Pandemic Preparation – the government needs to set up a permanent response initiative urgently

A pandemic preparedness strategy should be a high-level, cross-cutting mechanism to coordinate the national components of a robust public health initiative that plans for future pandemics and activates emergency responses when a new pandemic risk develops.
This is an updated version of an early essay on Daily Maverick in April
The Covid-19 pandemic came as no surprise to infectious disease specialists, as this had been anticipated for decades. Although the spread of a virus from one species to another is, fortunately, a relatively rare event, viruses do have potential to adapt to a new species environment with the potential to spread to become a pandemic. Therefore, it is imperative that countries develop robust strategies for responding to pandemics, supported by clear operational plans at national and subnational levels. This piece argues in favour of a structured, nationally mandated and coordinated, permanent programme to achieve this.
Almost two decades before Covid-19, we were warned of this risk with the spread of two other coronaviruses to humans. There was the “first” Severe Acute Respiratory Syndrome (SARS-CoV-1 virus) in 2002-4, which spread from bats and infected about 8,000 people in China and had a mortality of 8%. Again in 2012, the Middle East Respiratory Syndrome (MERS) virus spread from camels to humans and infected 2,500 people, killing more than 30% of those infected. Pandemics such as HIV/Aids, influenza and Zika are among those that have spread to humans and added to significant human suffering and death. The 2013-16 epidemic of Ebola in West Africa caused 11,323 deaths and had significant human suffering and socioeconomic impact on Africa.
Despite these warnings, the world was still caught unprepared for a pandemic such as Covid-19. As millions succumbed to the various waves across the globe, hospitals became overwhelmed, PPE supplies were in short supply, oxygen was unavailable for severely ill patients, diagnostic tests were unavailable and scale-up took months instead of days/weeks. Surveillance systems were lacking in most parts of the world, and appropriate national intervention teams often did not exist – even in the most resourced countries. Even when effective vaccines were developed in a timely manner, there were limited national plans for acquisition and equitable distribution. Manufacturing capability in LMICs was limited to countries like India. Investing in long-term public health does not garner votes and is just not attractive politically almost anywhere in the world.
The result of this lack of pandemic preparedness was that millions died, the ...