Shortchanging Global Health Now Will Cost Us Later

March 21, 2018

Shortchanging Global Health Now Will Cost Us Later

by Ashley Arabasadi

This story was originally published by STAT News.

The White House recently released a report outlining the progress and investments the U.S. has made to make the world safer from the threat of epidemics. But the key to epidemic preparedness and response is the Centers for Disease Control and Prevention, whose operations abroad will radically scale back due to looming funding cuts.

Every global health security expert warns us that it’s not a matter of whether the next deadly epidemic will happen, but when. Withdrawing global health funding now will virtually guarantee that any future outbreak will be far-reaching and economically disastrous; the World Bank estimates that an epidemic such as the 1918 Spanish Flu could cost as much as 5 percent of global GDP.

The CDC faces an 80 percent cut to global health security programs in 39 of the 49 countries in which the agency currently focuses, many considered hot spots for emerging infectious diseases. This could have a negative impact on the health, economy, and security of the U.S. The proposed cuts rightly drew an outcry from a number of health organizations and was thoroughly covered in the media.

In addition to stopping vital CDC programs, the funding cliff jeopardizes other U.S. investments in global health, such as those made through USAID. This money protects Americans at home and abroad, saves lives, strengthens fragile states, and promotes social and economic progress. Programs that invest in women and children, HIV, malaria, and other key areas create more resilient health systems that are the first line of defense against emerging disease threats.

As CDC Acting Director Anne Schuchat has said, “Here in the U.S., we rely on frontline health workers to detect and respond to health emergencies. But we can’t protect our citizens unless other countries can also protect theirs through strong investments in health systems.”

Health workers are indeed the frontline response mechanism for infectious disease outbreaks. And in many parts of the world, their work is supported by international donors, with the United States traditionally leading the pack.

Take Madagascar, which had a severe outbreak of plague last year. Thanks in part to a cadre of community health volunteers working with Madagascar’s authorities and, among other U.S. players, Management Sciences for Health — the nongovernmental organization where I work — a coordinated and swift local response quickly stopped the disease from spreading.

Past investments in HIV/AIDS have trained health workers and strengthened surveillance systems, laboratory networks, and biocontainment capabilities that helped to stop Ebola in its tracks in Nigeria and the Democratic Republic of Congo.

At this point, there should be little resistance to the notion that it is in our country’s interest to fund programs that detect and contain diseases at their source. After all, a pathogen can travel around the globe in as long as it takes to fly a plane from Liberia to Dallas.

The proposed CDC cuts will cost the U.S. much more down the road. The economic burden of epidemics is well-documented: massive expenditures, disrupted global business and supply chains, costly trade implications, and more. Ebola cost U.S. taxpayers a total of $5.4 billion, and it put American lives at risk.

The 2002-2003 outbreak of SARS, or severe acute respiratory syndrome, cost the global economy an estimated $40 billion. According to the World Bank, the next severe pandemic could cost the world economy up to $6 trillion. Additionally, global health security, which relies on the capacity of all countries to detect and control health threats, is critical to the U.S. economy and jobs.

Strategic investments in public and animal health and pandemic preparedness need to be a national security priority of governments and a key commitment from multilateral agencies, development banks, NGOs, academia, and private sector stakeholders worldwide.

When calculated in terms of lives lost, economic meltdowns, and global instability, infectious disease outbreaks can cause catastrophic losses when not stopped at the source. Doing that requires investing in the CDC and USAID, and the programs and people watching and working in vulnerable countries. Now is not the time to scale back.

Ashley Arabasadi, Global Health Security Policy Adviser for Management Sciences for Health, describes the negative consequences of scaling back investments in CDC and USAID global health programs in this op-ed for STAT First Opinion.