The Lessons Not Learned From COVID-19

We had great hope that real change would spring from the COVID-19 pandemic. After all, tragedies—whether it’s a building collapse, a tsunami, or a nuclear accident—can teach leaders hard lessons that, if properly applied, result in transformational change. New building codes. Better warning systems. The Chernobyl nuclear disaster in 1986 led to new global conventions that major powers agreed to within six months.

It has now been five years since the World Health Organization (WHO) characterized COVID-19 as a pandemic. In the emergency’s immediate wake, there was global momentum, albeit slow, to build back better and to make COVID-19 the last pandemic of such consequence.

A number of countries joined together to invest in a Pandemic Fund to help increase surveillance and other capacities to identify and tackle infectious agents. A promising multicountry initiative brought researchers in the global south together to collaborate and develop cutting-edge vaccines.

At the WHO, member states initiated negotiations for a new pandemic agreement that could set the international rules and norms to identify, prevent, and collaborate to mitigate the impacts of pandemics. They agreed to a plan to increase the proportion of the organization’s core funding. Member states also amended international rules to speed up reporting of new infectious agents and to help bring tools like tests and vaccines to countries where they were needed most.

We have said many times that the progress toward reforming global systems that detect and contain pandemic threats has been slow and insufficient. While new funding is encouraging, it has not been enough to prepare for or respond to new threats. In a health emergency, the needs of people living in low- and middle-income countries may not be met.

But in the roughly nine weeks since U.S. President Donald Trump’s inauguration, his administration has abruptly put the important progress that was being made at great risk.

The United States has long been a leader in global health security. Experts at the U.S. Centers for Disease Control and Prevention (CDC) were tracking disease outbreaks around the world and providing training and financial support to help stop them. Funding from the U.S. Agency for International Development (USAID) was to be catalytic in the effort to contain mpox in the ongoing public health emergency in east and central Africa. U.S. funding for research and development for tools like vaccines was unparalleled; Operation Warp Speed, which Trump launched during the COVID-19 pandemic, protected millions of lives.

But suddenly, the world can no longer rely on the United States to play these roles. The abrupt end to thousands of USAID grants has not only put people’s lives at risk by jeopardizing health programs—including those meant to prevent and treat HIV, malaria, and tuberculosis—it also undermines the programming that keeps the United States itself safe from deadly disease.

In a memo released earlier this month, a senior USAID administrator warned the cuts could potentially lead to thousands of new cases of Ebola and Marburg, uncontrolled outbreaks of mpox and avian flu, and major increases in drug-resistant tuberculosis. The Africa Centers for Disease Control and Prevention reported that stoppages in USAID funding in the Democratic Republic of the Congo meant that samples of mpox could not be transported to laboratories to be tested—including for new variants.

Following his Jan. 20 inauguration, Trump announced his intention to withdraw the United States from the WHO. To make matters worse, in late January, CDC staff were ordered not to communicate with WHO staff, weakening the abilities of both agencies to do their essential work of protecting people.

The WHO’s emergencies program will suffer greatly as a result, given that the United States provides a significant portion of its funding and that its staff frequently partners with U.S. experts from the CDC to contain outbreaks. This is the same emergencies program that worked in partnership with Rwanda to help it contain a Marburg outbreak in record time in late 2024; had a vaccine trial for the Sudan strain of the Ebola virus running within days of confirmed cases in Uganda last month; and has rapidly narrowed down the cause of a recent outbreak of an unidentified disease in Congo.

In Geneva, at WHO’s headquarters, negotiations on a pandemic agreement continue, but the United States’ withdrawal leaves a major gap; Washington would have played an important role in the treaty’s future implementation. Similarly, the amended International Health Regulations—the agreed rules for countries to report outbreaks to the WHO—are due to come into force in September of this year. They will be less effective for all countries if the United States does not implement them.

Beyond the United States, the pool of international development assistance is shrinking fast, due to a variety of factors including politics, domestic budget pressures, and a shift toward more military spending. The United Kingdom is the latest country to announce major cuts; it had previously been the second-largest donor to global health.

This trend has many implications, including for pandemic preparedness and response. Without maintaining global capacity for surveillance, detection, and rapid action, a new pathogen can slip through the world’s already fragile defenses. Let us not forget that COVID-19, which spread around the world in months, cost the global economy trillions of dollars, contributed to inflation, and the excess deaths associated with it is estimated at more than 27 million lives.

To move forward, there are several steps that national leaders—including those in the United States—can take.

First, we ask for certainty from the U.S. leadership about the status of its present and future plans for global health security. Investments in pathogen and medical tools research, infectious disease surveillance, and collaboration across animal and human health make Americans—and the world—safer. We are calling on the White House to issue a bold and clear plan on pandemic preparedness and response.

Next, for low- and middle-income countries to adjust to what is becoming a post-aid era, all donors must join them in transitional planning that ensures people are not suddenly left unprotected from current and future health threats, whether from measles, HIV, tuberculosis, malaria, or a new disease. Governments from these countries already recognize the need to scale up domestic funding, and they cannot be expected to do so overnight. Low-income countries may never have the funds required to pay for pricey vaccines and treatments.

We have long argued that finance ministers and development bank leaders need to seriously consider proposals that will unleash billions more to fund global goods such as pandemic prevention and response. We urge them to examine models including global public investment and taxation schemes that bring more wealth from the elite to the poorest people.

WHO member states must also fund the organization to implement the reforms they demand. We believe that if the WHO did not exist, countries would have to invent it. There is no other organization that can do the job it does to set standards in global health and coordinate the health response to pandemic threats.

Negotiations for the pandemic agreement need to be brought to a successful conclusion this year. The currently debated language is not perfect—we would like to see much more tangible commitments that guarantee, for example, equitable access to tools like tests and treatments. But a framework agreement concluded by the current May deadline countries have set for themselves, grounded in equity and solidarity, can lay the foundations for a world that can prevent pandemics. Member states must not lose this opportunity.

Countries should prepare now to implement the amended International Health Regulations. And next year, presidents and prime ministers should lead the charge in setting clear policy and financial commitments to prevent and mitigate pandemics at the planned United Nations General Assembly High-Level Meeting on Pandemic Prevention, Preparedness, and Response. Disease outbreaks have implications far beyond the health sector; surely, no leader wants to be faced with a new deadly virus that their country is not ready to handle.

The world has learned from and acted on the lessons of tragedy before. If we act, with certainty, on the lessons of COVID-19, we can make it the last pandemic of such consequence.