When the Panic Is Over, Health Care Challenges Face Neglect
Dr. Nahid Bhadelia explains how “pandemics become yet another stage on which geopolitics plays out.”
From devastation caused by climate change to the lingering threat of nuclear warfare, global pandemics are yet another existential threat to our global, and national, security. On the latest episode of Press the Button, Dr. Nahid Bhadelia explains that one of the reasons global pandemics pose such a threat is that “outbreaks tend to take advantage of the cracks that already exist in our communities. They prey on those that we leave out in the cold . . . they take advantage of the communities that are marginalized that don’t have access to the same resources.”
Bhadelia is a board-certified infectious disease physician and founding director of the new Center for Emerging and Infectious Diseases Policy & Research at Boston University. The center aims to bring experts together to work on answers to the questions that arise during pandemics, including how to educate the public on infectious diseases, prevent disinformation, successfully utilize science diplomacy, and advise on appropriate global governance. Her own goal goes even further to work to “bridge health inequities beforehand so that we make ourselves more resilient.”
In her interview with Ploughshares Fund President Dr. Emma Belcher, Bhadelia points out that it is not just federal policy that affects a nation’s ability to cope with catastrophic threats. She notes that the key issue, particularly in the United States, is that “over the last decade we have seen gutting of the public health infrastructure at the state level.” The Biden Administration’s proposed budget for health care will increase spending for Health and Human Services by 23 percent and bring the Center for Disease Control’s budget up to $8.7 billion with one of the largest budget increases over the past four administrations. However, Dr. Bhadelia explains that while “the national budget is important because CDC itself over the last administration did see decreases in funding . . . [what that] doesn’t cover is that difference between states . . . that requires engagement at the state level.” This disconnect is caused by the reality that in the US “public health is in the public sector and the health care system is in the private sector.”
In looking for solutions, Bhadelia points out that there are supply chain problems and health care infrastructure problems, but what has made global pandemics so easily occur is that “we are changing the world around us.” She explains that among these changes are a growing population and environmental degradation, but one of the key shifts is that there are more people living in closer proximity to animals. “This is allowing viruses to make the jump that they were not able to make before.”
On top of this, she highlights that we have not been able to recognize new viruses when they begin because we lack the infrastructure to do so. One of the biggest lessons from the coronavirus pandemic in particular, is that “what we also need to work on is health equity because that is protecting people from diseases . . . at baseline [and] also helps us tackle the emergence of new infections.” Far too often when “people come in with . . . fever nausea vomiting diarrhea they're just treated empirically for malaria . . . and they're sent home. There's no laboratory capacity to confirm whether that's a new infection.” Unfortunately, Bhadelia believes “we will have to go through this a few more times before it is realized that is what is needed.”
Like global pandemics, nuclear warfare poses a key danger to our communities, and thus to national security. When asked about the challenge of how we can mitigate these crises Bhadelia notes that “whether its nuclear wars or pandemics . . . these existential crises . . . all suffer from the same issue.” Citing a report from the National Academy of Medicine on The Neglected Dimensions of Global Security, Bhadelia explains that as both individuals and a society “we tend to cycle between . . . panic and neglect [and] when the threat is gone there is just neglect.” She warns that “we have a great capacity to force normalcy back on to what should be pressing existential crises.”
The entire interview with Dr. Nahid Bhadelia is available here on Press the Button. To learn more about Dr. Bhadelia’s new center visit https://www.bu.edu/ceid/ or follow https://twitter.com/BUCEID.
Alexandra B. Hall is the Policy Associate and Special Assistant to the President at Ploughshares Fund, a global security foundation.