Global Emergency Preparedness
Pandemic Security Is National Security: Why Preparedness Begins at Home.
In a December 11, 2025 Science editorial, Dr. Maria D. Van Kerkhove and Dr. Chikwe Ihekweazu of the World Health Organization make a clear and urgent case: pandemic security requires national leadership.
In an era marked by geopolitical conflict, anthropogenic climate change, rapid urbanization, and the growing threat of emerging infectious diseases, healthcare systems remain central to protecting lives, economies, and social stability. Pandemic preparedness is often framed as a global responsibility, yet as Van Kerkhove and Ihekweazu emphasize, true global readiness can only be achieved through robust national preparedness.
The next pandemic is not a hypothetical—not if, but when.
The drivers of pandemic risk are accelerating and converging. Climate-driven shifts in disease vectors, ecosystem disruption, expanding human mobility, and increasing zoonotic spillover are fundamentally reshaping how and where outbreaks emerge. Pandemics are no longer rare or unpredictable events; they are structural risks of the modern natural world.
Yet, paradoxically, since the peak of the COVID-19 pandemic, many governments across both high-income and low- and middle-income countries have reduced investments in public health preparedness while increasing military defense spending. This imbalance reflects a profound misunderstanding of security. A weakened healthcare system represents not only a public health vulnerability, but also a direct threat to economic stability and geopolitical resilience.
Embedding Preparedness into Global Healthcare Systems.
Emergency preparedness must move beyond episodic responses to crisis. As the authors contend, it should be embedded within national healthcare systems as a continuous, country-led function. To support this shift, the World Health Organization launched the Health Emergency Preparedness, Response and Resilience (HEPR) framework in 2023, outlining five core capacities all countries must develop and sustain:
Disease surveillance and population health management.
Essential healthcare and public health services.
Protection of communities.
Access to medical logistics countermeasures.
Emergency operations and rapid response.
The World Health Organization offers empirically-derived evidence-based guidance, technical support, and global coordination, but strategy only becomes impact through national operational leadership. This leadership is reflected in how countries finance, govern, and integrate preparedness into everyday functions across national, state, and local healthcare systems.
Lessons from COVID-19: Leadership Matters.
COVID-19 demonstrated that sustained investments in preparedness deliver measurable returns. Countries with well-developed emergency response systems were able to act quickly and decisively—implementing early contact tracing, targeted diagnostic testing, genomic surveillance, and supportive clinical care—because they had incorporated lessons from previous outbreaks.
The World Health Organization issued global alerts and technical guidance within days of the first reported cases in early 2020. Where strong national leadership was in place, healthcare systems avoided being overwhelmed. In the aftermath of COVID-19, many countries have institutionalized these gains by establishing all-hazards emergency operations centers within national public health agencies; integrating disease surveillance with logistics for medical countermeasures; and creating or strengthening national public health institutes or centers for disease control to work alongside ministries of health.
With continued WHO guidance and capacity-building support, these institutions now play a critical role in detecting outbreaks early and preventing localized threats from escalating into global crises.
Preparedness Is a Strategic Choice.
The WHO 2025 Pandemic Agreement—an accord the United States did not sign—alongside strengthened International Health Regulations (IHR), signals an important, if uneven, shift toward shared global responsibility for pandemic preparedness. These instruments reflect growing recognition among governments that transnational health threats require coordinated action. Yet commitments on paper, even when politically significant, are insufficient on their own.
Preparedness cannot be sustained by political will alone. It requires long-term financing, institutional continuity, and integration into core functions of national health systems and governance. Preparedness is not a discretionary expenditure to be scaled back in periods of political or fiscal pressure; it is a strategic investment that underwrites economic stability, public trust, and national resilience.
The lesson is unambiguous: pandemic security is national security. Without sustained investment in preparedness, countries remain vulnerable not only to health emergencies, but to cascading economic, social, and geopolitical disruption. Preparedness is no longer optional—it is a defining responsibility of effective governance.
The next pandemic will test more than the world’s capacity for global collaboration, cooperation, and coordination; it will test the resolve, foresight, and accountability of national leadership to act decisively before a crisis escalates into catastrophe. Early action—grounded in sustained investment, institutional readiness, and clear governance—will determine whether emerging threats are contained locally or allowed to cascade into global emergencies. In this sense, preparedness is not merely a technical challenge but a measure of political leadership and national responsibility.
