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Pandemic Preparedness Demands More Attention From Presidential Contenders

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nathan Myers
December 1, 2019

The recent debates between Democrats vying for the presidency in 2020 have been characterized in the media as high pressure tests for those candidates. But what if the candidates were asked, not about their stands on certain issues or their legislative priorities, but how they would address a massive shortage of antiviral medication in the face of a fast-emerging pandemic? Or a complete shutdown of international travel? Or managing the financing of the response? Or combatting the intentional spread of misinformation about the response on the Internet?

These are the questions that confronted global leaders in government and business at a recent tabletop exercised called Event 201, co-sponsored by the Johns Hopkins Center for Health Security, the Bill & Melinda Gates Foundation and the World Economic Forum. Event 201 presented the assembled leaders with several scenarios and asked them to identify key issues and develop possible solutions. There are some who have questioned the value of such exercises, as those in attendance and those participating in the virtual exercise online are already invested in the issue of pandemic preparedness.

It is true that the public would be most enlightened by how candidates currently running to win the presidency in 2020 would respond to these events. Among the top four Democratic candidates (Joe Biden, Elizabeth Warren, Bernie Sanders and Peter Buttigieg), the issue of public health is not featured prominently on their web sites. All the candidates have staked out positions on how to expand access to health insurance coverage. Candidates have taken policy stances on public health-related issues such as combatting climate change and opioid addiction and providing affordable housing. One candidate, Mayor Peter Buttigieg of South Bend, Indiana, set forth a plan to bolster public health as part of a larger strategy to promote racial equality, in addition to focusing on improving disaster preparedness capabilities in the United States.

Public health underlies the importance of many major issues. A goal of expanding access to healthcare is making the population healthier as a whole in order to be stronger in the face of a public health emergency. Climate change negatively affects public health, including its contribution to the severity of global disease outbreaks. Opioid addiction must be treated as a public health issue, not an individual medical one. Opioid abuse has spread throughout the country, fueled by economic stagnation, a sense of hopelessness and a lack of responsibility on the part of certain doctors, pharmacies and corporations. And having an affordable and safe living environment for as many Americans as possible is at the heart of a healthy culture and a sense of health security.

It is time for public health to become a presidential agenda item in its own right. It is an issue that has a way of asserting itself at the top of the national policy agenda, as exhibited by the Obama administration and the 2014 Ebola outbreak. Jeremy Korndyk’s excellent summary of the United States global response to that emergency gives President Obama credit for resolving numerous bureaucratic logjams that were hampering effective response. However, it should be noted that this happened after President Obama began really focusing on the issue and exerting active leadership. When public health crises like Ebola or Zika emerge they often do so slowly and with less visibility. They don’t present themselves as a potential crisis until they’ve actually become one. That is why future presidents would be advised to begin focusing some of their attention on public health issues before they reach office. That way they will be in a better position to identify a pending catastrophe and begin leading departments and agencies regarding the response.

We are unlikely to find any presidential candidates near a simulation like Event 201 anytime soon. However, the value of potential commanders-in-chief engaging in such an environment are clear. It would educate candidates about the key issues involving pandemic preparedness while giving the public a better sense of their potential for crisis leadership. Such education would hopefully carry forth into the White House, where new presidents will be on higher alert for public health threats and will be a loud voice for obtaining and providing additional resources when an emergency presents itself. Presidential candidates can begin spotlighting the need for more public health today to combat pandemics tomorrow. Event 201 needs to spark an ongoing conversation about our health security vulnerabilities. All possible future presidents should be a part of it.


Author: Nathan Myers is an associate professor of political science and public administration at Indiana State University.

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The American Society for Public Administration is the largest and most prominent professional association for public administration. It is dedicated to advancing the art, science, teaching and practice of public and non-profit administration.

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