The ever-grimmer news about the spread of Ebola reminded me of the section about epidemics in the globalized world in The Butterfly Defect by Ian Goldin and Mike Mariathasan. The book is about the fragilities inherent in such an inter-linked world – economic, financial, social, environmental. And these are linked: a global pandemic will certainly have financial and economic consequences.
One of their key recommendations is that the international community needs to prepare for the realisation of big risks and be ready to act swiftly. As they acknowledge, there is nothing new about pandemics – think the Black Death or Spanish Flu after World War I. They also point out that the World Health Organisation dealt swiftly in response to SARS, and H5N1 – indeed, they say the ability of public health authorities to act on a global basis is a model for, say, financial authorities. SARS is a “superspreader” and quickly affected large cities. Speed of response is vital, however – the book contrasts the fast reaction to SARS with the tragically slow reaction to HIV/AIDS, initially a pariah disease which prompted little response until famous people started to fall ill.
In short, early detection and system-wide early reaction are everything. It’s not clear to me that the global public health response to Ebola – a disease staring in poor, rural countries – has been fast enough.
The Butterfly Defect: How Globalization Creates Systemic Risks, and What to Do about It