Forgotten but Not Gone - The Lingering Threat From Infectious Disease
Whatever happened to the Ebola virus disease outbreak? While there were 10 times fewer new diagnoses in March than six months before, new cases persist in Liberia, Sierra Leone and Guinea. Concerns abound that the coming rains will swell the gently rising numbers, while fears over it spreading continue to place limitations on the free movement of people.
That this emergency began in December 2013 is a grim reminder of how uncontrolled infection can leave a lingering legacy of unmanageable sickness and mortality. Months of declining cases fanned hopes the nightmare may be ending but the final 10% of infections is proving the hardest to eradicate.
Although centred in Western Africa, isolated Ebola cases emerged in more distant countries. Anxiety about its spreading was particularly marked in medically advanced countries where drug-resistant bacteria are capable of becoming significant threats in their own right.
As an epidemic dies away, medical impetus to develop countermeasures, including vaccines, often fades, too. This short-term outlook means that outbreaks remain hard to predict and control. (This time however, work continues - just in April more volunteers began receiving another experimental Ebola vaccine.)
Indeed, a staggering range of infectious diseases have the potential to cause widespread distress, illness and death, despite the advances in medical science. The low economic basis of some countries mean they are at most risk of future outbreaks while developed nations can deal with the illnesses more effectively. Could this change in future if a massive pandemic emerged?
Malaria, pneumonia, HIV, meningitis, plague, yellow fever and cholera all continue to pose real threats in many regions of the world, while the H1N1 influenza outbreak of 2009 shows the potential outbreaks have to become disease pandemics.
Because international cooperation is poor, awareness of the scale of new threats, through monitoring and reporting, remains weak. It remains equally difficult to predict when an outbreak will become a pandemic, meaning that control measures are only deployed once an outbreak is underway.
There is no evidence of falling demand for life and health insurance during a disease pandemic - in fact, the opposite is likely. Traditional underwriting approaches are ill-equipped to recognise acute infectious disease risk. It is unlikely that insurers would request disclosures of the mild symptoms of early infections, or ask underwriters to expend energy investigating them, because most are trivial. Arguably, questions about travel patterns and occupation could fill in the knowledge gaps about an applicants’ risk of exposure to infection.
What is clear is that better disease prediction, prevention and control will benefit both insurers and the economies they serve.
The spread of pathogens across international borders may be the price of globalisation. But that’s no reason to be complacent. Policymakers should strive to harness the power of scientific research, create effective disease models, collect and manage data, coordinate national public health systems and mobilise an international crisis response with adequate funding.
Without such vision, the human and economic cost of the next infectious disease outbreak could reach a new, and up until now, unimaginable level. As is being discovered each day in Western Africa, only zero cases mean zero transmissions.
Read my article in Risk Insights for more on the threat posed by infectious diseases.