Pandemic Risk paper for the WDR 2014

By Olga B. Jonas, The World Bank 

This paper looks at pandemic risk, what it means for development, and how management of this risk could be improved, both in countries and internationally. The paper was motivated by the prevalence of pandemic myths. Widely held beliefs—that pandemics are inevitable and thus not worth worrying about, that the health sector is managing the risks, and that the pandemic risk is not a development issue—lead to underestimation of pandemic risk, scant preparedness, and inadequate prevention. Examining the reasons why these myths persist could help governments and international organizations improve management of the risks associated with pandemics.

These risks are substantial. A single severe flu pandemic could cost $3 trillion. It is hard to imagine a more severe threat to ending absolute poverty or to boosting shared prosperity in developing countries. Indeed, OECD, among others, see a severe pandemic as a top global catastrophic risk, one that is higher than terrorism risk. It would bring shared misery, economic decline, and societal disruptions on a global scale, with the poor and those in fragile states hit the hardest.

Setting a goal to reduce pandemic risk should be the first step toward risk governance, complemented by mandates for international organizations to work toward the goal. Risk governance should ensure strengthening of public veterinary and human health systems in developing countries, and the bridges between them, to eliminate the weakest links in global defenses against pathogens. Reduction of pandemic risk is a public service that only governments, through their coordinated actions, can provide. Delivery of this service can benefit from systematic application of ‘science of delivery,’ notably by using One Health approaches for early effective control of contagion.

All countries can build and operate systems that meet international standards; the annual spending required to reach that goal is not only modest but also ten times less than the expected annual cost of inaction. Advocacy and communications for prevention and preparedness are key public sector responsibilities at global, country, and community levels. The main beneficiaries of pandemic risk reduction will be our children and future generations because their lifetime odds of experiencing a pandemic are now high and growing; they face worse odds than present-day adults, including the political and business leaders who need to lead if this risk is to be reduced. Preparedness for pandemics is low everywhere, but especially in developing countries, with potentially high-cost impacts on health, economies, and society. Whole-of-society planning for responses is a low-cost activity that will mitigate these impacts.