Scientific American - USA (2022-03)

March 2022, ScientificAmerican.com 49

adequate and equitably distributed supplies of medi­
cal resources, including by securing supply chains, in­
tellectual­property waivers, knowledge sharing and
technology transfers.
I have delved into remaking global institutions, but
it is obvious that we also must consider domestic pub­
lic health capacities. The Global Health Security Index
ranked the U.S. as most prepared for a pandemic, but
the country was among the world’s worst performers.
There are many reasons for this lack of success, includ­
ing a collapse of public trust and deep political polar­
ization. But the cdc’s guidance and actions—as well as
those of  state, local and tribal health departments—
were, by any measure, weak. That agency and health
departments at both state and local levels have lost
considerable capacities (surveillance, labs and re­
sponse) since the post­9/11 anthrax attacks. Buttressing
domestic health system capacities is vital. But the cdc
also erred badly in its health communications on top­

ics ranging from asymptomatic and aerosolized spread

to guidance on masks, vaccines and isolation. Its vac­

cine and mask recommendations, for example,

changed three times in  a matter of six weeks.

We are at a crucial junction in the COVID pandemic.

We could simply return to the unvirtuous cycle of panic

to neglect and back again. All too often, rather than

building resilience during the pandemic response, we

have blamed “the other,” engaging in stereotyping of

racial minorities and immersing ourselves in geostrate­

gic battles. But we could transform this crisis into a

historic opportunity for once­in­a­lifetime reforms

of  our national and global health systems based on sci­

ence, equity and solidarity.

Lawrence O. Gostin is University Professor in Global Health Law at

Georgetown University, faculty director of the O’Neill Institute for National

and Global Health Law, and director of the World Health Organization

Collaborating Center on National and Global Health Law. His latest book is

Global Health Security (Harvard University Press, 2021).

REFRIGERATED

TRAILERS

served as make-

shift morgues

during New

York City’s first

COVID wave

in May 2020.