Understanding the Threat

Nations worldwide are spending billions of dollars preparing for an influenza pandemic. This page provides a quick overview of the major factors shaping global preparedness efforts.

On this page...
  Interrupting vital supply chains »
  “You’re on your own” »
  The economic impact »
  Hope for the best, prepare for the worst »
  Are resources allocated appropriately? »

Interrupting vital supply chains

Global markets operate through global supply chains, with a focus on just-in-time delivery. As an example, about 80 percent of all pharmaceutical products used in the United States originate in foreign countries, with supplies delivered on demand as needed.

In a severe pandemic, when borders are closed or production and shipments are delayed by illness within the workforce, the supply of many vital drugs could be depleted in just a few days. The same is true for other essential products, including food and chlorine supplies for water treatment plants.

However, communities can build resilience by deciding ahead of time what to stockpile, which business operations are essential, and by planning how to share limited resources during a crisis.

“You’re on your own”

Many of the benefits of preparedness planning are not limited to influenza pandemics alone—such efforts also prepare communities for other major disruptions, from terrorism attacks to floods and hurricanes. However, severe pandemics are special in one important aspect:
Pandemics affect people in a country or region at roughly the same time and they can sweep the world in less than a month. It is quite possible that no states or towns will be able to assist others during a severe pandemic, even if they would like to. In the same fashion, the military and National Guard cannot come to the rescue of all towns in the United States at once.
Federal and state governments have spent the past few years telling communities just that: “You’re on your own,” or “YOYO,” as the slogan goes. Communities have been urged to find out how they can best manage a crisis with their own resources. (For a glimpse of what one assistant city manager thinks about this, see this blog entry.)

The economic impact

It is estimated that the Spanish Flu of 1918-19 immobilized 20 percent of the U.S. workforce, costing the economy about $2 billion.

The Congressional Budget Office of the United States estimated in 2006 that another severe pandemic might cause a 4.25 percent decline in the U.S. gross domestic product (GDP). A milder pandemic, in line with those that occurred in 1957 and 1968, might reduce GDP by about 1 percent.1

In 2005, researchers at the World Bank estimated that international costs in a pandemic would rise over the course of a year to at least $800 billion, or 2 percent of annual global output.2

Hope for the best, prepare for the worst

While a severe pandemic such as the Spanish Flu of 1918-19 is highly unlikely, the devastation it could create makes it the most serious of all current infectious disease threats. It is important to consider how many people would eventually die, as deaths could quickly exceed those of the HIV/AIDS epidemic or any other known health threat. (The Spanish Flu killed more people than World War I).

In such a scenario, hospitals would not be able to take care of all the sick seeking help; people would be forced to search for food; dead bodies would emerge faster than morgues could process them; supply chains and local services such as waste-management and electricity would eventually break down; and much of this would happen simultaneously across the nation, and likely around the world.

Are resources allocated appropriately?

How much or how little any nation, state, community, business, or individual should prepare for an influenza pandemic has been subject of occasional debate.

Some advocates have questioned how the threat of a severe but unlikely influenza pandemic compares to that of other pressing public health and safety issues, and whether common resources are being allocated appropriately.

Government, community and businesses leaders worldwide emphasize that they are building more resilient systems to meet the pandemic threat, and point out that while they hope for the best, they believe it is important to prepare for the worst.


  1. Congressional Budget Office, A Potential Influenza Pandemic: An Update on Possible Macroeconomic Effects and Policy Issues, revised July 27, 2006.

  2. Tom Wright, “World Bank Creates $500 Million Loan Plan to Combat Bird Flu,” International Herald Tribune, Nov. 7, 2005.

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