World Bank: How Central Asian Countries Can Prevent Future Pandemics

This interview was originally published in Russian by Forbes Kazakhstan on November 29, 2022

Martien van Nieuwkoop, the World Bank's Global Director for the Agriculture and Food Global Practice, visited Almaty to attend a regional meeting Protecting Livestock and Preventing Pandemics held on November 14 in Almaty. Representatives of the ministries of health, agriculture, and environmental protection agencies of the five Central Asian countries consulted on how to cope with the next pandemic. Global organizations such as the WHO, the OIE, FAO, UNEP and the World Bank put forward a solution: the One Health initiative. Participants endorsed this approach, and even issued a communiqué giving a formal start to the development of the Central Asia One Health Framework forAction. In this interview, the World Bank representative spoke about the rationale behind the initiative and why the approach is so crucial for Central Asia.

Mr. van Nieuwkoop what is "One Health" in simple terms? Veterinary offices will be located next to the offices of community physicians?

Of course not. But we must understand that human health depends on both animal and environmental health - for example, 70 to 80% of the pandemic diseases that have occurred in the last 20 years were zoonotic in nature (transmitted from animals to humans). The One Health initiative focuses on the interaction between the health of environment, animals, and people. Experts must work together so that problems in one area do not cause problems in another.

Is it expensive? Will restructuring the health care system under the new concept require additional funds?

Pandemic prevention, preparedness and response require investment. Currently countries are underinvesting. When an epidemic breaks out, it's the same cycle of panic and neglect over and over again. When people get sick, governments promise to allocate more money to prevent future pandemics, but as soon as the wave of infections passes, these priorities vanish into thin air. It's hard for health ministries to then argue that pandemics are still dangerous - because physically, for the moment, they're not.

Studies by the World Bank suggest that the world health system needs an additional $30 billion a year to be prepared for the next pandemic. Indeed, these are huge sums of money. But investing in pandemic prevention is much cheaper than preparedness (about a third of this amount) and is much more efficient than spending to combat a pandemic that has already begun.

A recent World Bank report states that the next pandemic is "just around the corner." What disease is in store for us this time?

It is hardly possible to say what exactly the next disease will be, but there is no doubt that it will come. Before COVID, there were SARS (SARS-CoV-2 - severe acute respiratory syndrome, or SARS, with a total of 8,098 cases in 29 countries in 2002-2003 and a 10% mortality - Forbes) and avian influenza (H5N1 strain, registered since 1997, with mortality over 50%). Experts said 10 years ago that the next pandemic is not a question of "if," but rather a question of "when."

No one knows what disease will cause the next pandemic. The only thing we can say is this: if the world continues to underinvest in preparedness and prevention, as after SARS and avian flu, there is a very high probability that the next pandemic will come much sooner than expected.

COVID-19 clearly is retreating. But a war has broken out, food shortages have arisen, and prices are soaring. Under such circumstances, how realistic is it to convince Central Asian governments to commit to spending extra money on a hypothetical epidemic?

This is what our meeting in Almaty was aimed at. There we asked the representatives of the countries in the region: when do you need an action plan? We suggested a reasonable timeframe, but the countries asked to speed up the process. Why?

First of all, I think that most of the decision makers in any Central Asian country have either had COVID themselves or have had someone close to them get infected. This is quite a personal issue for many. There was no such attitude after the avian flu - somewhere chickens were destroyed on farms, and that was it. Now the perception is completely different. Second, after the COVID, the finance ministers did the math and realized that prevention is cheaper than cure. Third, countries of the region spend a lot on state support of agricultural producers, and some of this support is not always effective. What if the subsidies allocated to agriculture were redirected so that they produce more impact?

In addition, in September 2022, the World Bank created the Financial Intermediary Fund for Pandemic Prevention (FIF). It will receive donations from wealthier countries and channel them to low- and middle-income countries.

It's good that you're bringing up agriculture. In Kazakhstan, if they talk about issues within the agricultural sector, they usually complain about the harsh climate and inadequate state support. And what are the issues with Kazakhstan's agriculture as seen by the World Bank and what solutions does your organization suggest?

There are 50 million farms in the world, and if you ask farmers about their problems, most would complain about climate change. There are studies by climate scientists who calculate that if climate change had not occurred, agricultural productivity would have been 25% higher than it is now. Thus, climate change is a reality; it drives up costs for agricultural producers. Climate change is evolving much faster than previously predicted, meaning that most predictions have been more conservative than reality. How to deal with it?

First, government subsidies - globally, governments spend about $640 billion on this. And only one-third of this money is spent on investments in climate-resilient and smart farming practices. These funds need to be redirected towards adapting agriculture to climate change.

The second issue is innovation. Countries are underinvesting in innovation, in increasing agricultural productivity. We need solutions to increase productivity and resilience to climate change while reducing our carbon footprint.

Third, we see enormous potential in the digitalization of agriculture. Data-driven farming can help resolve a lot of farmers' problems. Precision farming can be implemented, marketing can be done on innovative platforms, financial services can be provided to farmers, etc.

One more point. Agriculture is usually a private business. And if you look at the use of ESG (environmental, social and corporate governance), you can see that agriculture lags behind in the application of ESG standards compared to the energy and transportation sectors. Only a few agricultural companies in the world actually have a high sustainability index. Yet agriculture accounts for 12% of the global GDP.

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