A step change in security and preparedness

This chapter reviews the institutions, legal frameworks and international guidelines that have been introduced to tackle pandemics and the risks of novel infectious disease outbreaks in the last 20 years, and following the SARS outbreak, to prepare, mitigate and respond at various levels, nationally and internationally. The chapter discusses issues of continuity and discontinuity between outbreaks (for instance the argument about intense and extensive mobility today, versus what happened in the past) and introduces political debates about global health governance today. This includes considering whether pandemic preparedness can be regarded as a priority for the West first and foremost. It involves discussing its relevance to the needs of the Global South, for instance in relation to tackling other serious widespread (or endemic) diseases such as malaria, which cause a much higher death toll already every day in many parts of the African continent. The chapter also addresses the tensions that emerge when working globally within WHO-led frameworks for collaboration on surveillance and data sharing. It discusses the disputes that sometimes arise, also in relation to collaborations with the pharmaceutical industry and other public-private partnerships and funders.