In the months since the COVID-19 pandemic took hold, many public and private funders have stepped up with resources to meet the challenges at hand. Philanthropic capital has been spent on everything from supporting clinical trials, developing vaccines and treatment, disbursing computers to school children, ensuring access to mental health care and more. However, if past realities predict future trends, this funding bump will quickly recede when the pressures brought on by the pandemic ease.
Panic, Neglect, and Stagnant Funding
Public health philanthropy and disaster philanthropy follow similar patterns: an unexpected challenge catalyzes immediate action, then funders move to other causes as the acute crisis wanes. This is called the panic and neglect cycle. In public health, funding to strengthen the general public health apparatus (which would prevent future crises) stagnates or declines after the initial panic is over. This behavior arguably results in an even weaker health system.
According to data collected by Candid, the magnitude of philanthropic contributions in response to the COVID-19 pandemic broke previous disaster relief donation records. Funding for preparedness, reconstruction and recovery, as well as resilience, risk reduction and mitigation are significantly lower—even though these measures would mitigate, or may even have prevented, the catastrophic effect of the disease outbreak or natural disaster in the first place.
COVID-inspired funding is largely still in the “panic” phase of the stereotypical cycle. While the need for immediate disaster relief is still urgent, the severity of this pandemic must convince more funders to support prevention and mitigation strategies. This is truly strategic spending, as numerous economic studies have shown that prevention efforts in health are far less costly than disaster relief.
Breaking the Cycle
Confronted with immediate, real world problems, it makes sense that philanthropic funders respond to acute needs. However, COVID-19 has demonstrated that funding infrastructure and programs to protect from future outbreaks must be prioritized. Even as we are confronted with these seemingly oppositional realities, there are actually areas of investment that address immediate health needs and simultaneously lay the foundation for a safer, healthier future, thus eliminating the common perception that funders must choose between the two. While the hard part is knowing where to start, here, we share three examples of how philanthropy can achieve dual impact.
- Building Diverse, Global Expertise: In a world that is increasingly interconnected, the threat of another pandemic is ever-present. Philanthropic funders can work to build a global workforce, accessing the breadth of expertise available regionally to support health today and allow improved pandemic planning and response measures; Mike Bloomberg targeted this dual vision when founding the Johns Hopkins School for Public Health. The American Health Initiative challenges long-term health challenges, while training the workforce that will address these challenges in real time. An investment in human capital through workforce development creates efficiencies across industry sectors, offering innovative solutions, quickening the pace of progress, and more effectively meeting acute research endpoints necessary to quickly, yet safely, advance critical therapeutics and vaccines.
- Facilitating Health Data Infrastructure: Throughout the last decade, consolidated health data has been a robust driver of biomedical innovation, allowing clinician researchers to connect datapoints, or identify patterns across decades and geographies. These same capabilities and technologies are critical for tracking disease outbreaks. As valuable as health data is, existing systems are fragmented and laborious to use. To be sure, building a data repository infrastructure requires immense, intentional capital investment, but philanthropy is especially well-positioned to design this infrastructure in an open-source, neutrally regulated manner. Standardizing data collection on a national level would aid in accurate and transparent tracking, testing, and tracing of an emerging pathogenic threat. Establishing a coordinated health data infrastructure is a key facet of pandemic preparedness. The first step would be creating a basic dataset of pathogens with “pandemic potential” that could be readily accessed when a particular pathogen emerges. Having basic information immediately available would allow swift action and coordination among federal entities and scientific researchers, enabling rapid testing and guidelines to federal policy.
- Investing in Platform Technology: Predicting the future is rife with challenges, especially when it comes to guessing which emerging pathogen will become the next pandemic. Emerging technology, however, has made it possible to effectively pandemic-proof infrastructure investments. Platform technologies—a foundational infrastructure upon which other transposable applications are developed for data collection and analysis—are analogous to a loom used to make tapestries. Changing threads can generate distinct works. In biology, a platform technology is adaptable to the specific problem at hand, using specific markers such as the genetic code or a protein as the “thread” and the “tapestry” is the resulting vaccine, treatment, or diagnostic test. The system’s content—which is disease-specific—is interchangeable within an everlasting framework. For instance, NIH collaborated with Moderna prior to the coronavirus outbreak to develop a platform technology for rapid vaccine development. Once the SARS-CoV-2 virus was sequenced, NIH was able to support vaccine development within 5 days, and clinical trials began two months later—an unprecedented speed that held true to the highest standards of safety and scientific integrity.
COVID-19 did not break the public health infrastructure within the US; it exposed what was already broken. Herein lies the opportunity: philanthropists can disrupt the cycle of panic and neglect funding by investing in long-term, sustainable solutions to public health. The proactive construction of disease-agnostic infrastructure that can be activated at short notice will improve our healthcare systems today and allow for a more resilient response when the next pandemic hits. COVID-19 unapologetically laid out system failures. By investing in these weak spots, philanthropic capital can be the lever that minimizes the devastating effects of the next pandemic without sacrificing the opportunity to help people today.