2.1 The Issue
The number of infectious diseases 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, and Ebola, have taken a significant toll, prompting experts to call for increased investment in global health security—efforts to help prepare countries prevent, detect, and respond to epidemic and potentially pandemic diseases.
U.S. government support for global health security has increased significantly in recent years. After an outbreak of Ebola killed eleven thousand and infected twenty-seven thousand in West Africa in 2014, the United States invested $1 billion in building capacity to detect and respond to dangerous disease events in low-income and weak states as part of an international initiative known as the Global Health Security Agenda. Those investments have helped nations make measurable improvements in their preparedness for dangerous disease events, but significant gaps and risks remain. The coordination and funding of the U.S. and international response to outbreaks is still largely ad hoc, which limits its effectiveness. Without a robust, predictable, and well-coordinated international response, an emerging and lethal infectious disease in a country without the capacity to respond and control that outbreak—a fragile or failed state, one that is mired in civil war, or one that is subject to a significant influx of refugees—could have devastating consequences for that country and its neighbors.