHSA. In order to ensure the U.S. continues its legacy of leadership on global health, Congress should reject the Administration’s latest budget request – as it did last year – and continue to allocate robust resources for the GHSA and other global health endeavors. Not only because these efforts represent the best of American values and compassion, but because they are a smart investment in our future health.