Lessons From an Epidemic

Daniel Farber

Oct. 8, 2014

Ebola’s natural reservoirs are animals, if only because human hosts die to too quickly. Outbreaks tend to occur in locations where changes in landscapes have brought animals and humans into closer contact.  Thus, there is considerable speculation about whether ecological factors might be related to the current outbreak. (See here).  At this point, at least, we don’t really know.  Still, it’s clear that outbreaks of diseases like ebola strengthen the case for forest conservation.  Which is also, obviously good for the environment.  But that’s not what I want to focus on here.

The Ebola outbreak also highlights the importance of the public health system.  In the places where the disease is worst in Africa, the health infrastructure is extraordinarily weak.  Obviously that’s not true here.  But we’re also seeing the importance of the public health infrastructure in the U.S., as the CDC works to contain the disease now that a case has reached the U.S.  What we see in both cases is the public good nature of certain aspects of health care — people who aren’t now sick and don’t know if they will ever be at risk are benefited by the public health system.

That being the case, it is unfortunate that the U.S. has been stripping resources from the CDC in recent years.  Consider the follow chart:

2010: $6.467 billion 2011: $5.737 billion 2012: $5.732 billion 2013: $5.721 billion 2013 (after sequestration): $5.432 billion 2014: $5.882 billion

As the saying goes, this is pennywise and pound foolish.

We live in an uncertain world, with a variety of threats whose exact magnitude is unknown.  Climate change is expected to pose serious public health threats, as discussed in this RFF report. But climate change is only one of the global threats  — let’s not forget terrorist use of WMDs, non-climate-related natural disasters,  and possible pandemics.  It makes sense to make investments that will help provide protection against all of these various threats, and perhaps against some other, currently unforeseen threats. A strong public health system is a multi-threat defense.  As ebola illustrates, we even have a stake in the strength of the public health systems in other parts of the world, regardless of their remoteness or lack of geopolitical importance.  It’s time to take a hard look at the adequacy of the entire public health system and its ability to respond to global health emergencies.  Climate change is only one of the reasons that we can’t afford to shortchange it.

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