Pandemic Unpreparedness and the Price of Profound Stupidity

“US Completes Withdrawal from the WHO.”

Samantha Anderer, Journal American Medical Association (JAMA), February 13, 2026

“Staff members at the United States premier infectious-disease research institute have been instructed to remove the words ‘biodefense’ and ‘pandemic preparedness’ from the institute’s web pages …"

Max Kozlov, senior science reporter, Nature, February 13, 2026

Despite its dark reputation, there is no evidence that more bad things happen on Friday the 13^th than on any other day of the month. I am not superstitious; nonetheless, to me, Friday, February 13, 2026 seemed to align with its mythical significance.

On that day, I learned that that the U.S. had finalized its withdrawal from the World Health Organization (WHO) and that the National Institute of Allergy and Infectious Diseases (NIAID) had been ordered to remove the words “pandemic preparedness” from its website. (Anderer, S., “US Completes Withdrawal from the WHO,” JAMA, February 13, 2026; Kozlov, M., “Key NIH research institute to told remove references to ‘pandemic preparedness,’” Nature, February 13, 2026). Given the enormous importance of these institutions in fighting pandemics, this was a very bleak day.

In this week’s Germ Gems post, I  provide my assessment of the consequences the U.S. will face by being in this rudderless situation when—not if—the next pandemic emerges.

Pandemics throughout history (a recap). A pandemic is an emerging infectious disease that spreads worldwide. According to University of Cincinnati scholars, there have been 249 pandemics throughout recorded history. (“A History of the World’s Pandemics,” https://www.uc.edu). 

During the last 100 years, there have been five major pandemics. Two that occurred during the course of my career as an infectious diseases specialist almost brought the world to its knees: HIV/AIDS and COVID-19, caused by the novel coronavirus. SARS-CoV-2.

Lessons learned from pandemics. As Adam Kucharski, author and infectious diseases modeler, stated: “If you’ve seen one pandemic, you’ve seen one pandemic.”(Kucharski, A., Rules of Contagion, Welcome Collection, 2020). Indeed, every one of the 249 pandemics that have occurred to date has been unique. Irrespective of this uniqueness, when dealing with a pandemic we can learn and gain experience that can guide us when confronted with a new pathogen that spreads around the world causing the next pandemic.

The time to prepare for the next pandemic is now. The U.S. should not be isolating itself and withdrawing from world organizations that provide international outbreak intelligence and respond to infectious diseases outbreaks around the world. As the editors of The Lancet recently wrote: “The next decade will unfold in a multipolar and increasingly complex scientific landscape, where rivalry and collaboration coexist. Yet the history is clear: the best science often emerges from scientific collaboration.” (“The rise of China’s research: a global opportunity,” Editorial, The Lancet, January 17, 2026.)

Potential impact of U.S. withdrawal from the WHO.  Founded in 1948 as a specialized agency of the United Nations and initially comprised of 194 member states, the WHO is responsible for international public health. The U.S. was a founding member of the WHO and was its most important partner, serving as its largest financial contributor as well as a key driver of global health policy.

The WHO is primarily an advisory and coordinating organization with no enforcement authority. Nonetheless, it is the most important provider of global health coordinating services for the world.

Propelled by the failures of global solidarity during the COVID-19 pandemic, on May 20, 2025, the World Health Assembly, the decision-making body of the WHO, adopted the Pandemic Agreement. This historic international agreement is aimed at improving global coordination for pandemic prevention, preparedness and responses. It isconsidered transformational in improving scientific cooperation and equity in future health emergencies. (Gostin, L, et al., “The WHO Pandemic Agreement: The World Together Equitably,” JAMA, May 27, 2025). The U.S. will not be a party to the Pandemic Agreement and will not be able to reap any of the benefits of participation.

On January 22, 2026, the U.S. finalized its withdrawal from the WHO. According to Larry Gostin, Director of the O’Neill Institute for National and Global Health at Georgetown University, and his colleagues, the key impacts of the U.S. withdrawal from WHO will be a financial crisis resulting in reduced disease surveillance, weakened U.S. health security, undermined global health programs and increased geopolitical competition in health, especially involving China.

Gostin and his colleagues also claim that the absence of the U.S. from the Pandemic Agreement “weakens the agreement’s vision for universal international cooperation.”  They assert, however, “A great deal can and will be accomplished by the Pandemic Agreement without the United States. But the United States is irreplaceable.”

Deprioritization of pandemic preparedness at NIAID. The NIAID is one of 27 different Institutes and centers of the National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services. Its mission is to “conduct basic and applied research to better understand, treat and prevent, infectious, immunologic and allergic diseases.” (www.niaid.nih.gov). “For more than 60 years, NIAID research has led to new therapies, vaccines, diagnostic tests and other technologies that have improved the health of millions of people in the U.S. and around the world.”

About one-third of the NIAID’s budget has funded projects involving emerging infectious diseases and biodefense. Few other agencies have the budget or infrastructure to fund basic research into these topics. It was therefore disturbing to learn that NIAID was to deprioritize funded research on biodefence and pandemic preparedness. (Kozlov, M., “Key NIH research institute told to remove references to ‘pandemic preparedness,’” Nature, February 13, 2026).

According to Jay Bhattacharya, director of the NIH, there will be a complete transformation of the NIAID away from the old model that historically prioritized research on HIV, biodefence and pandemic preparedness. Bhattacharya said the institute would now “focus more on basic immunology and other infectious diseases currently affecting people in the United States…rather than on predicting future diseases.”  This approach is short-sighted, to say the least.

The anticipatory basic research that the NIAID funded helped make possible the development  COVID-19 vaccines in “warp speed” time. These vaccines helped reduce mortality from the COVID-19 pandemic.

“The decision to deprioritize these areas [of emerging infectious diseases and biodefense] will leave people in the U.S. far more vulnerable to pathogens that are constantly evolving in wildlife around the world and spilling into human populations, sometimes sparking outbreaks.” As Nahid Bhadelia, MD, director of Boston University’s Center on Emerging Infectious Diseases, said: “Just because we say we’re going to stop caring about these issues doesn’t make the issues go away—it just makes us less prepared.”

Gigi Gronvall, PhD, a biosecurity specialist at the Johns Hopkins Bloomberg School of Public Health, put it bluntly. She said the new approach of the NIAID is “full of hubris.” She added: “We know there are groups of viruses that are more likely to cause illness, epidemics and pandemics and it therefore makes sense to study them.”

“Stupid is as stupid does.” (1994 film Forrest Gump). No one has the ability to predict when or what new pathogen will emerge as a cause of the next pandemic. But, it is easy to predict what will happen in the U.S. when the next pandemic hits: the U.S. will be ill-prepared. The cost of being ill-prepared will be enormous. And, everyone will pay the price, directly or indirectly.

The recent developments in our country’s reprioritization of pandemic preparedness in global health underscore the importance of leadership in such momentous events. Right now our once prestigious national research institutes are being run by President Trump and toadies in his administration instead of being led by the best, brightest and most qualified people for the job.

Recently, William H. Foege, MD, a global health leader, died. He was one the best and brightest in his field. He embodied everything one would “want in a global public health leader, everything we seem to be missing today.” (McLellan, F., “Obituary: William H. Foege,” The Lancet, February 14, 2026).

Dr. Foege served as the director of the Centers for Disease Control and Prevention (CDC) from 1977 to 1983 and led the CDC’s Smallpox Eradication Program. In his obituary, some of Dr. Foege’s previous comments about the current administration’s bulldozing of public health are quoted.

In 2025, Dr. Foege said: “They don’t understand public health. They don’t understand what it was like to encounter the dangers of the past.” And of Robert F. Kennedy, Jr.,  Foege surmised: “Kennedy would be far less hazardous if he decided to do cardiac surgery. Then he would kill people only one at a time rather than his current ability to kill by the thousands. Why is it that killing a single person is seen as murder but killing masses is excused if you are a politician?”

The current state of chaos in public health in the U.S., chaos created under the leadership of Messrs. Trump and Kennedy, will ultimately pass, as will they. But, as the editors of The Lancet wrote: “The destruction that Kennedy has wrought in 1 year might take generations to repair, and there is little hope for US health and science while he remains at the helm.” (“Robert F. Kennedy Jr: 1 Year of Failure,” Editorial, The Lancet, February 28, 2026).