public health

The Coronavirus Should Be a Wake-up Call for Congress

We must invest in public health if we want to breathe easy. Photo: Kevin Frayer/Getty Images

Last month, a new strain of coronavirus emerged at a seafood and wildlife market in the Chinese city of Wuhan. The infectious agent spread from livestock to humans — and then, more alarmingly, from those humans to other humans. As of Thursday afternoon, the disease had sickened more than 650 people and killed 18. Across China, public celebrations of the Lunar New Year are being canceled, while two entire cities have been placed under quarantine. But already, the virus has spread widely, sending its victims to hospitals in Singapore, Saudi Arabia, and the United States.

Still, things could be worse. Much worse. Less than three months ago, public-health researchers at Johns Hopkins ran a simulation of what would happen if an especially lethal, treatment-resistant strain of coronavirus emerged on a Brazilian pig farm. Its model suggests that such a disease would kill 65 million people within 18 months. For the moment, the actually existing coronavirus appears far tamer. Current reporting suggests that the bug requires close contact to spread between humans and that the majority of those who have perished from the illness suffered from other immune-system deficiencies. After some deliberation, the World Health Organization declined to classify the outbreak as a global health emergency, although the WHO plans to reassess that question in ten days, if not sooner.

Humanity’s luck in averting a global pandemic may hold up for a bit longer. But eventually, our good fortune will run out. The coronavirus outbreak must serve as a wake-up call to governments around the world, but especially to the one in Washington, D.C.

The United States is the wealthiest nation in human history. And yet, at present, our Centers for Disease Control and Prevention is spending only $500 million on programs aimed at tackling emerging diseases. The National Institutes of Health’s total budget for its program on infectious diseases, meanwhile, was roughly $5.5 billion last year, only a small fraction of which goes to pandemic prevention. To put these figures in perspective, consider two statistics: (1) Since Donald Trump took office, the Pentagon’s annual budget has grown by $130 billion, and (2) according to a WHO report released last week, absent government intervention to spur the development of new antibiotics, drug-resistant infections could kill
10 million people annually by 2050 and “prompt an economic slowdown to rival the global financial crisis of 2008,” an event that cost the U.S. economy many trillions of dollars in lost output.

The scale of the threat posed by infectious diseases in our globalized age is hard to overstate. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, described the risk evocatively for the New York Times in 2018:

The world has about four times the number of inhabitants it did in 1918 [the year of the Spanish-flu pandemic], including hundreds of millions of people, poultry and pigs living close together. This provides a potent biologic mixing bowl and natural influenza virus mutation factory. What’s more, nearly any point on the planet is accessible to any other point within hours, and there are more than a billion international border crossings each year. The virus will spread rapidly.

When a pandemic does strike, we’ll be in trouble in part because American hospitals and pharmacies keep in stock no more than a few days supply of most lifesaving drugs, almost all of which are made in Asia. Worldwide manufacturing and shipping are highly susceptible to disruption, which could mean shortages in many areas.

A 1918-type influenza pandemic could cause ruin on the order of what the Black Death did to 14th-century Europe, but on a global scale. Like the Black Death, such a pandemic would alter the course of history.

Given the size of this threat — and the equally massive scale of America’s resources — the fact that we’re only investing tens of millions of dollars into the development of a universal influenza vaccine, and hundreds of millions into research on emerging diseases, is a scandal — as is Congress’s failure to mount a serious response to the crisis in financing for new antibiotics. Although a virus birthed our present outbreak, drug-resistant bacteria could eventually pose an even more harrowing threat.

As mutating germs develop resistance against existing drugs, the maintenance of global public health depends on the emergence of a new class of antibiotics. But the economics of antibiotic research are terrible. Developing a new antibiotic often takes upwards of a decade and $2 billion. And even when that massive investment bears fruit, monetizing a drug that’s meant to be prescribed as little as possible (to avoid seeding resistant mutations) is difficult. For these reasons, multiple antibiotic start-ups have gone bankrupt in recent months, while major pharmaceutical companies have cut their losses and withdrawn from the sector. As Bloomberg’s Max Nisen shows, only a small fraction of the pharmaceutical industry’s R&D is devoted to infectious diseases of any kind, and an even smaller slice goes toward antibiotics.

Only drastically higher federal investments in both public research and incentives for private firms to pursue new vaccines and antibiotics (such as enormous cash prizes for breakthrough medicines) can ensure that the U.S. will be prepared when the next superbug or pandemic virus emerges.

The Coronavirus Should Be a Wake-up Call for Congress