The sirens didn’t stop.
I still hear them when I think of March 2020 in Rimini—the thin, rising howl bouncing off empty apartment blocks, mingling with the salty smell from the Adriatic and the faint hum of my old laptop fan on the desk. I was stuck at home in my wheelchair, hands cold on the metal push-rims, refreshing case numbers, wondering how something as invisible as a virus could make an entire city sound like a war zone.
I’ve just been reading an article in Science about pandemic security and national leadership, written by Maria Van Kerkhove and Chikwe Ihekweazu from the World Health Organization (WHO). On the screen in front of me here in Tirana, the text glows against a dark-mode background, while the smell of strong Albanian coffee curls up from the cup next to my trackpad. The article argues, very clearly, that real safety from pandemics doesn’t start in fancy global meetings—it starts inside each country’s own health system, with boring-sounding stuff like surveillance, emergency operations centres, and community health workers.
So, let’s say this bluntly: I’m going to simplify some heavy concepts, on purpose, so you can follow every part. That’s not dumbing things down; it’s respecting your time and your brain. Think of it like adjusting a telescope: same universe, just clearer on your screen, with the quiet whirr of the focus knob and the cool metal tube under your fingertips.
Three Comfortable Myths We Keep Repeating
Let me start by throwing three ideas on the table—ideas you’ve probably heard in late-night TV debates or at the dinner table, with the clatter of plates and the smell of reheated pasta in the air.
The first idea is that pandemics are “black swans,” strange accidents that blindside us, so there’s not much to do beyond hoping for good luck and good vaccines. The second is that pandemic preparedness is mainly a global job, something for WHO, the UN, and some suited people in Geneva, far from the uneven pavement and traffic fumes of your own city. The third is that we simply can’t afford to invest seriously in public health when there are louder priorities like military security, economic growth, and fixing potholes that rattle your teeth when the bus hits them.
Those three ideas sound reasonable when you hear them over the television noise and the buzz of your fridge at midnight. They’re also deeply wrong. The Science article lays out, almost in passing, a far harsher view of reality: the threat of another pandemic is not hypothetical at all, it’s driven by things we already see—rapid urbanisation, ecological destruction, climate-driven spread of disease-carrying organisms, and viruses jumping from animals to humans.
In simple terms: we’re building a world that is perfectly designed for new outbreaks, while pretending they’re freak accidents. And you can almost smell the wet soil and rotting leaves of disrupted forests in that sentence.
What The Science Article Actually Says (In Plain Language)
Let me translate their main message into normal human language, with my keyboard clicking in the quiet of my small Tirana apartment.
They argue that health systems are the first line of defence—more important, day to day, than borders or fighter jets—when it comes to protecting people, economies, and political stability from pandemics. You can imagine a health system as everything from the nurse taking your temperature under harsh fluorescent lights that buzz slightly, to the lab tech loading samples into a humming machine, to the public health official answering a phone that never stops ringing.
The article insists that while pandemic preparedness is often marketed as a “global” project, it only actually works when countries build their own strong national capacity and then plug that into international efforts. WHO can give guidance, coordinate, and send backup teams—like a support crew with boxes of gear that smell faintly of new plastic and shipping dust—but they can’t run your hospitals, your labs, or your local communication with communities.
They talk about something with a long name: the Health Emergency Preparedness, Response and Resilience framework, or HEPR, launched in 2023. In everyday terms, that framework says countries should get five things right: spotting new health threats early, providing decent clinical care, protecting communities, getting medicines and vaccines where they need to go, and running emergency operations centres that actually coordinate things rather than just collect dust and coffee cups. Think of it as a very unglamorous but very real control panel, filled with blinking lights and labelled switches.
The whole piece has one message that echoes like a steady drumbeat under the text: national preparedness is a choice, not a natural gift. And while I scroll through it with my finger, I can hear the tiny scratch of my fingernail on the glass trackpad, like a reminder that this is all uncomfortably real.
The Story That Changed How I Read This
Reading policy language is one thing; living through a failure of preparedness is something else. I still remember the sharp smell of disinfectant in the elevator of my building in Rimini in early 2020, the metal handrail cold and sticky through the latex gloves everyone wore too long. Someone had printed a notice and stuck it up with tape that peeled away from the damp wall: “Stay at home. Protect the elderly.” The paper curled at the edges like old leaves.
Italy, where I’m from, was hit hard and early. From my wheelchair near the window, I watched military trucks on the news carrying coffins out of Bergamo, the rumble of their engines faint behind the newsreader’s flat voice. I wasn’t thinking about WHO frameworks or national surveillance systems then; I was thinking about my friends who worked in hospitals, sending voice messages at 2:00 a.m. with the hiss of oxygen machines in the background and the weird echo of tiled corridors.
Later, when I moved to Tirana, I felt something different. Albania had fewer resources, you could smell dust and damp plaster in some clinics, but there was a raw, improvisational determination in the way local doctors, nurses, and volunteers tried to organise systems for testing, tracing, and community outreach. You’d hear people shouting to each other across crowded waiting rooms, fans rattling overhead, while someone tried to explain quarantine rules over a crackling loudspeaker. That contrast stayed with me, like two different songs playing in one pair of headphones.
This is where the article hit me hardest. It points out that countries that had already learned from SARS in 2002–2003 or from Ebola outbreaks in West Africa were able to react faster to COVID‑19 because they had real emergency systems ready: operations centres, surge plans for hospitals, and the muscle memory of testing and contact tracing. That’s not abstract theory; it’s the difference between sirens every night, and sirens once in a while.
One Number That Should Haunt Every Finance Minister
Here’s the single statistic from the article that made me stop scrolling and just stare at the screen, while the hiss from the radiator filled the silence.
COVID‑19 caused an estimated global economic loss of more than 16 trillion US dollars in 2020 alone. Sixteen. Trillion. The word feels heavy in your mouth, like you’re chewing on a chunk of cold metal.
Now set that next to this: the World Bank estimates that building and maintaining core preparedness capacities worldwide would cost around 10–11 billion US dollars per year. That’s billions with a “b”, not trillions. To give you a physical sense of the gap, imagine two piles of coins on a rough wooden table: one the height of your coffee mug, the other towering above a skyscraper you have to squint at through smog.
We live in a world where governments quietly cut health budgets after COVID peaked, while raising military defence spending, even as new threats like H5N1 avian flu infect new animal species and occasionally humans, and Marburg virus shows up in Ethiopia and Rwanda. Western Europe has started to see dengue and chikungunya transmission, diseases once labelled “tropical,” as if climate and travel respect our mental categories. You can almost hear the mosquito buzz in that detail.
So when someone says, “We just can’t afford all this preparedness stuff,” I think of that 16‑trillion‑dollar bill and the dry rustle of the printed report landing on a minister’s desk. We did pay for it. We just paid in the most expensive and painful way possible: lives, jobs, and years of lost normal mornings with fresh coffee and the sound of kids going to school.
Why “Global Only” Thinking Lets Governments Off The Hook
There’s another part of the article that deserves a loud highlighter squeak across the page.
It says clearly that WHO offers surge teams, technical advice, and coordination across borders, but those efforts are meant to support, not replace, national capacity. Read that again with the buzz of cheap fluorescent lights in a government office in your mind. If your country’s surveillance system is weak, if your hospitals crumble under pressure, there is no magic global cavalry that can ride in fast enough to fix everything.
Yes, WHO has networks like the Global Outbreak Alert and Response Network, which ties together universities, research labs, and health organisations to share expertise and support operations. There’s also the Global Health Emergency Corps, launched in 2023 to train and deploy health workers for emergencies. You can picture rooms full of people in mismatched chairs, watching slides on projectors that hum softly, learning how to respond to the next threat.
But here’s the uncomfortable truth the article makes plain: sustained preparedness depends on national investments in emergency medical teams, public health professionals, community health workers, and long-term trust-building with local leaders and civil society. That’s not glamorous. It smells of old office paper, overused coffee machines, and community halls with scuffed floors.
The myth that “global organisations will handle it” lets governments dodge responsibility. It’s a bit like assuming your neighbour will fix the broken stairs in your apartment building while you keep buying bigger locks for your own door. One day you grab the cold railing, step out, and the whole staircase gives way.
From Tanks To ICU Beds: What “Security” Really Feels Like
One of the central tensions in this piece is about what we mean when we say “security.”
Post‑COVID, many governments have reduced investment in public health while increasing military defence spending. You can almost hear the difference: the roar of jets over a parade, versus the beeping of monitors in an ICU where a nurse is adjusting a mask on someone’s face. Both sounds are part of the same word—security—but they protect us from very different threats.
When I think about security as a disabled person, I don’t imagine tanks; I imagine a functioning health system. I imagine an ambulance that actually arrives, its siren cutting through city noise; an accessible hospital with working lifts, whose doors slide open with a soft hiss rather than staying jammed; a doctor who isn’t on their fifth twelve-hour shift and who can still think clearly when she touches the cool metal of her stethoscope. That’s what safety tastes like when your body is more vulnerable.
The Science article treats investment in preparedness not as charity or an annoying cost, but as a cornerstone of economic stability, public trust, and global safety. If your health system collapses, your economy doesn’t hum away smoothly in the background; shops close, factories fall silent, the smell of fresh bread vanishes from the streets as bakeries shut for lack of staff. The world shrinks to your apartment walls and the blue light of your phone.
So maybe we need to ask: when politicians talk about national security, why aren’t we asking how many ICU beds they funded, how many epidemiologists they hired, how strong their early warning systems are? Why does the clang of medals on uniforms drown out the quiet, steady work of the people who prevent your local hospital from turning into a disaster movie?
The Hidden Work That Saved Some Countries
The article gives concrete examples of this hidden work, and the way it changed outcomes during COVID‑19.
Countries that had gone through SARS in 2002–2003 already had emergency operations, surveillance systems, and hospital surge plans ready to go. The more you drill those systems, the more they become muscle memory, like a pianist repeating scales until her fingers move automatically over worn keys, leaving a faint smell of metal and wood polish in the air.
Similarly, nations in West Africa that had battled Ebola were better prepared to run testing, contact tracing, and isolation systems quickly. They weren’t rich; some of their clinics still had peeling paint and fans that rattled like they were about to fall from the ceiling. But they had learned painful lessons and turned them into structures, teams, and habits.
WHO did issue global alerts and technical guidance very early in 2020—within days of the first COVID‑19 cases. That’s in the article, and it matters. But what made the real difference wasn’t the PDF documents uploaded to a website; it was whether national leaders listened, moved, and translated that guidance into local action: setting up targeted testing, tracing contacts, scaling genomic surveillance, and organising supportive clinical care before hospitals were overwhelmed.
If you think of preparedness as a score, you could almost hear different countries playing at different tempos: some in sync, some always just a beat too late, their notes clashing and echoing in hospital corridors. That’s not destiny; that’s policy.
Money Is Not The Only Gap
The Science authors describe new financial tools—the Pandemic Fund set up in 2022 by WHO and the World Bank, which has awarded over 1.385 billion US dollars to low- and lower‑middle‑income countries to close preparedness gaps. There’s also the 60‑billion‑dollar Resilience and Sustainability Trust, where WHO, the IMF, and the World Bank have woven preparedness into long-term financing. You can picture negotiations in rooms with thick carpets that muffle footsteps and bottled water lined up on glossy tables.
These are big moves, and they matter. Money pays for labs, cold chains for vaccines that hum like giant fridges, training sessions where health workers gather with pens scratching over notepads. But the article is clear: cash alone doesn’t guarantee anything.
The real test is whether governments choose to keep funding public health workers, emergency medical teams, and community programmes over decades, not only when a crisis is screaming on the front pages. It’s about whether they build trust with communities, sitting in dimly lit halls that smell of sweat and coffee, listening to local concerns, adapting plans. That kind of work is slow, repetitive, and politically boring.
And yet, that’s exactly the work that keeps ventilators from running out, that keeps you from waiting twelve hours in an emergency room corridor that echoes with coughs and low conversations. The gap isn’t just money; it’s attention, courage, and the willingness to spend political capital on things that rarely earn applause.
So What Does This Mean For You And Me?
This all sounds huge and far away, like satellite images on a screen with continents in soft blue and green. But it’s not. It runs straight through your daily life—the tram you take, the crowded office you sit in, the smell of coffee in the bar where you meet friends.
You and I don’t run ministries of health. We don’t decide how much of the budget goes to intensive care units versus tanks. Still, we live in democracies or at least in political systems that react, even a little, to pressure, noise, and questions asked loudly in public.
So here’s the practical part. Next time there’s an election, a town hall, or even a TV interview with a candidate playing on the big flat screen in a noisy bar, listen with different ears. Ask yourself: have they ever talked about surveillance systems for disease, emergency operations centres, or support for community health workers, all the people who knock on doors and speak the local dialect? Do they understand that 10–11 billion dollars a year for global preparedness is dirt cheap compared with 16 trillion lost in a single pandemic year?
If you get the chance to ask a question, make it strangely specific: “How many field epidemiologists will you fund?” “Will you strengthen our public health agency so it can act quickly, not just issue press releases?” Picture their face under the glare of TV lights, maybe a bead of sweat rolling down as the studio feels a bit too warm.
You don’t have to be a scientist to change the conversation. You just have to care enough to be that annoying person who remembers the sirens, the empty streets, the rough feel of the mask on your face, and refuses to let everyone slide back into amnesia.
A Personal Reckoning From A Balcony In Tirana
As I type these last lines, I’m on my small balcony in Tirana. The air smells of exhaust, roasted chestnuts from a nearby cart, and damp concrete after a brief rain. Below, scooters buzz past like angry mosquitoes, and someone is arguing in Albanian on the street, their voice bouncing between the buildings.
I’m an astronomer and physicist by training, more used to thinking about galaxies than viruses. From space, pandemics don’t show up; you just see a calm blue marble, clouds swirling in slow motion. Down here, though, safety is not abstract. For a guy in a wheelchair, it’s whether I can get a vaccine easily, whether the hospital ramp is clear of trash, whether there’s a plan when the next outbreak hits and the elevators smell of bleach again.
The Science article ends with a sentence that stuck with me: national preparedness is a strategic choice. Not fate. Not a gift. A choice—made in budget meetings with stale air and dry sandwiches, in parliament halls where microphones crackle, in quiet offices where someone signs or doesn’t sign the order to fund that local health centre.
So I’ll leave you with this question, carried on the distant sound of traffic and a dog barking somewhere down the block: when the next virus comes—because it will—what kind of country do you want to be living in? One that poured its money into shows of strength, or one that quietly strengthened the health systems that keep you breathing?
And when the sirens start again, will they be the sound of a city breaking… or a city ready?
[This piece simplifies complex public health and economic concepts on purpose, to keep them readable and fair to different backgrounds. If something felt too simple, that’s by design—so you can carry the ideas with you the next time you hear a politician say the word “security.”]
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