Infectious Disease Threats: A Rebound To Resilience: A rebound to resilience

Peter Daszak, Gerald T. Keusch, Alexandra L. Phelan, Christine K. Johnson, Michael T. Osterholm

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The US has experienced a series of epidemics during the past five decades. None has tested the nation’s resilience like the coronavirus disease 2019 (COVID-19) pandemic, which has laid bare critical weaknesses in US pandemic preparedness and domestic leadership and the nation’s decline in global standing in public health. Pandemic response has been politicized, proven public health measures undermined, and public confidence in a science-based public health system reduced. This has been compounded by the large number of citizens without ready access to health care, who are overrepresented among infected, hospitalized, and fatal cases. Here, as part of the National Academy of Medicine’s Vital Directions for Health and Health Care: Priorities for 2021 initiative, we review the US approach to pandemic preparedness and its impact on the response to COVID-19. We identify six steps that should be taken to strengthen US pandemic resilience, strengthen and modernize the US health care system, regain public confidence in government leadership in public health, and restore US engagement and leadership in global partnerships to address future pandemic threats domestically and around the world.

Original languageEnglish (US)
Pages (from-to)204-211
Number of pages8
JournalHealth Affairs
Issue number2
StatePublished - Feb 2021

Bibliographical note

Funding Information:
Funding of NIH’s domestic and internationally focused emerging infectious disease research should be ensured, both for individual researchers and at an institutional level, including for NIAID’s Centers for Research on Emerging Infectious Diseases Network; the Fogarty International Center’s Global Health Program for Fellows and Scholars; research sponsored by NIAID, the National Institute of Environmental Health Science, and the Fogarty International Center on the origins and spread of novel emerging infectious diseases; and the National Science Foundation–NIH Ecology and Evolution of Infectious Diseases program. Funding for USAID’s Emerging Pandemic Threats program also should be renewed and expanded, including for the PREDICT initiative and for support for discovery of novel viruses in wildlife that could become future pandemics.

Funding Information:
The authors acknowledge the support of Victor Dzau, president of the National Academy of Medicine, and the excellent assistance of Jessica Marx and Jessica Covington, also from the National Academy of Medicine. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) license, which permits others to distribute this work provided the original work is properly cited, not altered, and not used for commercial purposes. [Published online January 21, 2021.]

Publisher Copyright:
© 2021, Project HOPE. All rights reserved.


  • COVID-19
  • Civil Defense
  • Communicable Diseases, Emerging/prevention & control
  • Delivery of Health Care
  • Health Care Reform
  • Humans
  • Infection Control
  • Leadership
  • Public Health
  • Resilience, Psychological

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article


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