The best way to prevent an outbreak like Coronavirus

“Death Toll in China Overtakes SARS.” Amid headlines such as this, the World Health Organization declares the new outbreak a global health emergency. Quarantines spring up from cruise ships to military bases.

The disease – newly christened COVID-19 — is new, but the story is familiar. A new microbe emerges. There is no treatment, no cure. It is hard to predict how devastating it will be. An outbreak becomes an epidemic. Public health officials work to contain it. Researchers work overtime to identify it and develop a treatment. An epidemic becomes a pandemic.

As journalists race to cover the story, almost no one mentions the Declaration of Alma-Ata. Very few people have heard of it. Maybe the middle of a pandemic doesn’t feel like the right time for a history lesson. But this is exactly the time to remember Alma-Ata and to note how far we remain from its goals.

In September of 1978 the World Health Organization and UNICEF sponsored an international conference on primary health care in Kazakhstan’s largest city, formerly Alma-Ata (now Almaty). Delegates from 134 nations, including the United States, adopted a declaration affirming that health was a basic human right. The signatories pledged to work for universal access to primary health care by the year 2000. The declaration proclaimed the goal realistic. “An acceptable level of health for all the people of the world by the year 2000 can be attained through a fuller and better use of the world’s resources,” it said.

Why should we remember the Declaration of Alma-Ata now, in the midst of an unfolding coronavirus pandemic?

Because outbreaks of new disease will happen. We cannot stop them. But we can do much more to contain them when they start. Universal access to primary health care is a crucial step in containing an outbreak.

Universal access to health care means people will be more likely to seek care when sick. Diseases will be more quickly identified. It means people will be healthier and therefore better able to resist disease. Fewer sick people makes it easier to contain an outbreak.

Yet half of the world’s population still lacks access to primary health care, according to the World Economic Forum. And health is not just the absence of disease. Health means having enough good food to eat. Having clean water to drink. Having proper clothing and shelter. Most of the world’s citizens lack access to one or more of those basic needs.

In 2008, Margaret Chan, then director-general of the World Health Organization, celebrated the 30-year anniversary of Alma-Ata by making it the subject of a year-long theme. She emphasized “Health For All” in the annual world health report. It was time, she proclaimed, to “return to Alma-Ata,” with its goal of universal access to primary health care.

Health is first and foremost a humanitarian issue. It is also a social issue, a political issue, an economic issue. Pandemics remind us how intimately connected we are. They also make clear that we cannot afford — in any sense of the word — to continue to ignore the issues of health and health care.

Economics should not be the first concern when thinking about health care. The cost in human lives should be. But the economic cost of universal health care is often the argument used to explain why we aren’t addressing it more effectively.

Chan, along with many others, argued that the estimated cost of a global pandemic would be in the trillions. The expense necessary to provide universal access to health care is considerably less. Using estimates from the World Bank, the WHO shows that “it costs less to prepare than to respond” with preparedness costs estimated at less than 1 percent of the estimated cost of a response.

Counter to the argument that the cost of universal access to health care is out of reach, these estimates strongly suggest the world cannot afford not to address them.

The call for return to the Declaration of Alma-Ata was sounded again in October of 2018, when Kazakhstan once again hosted a global conference on primary health care sponsored by WHO and UNICEF.

In February of 2020, as we watch the mounting death toll of the most recent newly emerging infection, it is time to pass that word around.

Let the personal tragedies remind us that we cannot afford not to.