2.1 The Issue
The number of infectious disease outbreaks has been rising for several decades. As populations grow and expand into previously forested areas, more people are contracting zoonotic diseases—infections that can be passed from animals to humans. Given increasing trade and travel to and within low-income countries, outbreaks of infectious diseases such as Ebola and Zika viruses in remote rural villages are more likely to reach crowded cities with limited health systems, which are the ideal incubators for diseases. Since 2000, a series of epidemics, including severe acute respiratory syndrome (SARS), H1N1, Zika, Ebola, and most recently coronavirus disease 2019 (COVID-19), has taken a significant toll, prompting experts to call for increased investment in global health security to help countries prevent, detect, and respond to epidemic and potentially pandemic diseases.
The coordination of international responses to outbreaks is still largely ad hoc, which limits their effectiveness. After an outbreak of Ebola killed eleven thousand and infected twenty-seven thousand in West Africa in 2014, international agencies and countries around the world invested in building the capacity to detect and respond to dangerous disease events globally, especially in low-income and weak states. Those investments have helped nations make measurable improvements in their preparedness for dangerous disease events, but significant gaps and risks remain. Without a robust, predictable, and well-coordinated international response, an emerging and lethal infectious disease in a country without the capacity to respond to and control that outbreak—a fragile or failed state, one mired in civil war, or one subject to a significant influx of refugees—could have devastating consequences for that country and its neighbors.