Community Resilience, Centralized Leadership & Multi-Sectoral Collaboration

Since the end of the 1918 pandemic the world has faced three more influenza pandemics, the most recent being the 2009 H1N1 pandemic which infected 2 billion people in 6 months. Additionally, we face an ever increasing frequency of emerging infectious diseases with pandemic potential. These diseases could kill millions, cost billions, and have other significant economic, social, national security, and political consequences. If the United States and international system do not make progress towards closing the gaps addressed in this and previous Scowcroft white papers, countries will remain vulnerable to a devastating outbreak.One hundred years ago the 1918 influenza pandemic swept the globe, killing between 50-90 million people. The loss of life was so great that cities throughout the United States struggled to keep up with burials; it is estimated that 195,000 Americans died in October 1918 alone (CDC, 2018). During the height of the outbreak, Chicago reported 1,200 people dying per day and Philadelphia had so many dead bodies they weren’t able to bury them in a timely manner, with some awaiting burial for over a week (CDC, 2018). In 2006, the last remaining survivor of the 1918 outbreak was asked about his memories of the pandemic and he recalled that people would become ill in the morning and be dead by nighttime stating, “That’s how quickly it happened. They disappeared from the face of the earth” (Associated Press, 2006). Since the end of the 1918 pandemic the world has faced three more influenza pandemics, the most recent being the 2009 H1N1 pandemic which infected 2 billion people in 6 months. Additionally, we face an ever increasing frequency of emerging infectious diseases with pandemic potential. These diseases could kill millions, cost billions, and have other significant economic, social, national security, and political consequences. Technological developments of the last hundred years have brought incredible international advancements and have created a more dependent and interconnected global economy, but these same advances that promote economic prosperity, also create new and unique challenges for pandemic preparedness and response. In an increasingly interconnected world the threat of pandemics continues to grow. It is not a matter of if there will be a major pandemic, but when. The Scowcroft Institute of International Affairs is committed to elevating the importance of pandemic preparedness and biosecurity as a national security priority, and to bringing attention to the challenges and gaps, as well as the opportunities to improve our response systems so that when the next pandemic strikes, the catastrophic impacts can be mitigated or reduced. In this white paper, we address four gaps and provide accompanying recommendations that we believe must be addressed in order to increase our pandemic preparedness and biosecurity. These gaps and topic areas include: 1) Establishing greater community resilience; 2) Strengthening coordination and leadership at the federal level in the United States; 3) Changing the university and funding reward systems to encourage greater interdisciplinary research, education, and service; and 4) Elevating the importance and incentives for private sector involvement in pandemic preparedness and response, as well as their involvement in overall biosecurity. In addition to the topic areas, which are present in each annual policy white paper, we have included short inserts by experts in the fields of pandemic preparedness and biosecurity. Lastly, for the first time we have included a pandemic report card. This examines progress made, if any, on the recommendations presented in the 2018 Scowcroft Institute White Paper. The purpose of this new addition is to provide an added element of accountability for those at the national and international level tasked with pandemic preparedness and response. If the United States and international system do not make progress towards closing the gaps addressed in this and previous Scowcroft white papers, countries will remain vulnerable to a devastating outbreak