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The Fight Against the Next Pandemic Starts Now

Tech billionaires are pushing for funding to prep for future pandemics.
Why not the left?

 

President Joe Biden speaks as Kizzmekia Corbett, an immunologist with
the Vaccine Research Center at the National Institutes of Health, looks
on during a visit to the Viral Pathogenesis Laboratory at the NIH,
February 11, 2021, in Bethesda, Maryland. (Evan Vucci/AP Photo)

 

****

**** When Abie Rohrig saw a video of Vox's Dylan Matthews
donating his kidney

to a stranger, he was hooked.

"Immediately, I was just like, definitely something I want to do. I
looked at the numbers. It's like, 3-in-10,000 risk of death, which is
similar to appendicitis," Rohrig said. "It's only slightly higher than
childbirth, which I would do, if I wasn't a guy."

Rohrig donated his kidney after his freshman year in college. He is now
a senior at Swarthmore, and undergoing major surgery was just the start
of his passion for bioethics. When the pandemic hit, Rohrig began
advocating for high-risk, high-reward challenge trials
, signing up to be infected with COVID-19
in order to speed along epidemiological research.

Rohrig might be keener to put his own body on the line than more
typically demure public-health advocates, but he's most unusual for
being a young leftist pushing science policy. Right now, he is alarmed
that, despite the ongoing coronavirus crisis, Congress is reportedly
considering slashing funding for pandemic preparedness

from the public-investment package being hashed out in budget
reconciliation.

Originally, the Biden administration had sought to put $30 billion
toward programs like medical stockpiling and vaccine development. But as
the bill faces an uncertain future, with conservative members of the
caucus calling for trims, that program has been an early target for
cuts.

Last Friday, science adviser Eric Lander introduced a $65.3 billion
preparedness initiative, but said the White House would urge Congress to
provide only around $15 billion as a down payment, just half the
original number

demanded in the American Jobs Plan.

It's a striking item to downsize in a year that by early summer had
already seen more global COVID-19 deaths than 2020.

Mild-mannered scientists and Biden bureaucrats have quietly backed the
funding, boosted by an eccentric cohort of science-policy enthusiasts
like Rohrig. But it's not obvious why preventing disease outbreaks
should be defended by wonks and insiders, instead of public pressure
campaigns. As a result, pandemic preparedness, even in name, has taken
on a certain "eat your broccoli" flavor.

The pandemic revealed the fault lines of American inequality. We are
overdue for a bout of avian flu
,
and climate heating is multiplying the threat
of emergent infectious
disease. Another pandemic would probably also punish the poor, and
threaten national security. These seem like nakedly political issues,
yet neither party has claimed them as a priority.

Some on the left say Democrats should draft off outrage from the
coronavirus to make the case for initiatives like Medicare for All,
better public housing with improved ventilation, and worker protections.
But organizers have struggled to build campaigns around the COVID-19
shock.

Public health in the United States, where even hospital bills

are made "personal" through extreme price discrimination, is a highly
individualized affair. As a result, there is no pre-existing
constituency to champion pandemic prevention. It's a politically
neutered issue, left to technocrats.

Maybe that's not such a bad thing, some of those technocrats told the

**Prospect**. The return on investment for outbreak prevention is huge.
If it is not politicized, $30 billion (not even 1 percent of the
proposed $3.5 trillion bill) could be slipped in under the radar,
possibly helping avert trillions of dollars in losses to future
outbreaks.

On the other hand, without a popular constituency, even small and highly
cost-effective line items are the first cuts in a bill with a forced
upper-bound limit.

**Read all of our infrastructure coverage here**

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"I'M A QUANTY GUY," Gabe Bankman-Fried, executive director of the
nonprofit Guarding Against Pandemics, told the

**Prospect**. Out of college, Bankman-Fried worked at Jane Street, a
proprietary trading firm, before becoming a Hill aide.

"As a trader, the mindset is to look for inefficiencies, good bets,
trades other people haven't found. It's sort of the same philosophy
in donations," he said. Even before COVID-19 hit, he said, that ethos
drew him to chronically underfunded public goods, like biosecurity and
climate.

Now, he wants to fund U.S. capacity to design and approve a vaccine for
a future pathogen within 100 days of identifying an outbreak. For
COVID-19, that would have meant vaccine viability by May 2020.

Guarding Against Pandemics is funded by Bankman-Fried's brother Sam,
who as of July was the world's richest person under 30. After his own
stint at Jane Street, Sam launched FTX, a cryptocurrency exchange.

The brothers are part of a growing set of tech philanthropists,
including Facebook co-founder Dustin Moskovitz, who are using private
wealth to fund utilitarian aims. Many support "effective altruism," a
movement for evidence-based giving, and are interested in risks with
exponential or long-term harms. Moskovitz has bragged
that his
charity, Open Philanthropy, supported averting global catastrophic risks
like pandemics long before COVID-19.

If pandemic preparedness wins full funding in the final bill, it may be
due to their inside lobbying.

"People haven't formed much of their political identity around this
issue," Sam Bankman-Fried told the

**Prospect** in an interview. "It just hasn't been on the public
consciousness for that long." Even as COVID-19 has become a political
football, Sam said, the broader problem of developing vaccine capacity
hasn't gained much currency.

That's not an obstacle, but an opening. Sam worries that if pandemic
preparedness is politicized, it would quickly be snarled in
congressional gridlock.

According to this logic, early detection and response systems

not only help prevent disease outbreaks-they also stave off culture
wars.

Once a pandemic gets out of control, "any decision you make is going to
be infringing on something that people hold really deep," Sam said.
"What we're left with is, for many people, a really galling choice,
which they see as having to choose between their health and their
freedom."

The way out of this box, Sam argued, is to build rapid disease
containment into a perfunctory budget line. "Ideally, what you can do is
take the technocratic approach before it seems like a choice," he said.

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CALLS FOR PANDEMIC PREP from progressives, meanwhile, have been tepid.

Twenty Democrats last month asked

congressional leaders to back the full $30 billion in spending, citing
broad public support

for heading off "more devastating impacts to our country when the next
pandemic arises."

A few progressives, including Massachusetts Sens. Elizabeth Warren and
Ed Markey, signed on to the letter, which was organized by Rep. Ritchie
Torres (D-NY) and emphasized COVID-19's disparate racial impacts.
Senate Budget Committee chair Bernie Sanders did not.

Sanders has been a longtime supporter of increased funding for pandemic
prep. In 2005, he invoked the death toll of the 1918 influenza pandemic

to argue that when preventing catastrophic harm, Americans "will forgive
us if we end up doing things and spending money that in the long run may
turn out not to be necessary."

Now, Sanders is being forced to pick among competing interests he has
previously championed. Joe Manchin's rejection of the bill's price
tag

inflicts real penalties, and the choices should be seen as a test of
tactics rather than values.

In that environment, some on the left say pandemic prep is a line item
best left to moderates.

"Moderates tend to be more focused on what the middle class and upper
middle class is experiencing. And the pandemic was a moment of profound
vulnerability for everyone," said Emma Claire Foley, who chairs the
health care working group of NYC Democratic Socialists of America.

The pandemic preparedness proposal, Foley said, is a "piecemeal, and
hopefully efficient, but fundamentally limited approach that fits very
well in a moderate agenda."

Several organizers said the left should prioritize universal health care
in the wake of the pandemic, but admitted it has been hard to mobilize
people amid fallout from COVID-19. "We were really just baffled that it
did not lead to like a groundswell for health care expansion," Foley
said.

The left has favored expanding health care benefits wherever possible,
predicting that people will then fight to keep them. One attempt was
Washington Rep. Pramila Jayapal's Health Care Emergency Guarantee Act,
which would have looked something like short-term Medicare for All
. In
the reconciliation bill, the action has been on Sanders's priority of
adding dental, hearing, and vision benefits for Medicare
.

Some would like to see a more combative approach, but the discussion has
been kept to backroom conversations.

Partly, it's a constituency problem: Pandemics are diffuse, whereas if
Democrats abandon benefit plans, AARP would balk. Also, there's the
problem of claiming credit. It's hard to do a political victory lap on
an averted crisis.

It's not impossible. Invoking the

**Iliad**, Boris Johnson has sought to rally
Europeans around pandemic
preparedness, saying Britain would help forge the way past a world "as
disunited as Achilles and Agamemnon."

For now, though, the American effort is still led by understatement.

"Research takes time. And obviously, if it's not funded, then things
are slowed down," said Stanley Plotkin, a distinguished vaccinologist
and consultant to vaccine manufacturers, in an interview with the

**Prospect** about the need for pandemic preparedness funding.

Asked why his manner didn't seem to match the urgency of his message,
Plotkin demurred.

"There are people like Dr. Fauci, who are more voluble," Plotkin said,
but most scientists aren't activists. "It's not our style. We prefer
to spend time in the laboratory, rather than out on the streets."

To read more about infrastructure and the Build Back Better Act, check
out our series Building Back America
.

 

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