Monday, June 30, 2014
The Omega Man?
I wrote recently that I was losing no more than an hour of sleep each night over the prospect of a horrific global pandemic, mostly because we supposedly know what we are doing more so than the medieval folks who were decimated by the Black Death.
Well, maybe, but three essays in the new BMJ should give us pause. The problem is that scientific understanding of infectious disease isn't enough if we don't have global mechanisms for putting that knowledge to work in an emergency. I think you'll only get the first paragraphs, but it isn't hard for me to hit the high points for you.
First, Ilona Kickbusch (yeah yeah) and Mathias Bonk (also too), went to the World Health Assembly in May and they didn't have such a great time. That's the annual meeting of the WHO, involving all 194 member states. It seems that the delegations from some of the poor states didn't have high quality presentations to offer, the communications and AV technology was poor, and there were too many people there and a lot of blather. Okay, well you have to take the thick with the thin.
Journalist Sophie Arie then asks if current arrangements are good enough to prevent The Big One. Following the SARS scare, global agreements were revised in 2007. All 194 countries signed on, pledging to report outbreaks to WHO immediately and to set up monitoring systems and designating "disease free" (i.e. vermin free) entry points where travelers can be checked. But a lot of countries haven't done this yet, mostly because they can't afford it, and just don't have the means to comply.
So, Devi Sridhar and friends explain the real problem, which is that major funders -- excuse me, mostly one major funder, that is the United State government -- has drastically cut back on its core support for the WHO. Instead, the U.S. makes what it calls "voluntary contributions" which means it gets to designate how they are spent. Right now the biggest funders are U.S. and U.K. voluntary contributions, and the Gates Foundation. These don't cover core operations and they don't help poor countries set up surveillance and reporting systems. The U.S. adopted zero nominal growth -- that is, a guaranteed annual decline in real dollars -- in its contribution to the core budgets of UN agencies in 1999. Joe Biden's name is on the bill, next to Jesse Helms. So when we all die in the zombie apocalypse, you can thank Uncle Joe.
The fact is, we all live on one small, shrinking (metaphorically) planet. If we don't get over this sovereignty fetish, we're screwed.