Pandemic preparedness | Pakistan Today

Pandemic preparedness

  • We must prepare for future pandemics

By: Dr Jawad Mushtaq

In 2015 Bill Gates warned us that the world was not ready for the next pandemic, but viruses were out there mutating waiting for an outbreak. In the past century we have seen the flu pandemics of 1917, 1957, 1968 and 2009. We have already seen three corona pandemics in the first 20 years of this century alone and do not forget Ebola and Zika virus epidemics. Any new disease transmitted by air will spread like fire in this global village, giving no time for any country to prepare for itself. In desperate times of war when countries are ready to defend themselves with deadly atomic weapons why not just prepare a deadly virus in lab, also prepare a vaccine for immunization of your own country, and then unleash that virus onto the world? To some it still may seem more ethical than using nuclear weapons, whose ionizing radiations can haunt the remaining population for the next century. Rogue nations can entertain this idea easily, and Iran which has been pushed to the corner again and again just to protect the strategic interests of Saudi Arabia and Israel might find this not very expensive solution amusing, to avoid the fate of Iraq nothing seems unethical, but what if this not so expensive weapon becomes a fantasy of some terrorist, whatever the reason.

If this pandemic has taught us one thing, it is to always be ready for the outbreak of a virus, whether once in a 50 years or six times in just 20. Pandemic preparedness should be made a part of strategic doctrine from now on.

We are living in an age of globalization where a humble cup of coffee requires 29 firms to collaborate across 18 countries according to one estimate, where China supplies roughly 10 percent of the world’s intermediate goods, where test kit swabs are produced in Northern Italy, exam gloves in Malaysia, personal protective equipment in Cambodia, face masks in china. But what happens to this efficient global supply chain in a pandemic? More than 50 governments have so for restricted the export of medical supplies. Trump pressed 3M, a US multinational which make masks, to divert more of them home, at the expense of other countries. The EU has curbed the export of medical gear. India, the world’s biggest maker of generic drugs, has banned the export of hydroxychloroquine, an antimalarial drug that some suggest might treat covid-19. Take a look at the statement of US  trade advisor Peter Navarro “if we have learnt anything from this crisis, it is that never again should we depend on the rest of the world for our essential medicines and counter measures “.

In the absence of a vaccine and any effective medicine, mass testing is the only weapon available out there, but our country still has not invested on a large scale to ramp up the production lines for developing PCR machines and for developing test kits for coronavirus at a massive level, we are still waiting for other countries to mass-produce for themselves first and then for us, and the easing of lockdown should coincide with mass testing. It is the only exit strategy available out there

Also taken a look at the statement of Amitabh Kant, who is chairing the empowered committee for strategizing ways to tackle the spread of coronavirus in India, “India needs to build a manufacturing base for ventilators and personal protective equipment (PPEs) not only to contain the spread of Covid-19 but for the future pandemic prepardness as well.” The coronavirus has reinforced an old idea that in an uncertain world some industries are  “strategic”, simply too important for countries to leave to free markets and so deserve special protection. First the world faced the shortage of masks because they are not easy to produce, Both the masks made for medical personnel and for consumer purchase require a once-obscure material called melt-blown fabric. It’s an extremely fine mesh of synthetic polymer fibers that forms the critical inner filtration layer of a mask, allowing the wearer to breath while reducing the inflow of possible infectious particles. Costing upward of 3.8 million euros ($4.23 million) apiece, the machine that creates this fabric melts down plastic material and blows it out in strands, like cotton candy, into flat sheets of melt-blown fabric for face masks and other filtration products. Chinese engineering firms say they’re struggling. “We need about six months to make the machines, and it takes another month to assemble them”.

China made half the world’s face masks. When the outbreak took off there, China started to use its supply and hoard what remained. This problem has only spread since, as more and more countries hoard whatever medical supplies they can get, banning export of medical equipment at the same time. Similarly countries which relied on home grown personal protective equipment had necessary know to scale up production on a massive scale to fight the virus efficiently but countries like Pakistan have been left to fend for themselves.

The earth is going to need the addition of a whole new chapter in terms of free trade when it comes to trade of medical supplies, in future every country should incentivise  the production of medical equipment at home first through heavy duties on imports and then through complete ban on import, and through the WTO it should be made the global agenda that every country should be self-sufficient and should not rely on complex global supply chains for the supply of medical equipment because at times of war and disaster, disruption of these supply chains can prove disastrous for any country relying on it.

The world is already familiar with idea of war games which test the combat readiness of troops of any country. But now it is time to promote the idea of germ games, already being held in the USA, which show the ability of any country to fight with epidemics and pandemics, test the abilities of doctors to identify the pathogen, its mode of transmission and its mode of action in the human body and how quickly they can identify the efficiency of a different medical substitute already available out there, and the whole exercise should somehow culminate in designing an effective vaccine.

Ideally vaccine research should be funded in such a way that during an outbreak, a vaccine could be designed, tested for safety and could be made ready for manufacture at a massive scale within a few months. The world is still at least 12 months away from the availability of a vaccine, and while the lockdown can continue for another month, but what about the remaining 11 months? What is the plan of action, how are we going to live with the virus for at least a year? In the absence of a vaccine and any effective medicine, mass testing is the only weapon available out there, but our country still has not invested on a large scale to ramp up the production lines for developing PCR machines and for developing test kits for coronavirus at a massive level, we are still waiting for other countries to mass-produce for themselves first and then for us, and the easing of lockdown should coincide with mass testing. It is the only exit strategy available out there.



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