Identifying epidemics early is all-important, because once a disease has spread beyond a local region, it becomes demonstratively difficult to control and contain.
You'd think the WHO would be all over this challenge, but as we've learned, there's a lot that agency isn't doing. And many poor countries just don't have the resources. Which helps explain why for more than a decade, the Rockefeller Foundation addressed the “rapid emergence of new infectious disease” with the potential for escalation from outbreak to epidemic to pandemic. The foundation had a disease surveillance program that encompassed resource deployment, quick and effective communication, collaboration, and the “early detection and response to emerging diseases and pandemics.”
After first awarding disease surveillance-related grants in 1999, Rockefeller expanded upon its work, formally launching the $22 million Disease Surveillance Networks Initiative (DSN) in 2007. Five years later, the foundation conducted a comprehensive evaluation which led it to the conclusion that Rock had achieved its objectives. In 2012, the DSN Initiative ended.
That’s not to say that Rockefeller completely turned its back on disease surveillance. In 2015, for example, it gave Connecting Organizations for Regional Disease Surveillance a $2.5 million grant and the Royal Institute of International Affairs $1 million to help with the establishment of the West African Disease Surveillance Network.
So Rockefeller isn’t totally out of the game, but what’s apparent is that its grantmaking in this space is of the reactive variety. Nothing wrong with that, especially in the wake of Ebola and with the threat of Zika looming larger and larger.
But with Rockefeller out, who stepped forward to pick up the disease surveillance baton? That's a very good question.
The Bill and Melinda Gates Foundation might seem like the most logical candidate, but it is not really a disease surveillance grantmaker. On the other hand, this is Gates we're talking about, so even the loose change that falls out of this funder's pocket toward an issue can rival full-borne programs by funders. And in fact, we can think of a few big grants where some serious money went for disease surveillance. For example, in 2015, Gates awarded the Child Health and Mortality Prevention Surveillance Network (CHAMPS) a $75 million grant to back its work determining why vulnerable kids around the world are getting sick and dying. A portion of those funds were earmarked for capacity building and training in the event that a disease outbreak becomes epidemic or pandemic.
More recently, Gates made over $850,000 in disease surveillance grants related to rotavirus in Africa, enteric fever in India, and Acute Flaccid Paralysis (AFP) in the Lake Chad Basin.
Another funder filling the disease surveillance gap left by Rockefeller is the Skoll Global Threats Fund.
The Skoll Global Threats Fund was founded by eBay billionaire Jeff Skoll in 2009 and is led by founding President Larry Brilliant. The fund’s initial intent focused on “five global issues that, if unchecked, could bring the world to its knees.” Those five issues of focus remain climate change, water scarcity, pandemics, nuclear proliferation, and Middle East Conflict.
According to the fund’s website, “Few things hold the power to stop the global economy in its tracks. A pandemic is one of them,” noting how the H1N1 pandemic was a good barometer for measuring how prepared the world was in its ability to handle a widespread disease outbreak.
Over the past couple of years, the Skoll Global Threats Fund has dedicated between $2 and $4 million each year toward organizations keeping a close watch on the movement of diseases around the world.
Connecting Organizations for Regional Disease Surveillance (CORDS) is the largest beneficiary of the fund’s grantmaking in this space, receiving over $2 million in grants over the past few years. Describing itself as a “network of networks,” CORDS is an international NGO working toward building collaboration and information exchange across various disease surveillance networks around the world.
Finally, we should mention that Paul Allen is another funder that's been thinking about disease surveillance, and some of his Ebola-related gifts have shored up public health systems with an eye on this challenge. It's too early to say, though, whether this will be a major focus of Allen's funding in the future.
Another funder to keep an eye on is the Open Philanthropy Project, which is closely tied to Good Ventures, the foundation of Facebook co-founder Dustin Moskovitz and his wife Cari Tuna. Earlier this year, OPP hired a new person to hire its Project initiative on Biosecurity and Pandemic Preparedness. It describes this work as follows:
We believe natural pandemics represent one of the biggest current risks to global welfare and stability, and the risks from engineered pandemics — whether via accidents or misuse — may grow in the future. We’re interested in supporting the strengthening of disease surveillance, the governance of dual use research, policy development, or other activities that could reduce the threat of a major global disruption.
Scary is the word here. Disease outbreaks can downright terrifying. And even if the world’s disease watchers and responders can keep the current threat of Zika at bay, it’s not a matter of if another outbreak will occur—it’s a matter of when.