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pandemic would mean that South Asia’s GDP would drop by 2% (US$ 53 billion), and sub-Saharan Africa’s GDP by 1.7% (US$ 28 billion), the latter equivalent to erasing a full year’s economic growth (Figure 3) (10,11,12). FIGURE 2 Costs of selected epidemics (US$ billions) Source: Resolve to Save Lives (www.resolvetosavelives.org). 70 60 50 40 30 20 10 0 2001 SARS H5N1 H1N1 MERS EBOLA 2003 Estimated costs of selected epidemics/pandemics in US$ Billions (2001-2017) 2005 2007 2009 2011 2013 2015 2017 Billions ($) A WORLD AT RISK 4 FIGURE 3 Predicted country vulnerability to pandemic economic loss, 2018 (% GDP loss) FIGURE 4 Costs of 2014-2016 Ebola epidemic, West Africa (US$) IBRD: International Bank for Reconstruction and Development. Source: Resolve to Save Lives (www.resolvetosavelives.org). The direct impacts on countries are severe. Guinea, Liberia and Sierra Leone lost an estimated US$ 2.2 billion in GDP in 2015 (13) during the 2014-2016 West Africa Ebola outbreak (14) (Figure 4). Source: Resolve to Save Lives (www.resolvetosavelives.org). GUINEA $600 MILLION SIERRA LEONE $1.9 BILLION LIBERIA $300 MILLION IBRD 43420 FEBRUARY Percent GDP Loss 2.0% 1.5% 1.0% 0.5% 0.0% $2.8 BILLION OVERALL COST 50% DROP IN TOURISM Drop in tourist arrivals in Sierra Leone from 2013 to 2014. The rest of West Africa also saw a 7.7% drop in arrivals in 2014. 51% NO LONGER IN WORK % of Liberian wage earners that reported no longer working in their latest job 9 months into the epidemic. 4.9-9.4% DECLINE IN REVENUES Decline in government revenues in 2015 in the 3 countries (incl. direct & indirect taxes, VAT). 20% DROP IN GDP Drop in Sierra Leone’s GDP in 2015, wiping out 5 years of development. The GDP per capita dropped by an average $125 per person in the 3 impacted countries. A WORLD AT RISK 5 Epidemics and pandemics disrupt trade and tourism, both of which are major global economic drivers and have provided a huge boost to African economies in recent years. In 2017: • global merchandise trade estimated at US$ 17.43 trillion • commercial services, including tourism: US$ 5.19 trillion. Combined, they made up about 18% of the global economy. • The world has become closely interconnected in terms of value chains and population movement, and not only for rich countries. The share of trade held by developing economies: - merchandise exports: 44% (almost half as trade among these countries). - commercial services, including tourism: 34% The chances of a global pandemic are growing. While scientific and technological developments provide new tools that advance public health (including safely assessing medical countermeasures), they also allow for disease-causing microorganisms to be engineered or recreated in laboratories. A deliberate release would complicate outbreak response; in addition to the need to decide how to counter the pathogen, security measures would come into play limiting information-sharing and fomenting social divisions. Taken together, naturally occurring, accidental, or deliberate events caused by high-impact respiratory pathogens pose “global catastrophic biological risks” (15). The world is not prepared for a fast-moving, virulent respiratory pathogen pandemic. The 1918 global influenza pandemic sickened one third of the world population and killed as many as 50 million people - 2.8% of the total population (16,17). If a similar contagion occurred today with a population four times larger and travel times anywhere in the world less than 36 hours, 50-80 million people could perish (18,19). In addition to tragic levels of mortality, such a pandemic could cause panic, destabilize national security and seriously impact the global economy and trade. Trust in institutions is eroding. Governments, scientists, the media, public health, health systems and health workers in many countries are facing a breakdown in public trust that is threatening their ability to function effectively. The situation is exacerbated by misinformation that can hinder disease control communicated quickly and widely via social media. ALL PARTS OF SOCIETY AND THE INTERNATIONAL COMMUNITY HAVE MADE PROGRESS IN PREPARING TO FACE HEALTH