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Writer's pictureSithmi Edirisinghe

South Asia and future pandemic preparedness

Updated: Nov 30, 2022



We can all unanimously agree that we do not want a repeat of the last three pandemic-riddled years. In fact, the moment I heard about monkeypox, my immediate reaction was, “Oh no, not again!”. While the emergence of pandemics is not easy to prevent, what we can do is take every measure humanely possible to prepare for them. This sentiment is easy to have, but humans have a history of not learning from their own mistakes. After all, one would think that after the devastation of the first world war, we would know better than to start yet another. Unfortunately, that is not how things work.

Now that we are coming out of a pandemic (sort of), it is time to think about the future. To be more specific, a future in which more pandemics are a very real possibility. Since COVID-19 has robbed us of the ability to hide the prevalence and possibility of global disasters under the cloak of human denial, we should probably start seriously considering preparing for climate disasters, nuclear annihilation, global famines, and a bunch of other things – but let us take things one step at a time.



Pandemic preparedness in pre-COVID South Asia

As we all discovered, pandemics do not just devastate the healthcare systems of the world. They have far-reaching implications that make massive (and often inconvenient) alterations in the socio-economic and even environmental makeup of the countries we live in.

Although it cannot be said that any country handled the pandemic with a 100% success rate, compared to other parts of the world, South Asia is a region that fell short in terms of preparedness for a pandemic (as measured by the Global Health Security Index). The score for all South Asian countries ranged between 33 to 46.5, while the highest possible score is 100. Countries in South Asia generally allocate only about 3 to 4% of their GDP to their healthcare systems. This is a less-than-ideal allocation under normal circumstances, but under pandemic conditions, it is simply not enough. This also served to exacerbate the negative effects of a major outbreak, because healthcare systems did not have adequate resources to prepare for such eventualities in advance. In addition, South Asian countries also did not have solid mechanisms to surveil and control the spread of harmful zoonotic pathogens, making them all the more susceptible to zoonotic diseases like COVID-19. They also faced a shortage of healthcare workers, especially ones who are trained to handle a pandemic. With all these factors combined, South Asia was hit hard by COVID-19 and is still on its way to recovery.


Why is pandemic preparedness important for South Asia? Preparing for future eventualities should ideally be a part of this road to recovery – after all, no one wants to be taken by surprise by yet another pandemic. Zoonotic diseases (transmitted from animals to humans) are emerging rapidly, especially in Asia. Only this week, China came up with yet another zoonotic virus, Langya henipavirus, and this is just one of an infinite number of them.


Although not all zoonotic viruses would cause a pandemic in the scale of COVID-19, the frequency of the discovery of these viruses show us just how vulnerable we are to the forces of Nature. South Asia, being tropical and rich in biodiversity, is a convenient breeding ground for these viruses. This combined with the scarcity of resources, restricted access to vaccines, high population levels, and poor sanitation can lead to yet another devastating outbreak if we choose not to learn from the mistakes of our past.

Investing in vaccine manufacturing

Vaccine inequality is a major issue in South Asia’s pandemic response. Most high-income countries were able to manufacture their own vaccines and had ready access to their choice of COVID-19 shots. However, most countries in South Asia faced delays in obtaining vaccines, as they had to wait until there were enough available to reach their country. These delays allowed the disease to gain an even stronger foothold in these communities. Since it is a given that we are only going to be battling more infectious diseases in the future, making countries in the region self-sufficient in terms of vaccine and medication production will be a fruitful endeavor in the long run. India is already producing vaccines and drugs on a large scale, and other countries in the region can take up its example.


Increasing healthcare budgets

South Asia as a whole invests only about 1% of its GDP in health security, while the WHO recommends 3%. Although the healthcare systems in this region are generally functional, they are not always resilient enough to counter pandemics. Therefore, it is necessary for countries to invest in pandemic-preparedness mechanisms. Although it might not seem viable to allocate resources to fight threats that have yet to show themselves, it is undeniable that this will be sustainable in the long run. South Asian countries can work in collaboration with international financial institutions, as well as request foreign aid, to gather the required funding to improve sectors such as diagnostics, research, manpower and more.

Disease surveillance at a regional level

The availability of disease surveillance at a regional level can help analyze trends in emerging infections and allow intervention before these diseases spread far and wide. Regional cooperation in creating and maintaining databases to collect information about new variants, outbreaks, infections and death counts will reduce the likelihood of healthcare systems being taken by surprise by pandemics. It will give them adequate time to take preventative measures and prepare resources for any eventualities that may occur. The availability of reliable information can also benefit the public, as they too can then be involved in the disease detection mechanism.

In a world that keeps introducing unprecedented challenges, it is important that we prepare for foreseeable issues such as pandemics. South Asia, as a region that has quite a few shortcomings in its health systems, has a long way to go in that regard. However, it is also a region of great potential, and with the right decisions and pandemic-preparation mechanisms, South Asia can undoubtedly ensure effective management of future healthcare challenges.

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