Since the Influenza Pandemic of 1918 when between 50-100 million died (5-10% of the human population) we have been fully aware of how vulnerable our place on this planet is.
Even in the absence of significant global mortality, epidemics and pandemics can cost tens of billions of dollars, reversing development gains and pushing communities and households into poverty. The SARS outbreak in 2003 cost the economies of East Asia between $30-50 billion and estimates of the global economic cost of an influenza pandemic range from $374 billion, for a mild pandemic, to $7.3 trillion, for a severe pandemic - with a 12.6% loss of gross domestic product.
Strategically, policies to address a potential pandemic threat are constrained by an unresolved debate over the use of adaptive measures - that aim through the use of technological measures to reduce the impact of diseases after they have emerged vs mitigation measures - that focus on the underlying causes of disease emergence. The adaptive tools we traditionally rely on to protect us from the world of infectious diseases – vaccine and therapeutics – too often are shown ineffective against a novel threat; and, the timely development and deployment of new and effective biomedical countermeasures is undercut by the speed at which the threat spreads.
Similarly, our ability to mitigate the emergence of new threats is undermined by a lack of knowledge about the viral ecology and the drivers, including human behaviors, which propel the emergence of a new threat. It is at these moments we realize just how few our adaptive and mitigation options are – and how vulnerable the global community is. After each episode the world admonishes itself for being ill prepared to deal with a global threat – but after decades of largely reacting adaptively to each event, with only a tangential focus on mitigation, we are only marginally better able to deal with the next one.