Why We Suck at Preparing For Pandemics
Three trillion dollars of lost economic output. Tens of millions of deaths globally. Years of disrupted supply chains, billions thrown into food insecure positions, and untold jobs lost and families disrupted. The pandemic has been awful on all accounts.
So let’s begin with the kicker: COVID really should not have taken us by surprise.
At the time of writing, there are two prevailing theories for COVID’s inception: zoonotic transmission or a lab leak. We’ve known for years that these two avenues are real risks.
On the zoonotic side, plenty of research has shown that deforestation and agriculture have led to unprecedented levels of human-animal contact, and that globalization has enabled diseases transmitted through this vector to spread faster than ever before. In 2014, after the Zika outbreak, Bill Gates gave a TED talk on this exact subject. Its title? “The Next Outbreak? We’re Not Ready.”
We recognized the risks of entities like engineered viruses even earlier; since 1972, 183 countries have signed onto the Biological Weapons Convention, a treaty which created a monitoring agency for dangerous biological agents (including viruses).
Yet, in spite of the research that had been done, few were interested in focusing on pandemic risk mitigation prior to COVID.
Prior to the pandemic, the Biological Weapons Convention had an annual budget of just $1.4 million — that’s the cost of a mid-sized New York City apartment. The United States’s pandemic response team, which had a global health/monitoring program in place, was disbanded for budget purposes in 2018.
In a conversation, Anthony Pelletier, a faculty member at the Scripps Research Institute in San Diego, summarized the prevailing attitude well. “Pre-COVID,” he quipped, “infectious disease research (ID) was like the one weird uncle that nobody really likes… for decades, three things dominated NIH (National Institute for Health) funding: cancer, heart disease, and diabetes. While there was definitely money in ID, if you went to the NIH for a grant, you would get less than others.”
Despite knowing the risks, we underfunded preparation and ignored research. In this piece, I’m going to offer a few reasons why.
To do so, I will illustrate—using concepts from economics, human behavior, and political theory—why governmental bodies are uniquely poor at tasks like pandemic preparation.
This is the first article in a two-part series; in the second, I will illustrate a program that the WHO introduced (“pandemic bonds”) in an attempt to fix the issues outlined here… and how that program also failed.
The first reason: pandemic preparation is an intergenerational, global public good.
Let’s consider what investing in “pandemic prevention” means for any particular country. To do this, we need to consider what it looks like from an economic perspective.
In general, this might involve institutional investment like lab oversight protocols and early warning programs, as well as tangibles like PPE supplies and population genomic testing.
In economic terms, this would be classified as a public good—something commonly seen in a four-part matrix found in introductory economics courses (a health-centered example is given below). In this matrix, rivalrous goods are ones where consumption by one party prevents consumption by other parties. Excludable goods are ones where consumption can be easily limited to paying customers.
Because pandemic preparedness can neither be easily monetized nor limited to one party, it is a public good. More orthodox examples of public goods include national defense, infrastructure, and clean air.
The common belief that “market is king” does not apply to public goods because it is difficult to create markets around something without a firm value. As a result, local or national governments often pick up the slack. For defense, infrastructure, and clean air, this translates to military funding, road/bridge initiatives, and environmental programs.
Pandemic preparedness has one key difference from the others: it is a global public good.
While some tangibles like PPE stockpiles primarily benefit just one nation, any research or preventive measures for pandemics largely benefit the world as a whole. As such, given a base existential risk investment rate of 0, every nation is strongly disincentivized from investing in existential risk prevention because they would bear the cost of something that (mostly) does not benefit them.
For instance, the United States has about 4% of the world’s population. If it acts alone on pandemic research, it will receive (about) 4% of the eventual human benefit and perhaps ~20% of the eventual economic benefit— despite investing 100% of the cost. Because no government has a proportionate stake in the problem, none (bar perhaps a superpower) have a strong incentive to fund it.
When markets fail, national governments fund public goods. When national governments fail, international bodies fund global public goods. But what happens when even the international body doesn’t have a strong incentive?
That is exactly the case here, because pandemic risk is an intergenerational problem.
We will never know when the next deadly contagion spreads. It might be tomorrow, but it might also be twenty years from now.
When decision-makers need to allocate budgets and direct funding, it makes sense that they would allocate vanishingly small sums toward existential risk. After all, there are much more immediate needs that must be addressed: solving malnutrition, disaster relief, etc.
This trend of behavior is closely linked to a psychological trait: the availability heuristic.
The availability heuristic is quite simple: It is harder for us to make decisions on experiences which we have not yet felt. When we make decisions, we tend to lean on past experiences (like the push to phase out nuclear power plants after some leakage) or acute emotion (such as the tendency to donate toward disaster relief when the disaster is highly televised).
We already saw that it’s hard to justify any one country’s funding for a problem that affects everyone. With pandemic prevention, however, it’s also hard to justify any intergovernmental funding for a problem that might not happen for a long time.
To policymakers in 2018, an imaginary pandemic that would cause millions of deaths would suck, but so would not passing more funding for a hometown highway before the next midterms. In their availability heuristic, that suck-iness is something they tangibly know — hence that is how they vote.
This offers a nice segue into the final issue: our term-based political systems disincentivize considering long-term risk.
Ultimately, someone—likely a national government or international body—must make an investment.
Unfortunately, most civil servants inherently operate on 2–8 year timescales — not sufficiently long enough to make existential risk a pressing priority of any kind. While workers for intergovernmental agencies don’t have similar timelines, they are often pressed from all sides by more near-term needs. As a result, long-term preparation gets swept under the rug.
In many ways, our political structure merely exacerbates the other issues: because of the availability heuristic, policymakers inherently don’t feel as inclined to prepare policy on the issues; because the problem affects everyone, it is not in anyone’s direct interest to make an issue of it and actually solve it.
With all factors combined, nothing ever gets done.
Concluding Thoughts
To me, the discussion around pandemics and existential risk drives a broader thought.
For the past few centuries, the singular most successful form of government has been representative democracies. They spur civic engagement, maintain checks and balances on power, drive innovation, and generally lead to wealthier, healthier, and more productive societies.
But representative democracies, by their very construction of short election cycles, are inherently ill-suited to the task of addressing long-term issues. If that’s the case, then, is there a better way of doing things?
Should this responsibility be devolved to the UN? Does there need to be a global governmental body for this? Or is this issue, like seemingly all issues these days, simply a matter of raising public awareness — getting people to care enough about something as mundane as pandemic preparation that they contact their representatives?
Food for thought.
Note: This piece is the first of a two-part series. In the next piece, I outline one solution that was introduced by the WHO to create a market out of pandemic responses—and why it didn’t work for COVID. Give it a read here!
