The Coronavirus and Global Health Security

MARCH 26, 2020

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The Novel Coronavirus – COVID-19 – has spread to nearly every continent since emerging in Wuhan, China in December 2019, with cases now reported in over 170 countries. On March 11th, the World Health Organization (WHO) declared the virus a global pandemic, the first since the H1N1 swine flu outbreak in 2009. As of March 26th, the disease has over 500,000 confirmed cases – while new cases in China and South Korea have begun to abate, major outbreaks are escalating in Italy, the United States, Iran, Spain, and Germany.

In today’s interconnected world, a major pandemic only takes 36 hours to spread around the globe. The global outbreak of COVID-19 has demonstrated that infectious disease threats know no borders, and has reinforced the importance of investments in preparedness and global heath security to combat pandemics and save lives.

The Global Response to COVID-19

The United States, alongside partner nations and multilateral institutions like the WHO, is playing a critical role in responding to the outbreak.

  • Congress passed and President Trump signed an emergency supplemental funding bill, to provide $8.3 billion in response to the pandemic – including $1.25 billion for key State and USAID global response, focused on strengthening global health systems, providing humanitarian assistance and economic support, and evacuation expenses to help Americans overseas.
  • The State Department has engaged with multilateral and international partners to coordinate response efforts, share information and best practices, and facilitate the delivery of emergency medical supplies overseas. The Department also evacuated over 1,100 Americans back to the U.S., and is continuing to issue detailed travel advisories.
  • USAID is assisting 25 countries with weak health systems to respond to the outbreak, with support including laboratory strengthening, enhancing surveillance capabilities, community engagement, public health screenings, and donations of personal protective equipment.
  • The CDC has focused on preventing a rapid escalation and has deployed teams across the country to manage contact-tracing. They are also studying the virus’ genome to improve detection.
  • The European Union has committed $140 million to the WHO emergency appeal and efforts in Africa.
  • The WHO has established a new COVID-19 Solidarity Response Fund, with the goal of leveraging $675 million to support countries with weak health systems.
  • The World Bank announced $12 billion in financing to help countries to respond to the health and economic impacts of the outbreak, and the International Monetary Fund (IMF) announced a $50 billion commitment to financing for low income and emerging market countries in response to the virus, including $10 billion in zero-interest loans to the poorest IMF member countries.

As a result of the outbreak, the World Bank, IMF, WTO, UN, and United States have postponed high level diplomatic meetings that typically could help drive and coordinate a global response. During a virtual meeting of the G7, the group’s leaders expressed solidarity in efforts to “set the stage for a strong recovery of strong, sustainable economic growth and prosperity.”

The Consequences of Pandemics

The 2019 Global Health Security Index found that no country is fully prepared to handle a major pandemic. If diseases like COVID-19 continue to spread while countries still have significant gaps in global health security, the international community could face severe consequences in health, economics, and security:

  • A pandemic on the scale of the 1918 Spanish Flu outbreak could lead to as many as 80 million deaths, and could cost the global economy up to 5% of its GDP ($3 trillion). Some economists have already estimated the costs of COVID-19 at as much as $2.7 trillion.
  • A potential disease outbreak across just nine Asian countries could place more than 1.3 million U.S. export-related jobs at risk.
  • In countries like Yemen and the DRC, ongoing conflict and instability leads to protracted and more deadly pandemics, as violence can increase transmission rates and hinder an effective response from healthcare workers.

The spread of COVID-19 has also impacted America’s development and diplomacy programs, with further repercussions on U.S. leadership in the world.

  • The Peace Corps has suspended operations and is evacuating all its volunteers worldwide.
  • The State Department has paused all foreign exchange programs with at-risk countries.
  • Many implementing partners of U.S. foreign assistance programs face significant disruptions to their programming, as they work to address the health and safety of their teams overseas.

Legacy of U.S. Investments in Global Health Security

American leadership in global health security is critical in preventing and controlling pandemics like COVID-19, Ebola, and Zika. U.S. investments in health systems around the world – including infrastructure like hospitals and roads, skills training for healthcare workers, and public education campaigns – can help countries contain pandemics at their source. While the costs of pandemics are high, the success of the President’s Emergency Plan for AIDS Relief (PEPFAR), which helped curb the AIDS epidemic and has saved 18 million lives since 2003, demonstrates that progress is possible. Importantly, investments in global health have far reaching impacts – PEPFAR’s investments in strengthening overall health systems also helped countries prevent and respond to the 2014 Ebola outbreak.

The Trump Administration’s Global Health Security Strategy calls for the U.S. to prevent, detect, and respond to infectious diseases at home and abroad, in close cooperation with international partners.

Global Health Security Agenda (GHSA): The GHSA was launched in 2014 as an international partnership of 65 nations, international organizations and NGOs. Through setting targets and facilitating cross-country collaboration, the agenda works to improve nations’ capacities to prevent, detect, and respond to infectious diseases around the world, bolstering international health security.

  • America’s support for the GHSA helped mitigate disease outbreaks in Ethiopia, Uganda, and Burkina Faso in 2017 thanks to improved equipment, training, and facilities. The U.S. has also enhanced disease monitoring systems in 13 countries, allowing for the rapid detection of diseases and quicker response.
  • The U.S. has committed an initial $1 billion to reach GHSA targets in 17 partner countries that total a third of the world’s population, making an additional $150 million investment in 2018 to help advance the agenda through 2024 and support 14 additional countries.

CDC’s Division of Global Health Protection: The Division of Global Health Protection works with partner countries to help build core public health capacities that are needed to identify and contain outbreaks before they reach the United States.

  • CDC has responded to over 2,200 outbreaks and other global health emergencies since 2007, with 500 emergency mobilizations since 2015 alone.

U.S. Agency for International Development: USAID’s global health and development programs make it less likely for diseases like COVID-19 or Ebola to spread rapidly – and make it easier to respond if they do.

  • In 2014, the Ebola outbreak was projected to spread to as many as 550,000 people and cost more than $32 billion. This worst-case scenario was avoided due to America’s swift whole-of-government response, as USAID, the State Department, and the CDC provided immediate assistance and helped stabilize communities. However, USAID has faced unique challenges in tackling the ongoing Ebola epidemic in the DRC – which is now the second most deadly in history – as over 100 armed groups are active at the outbreak’s epicenter, and health care workers have been unable to reach and treat those in need.
  • Through its PREDICT program, USAID invested $207 million in training and helping developing countries detect and monitor animal viruses that have the potential of spreading to humans, between 2009 and 2019. The program collected over 140,000 biological samples from animals and discovered more than 1,000 new viruses between 2009 and 2019. In 2019, the program was not renewed for an additional five-year funding cycle.