The world’s best early warning system for epidemics, ProMED, is in danger. The International Society for Infectious Diseases (ISID) announced changes without consulting ProMED’s moderators, including subscription fees, search limitations, and delayed stipends. This threatens ProMED’s vital role in detecting and reporting outbreaks, as it was the first to sound the alarm on SARS, MERS, and COVID-19.
If ProMED is in financial trouble, everyone worried about epidemics should be concerned. Science-oriented outlets have covered the potential collapse, but major news outlets have been slow to respond. Why is ProMED so important? It’s fast, relies on human expertise, and remains independent, making it an invaluable asset in the fight against global pandemics. This article delves into the importance of ProMED and why immediate action is needed to save this essential service.
Let’s explore the three crucial elements that make ProMED essential, examine how other alert systems compare, investigate what happened with COVID-19, and consider options for saving ProMED to ensure our global preparedness for future pandemics.
ProMED’s Essential Elements
ProMED is characterized by three key features: speed, human expertise, and independence. It rapidly disseminates dozens of tips from around the world, collating and distributing information twice daily, seven days a week. Unlike algorithmic systems, ProMED relies on experienced epidemiologists, clinicians, and veterinarians to sift through data and determine what’s important. Its independence from government and public health agencies ensures unbiased reporting based on the moderators’ expertise.
Founded in 1994 by the Federation of American Scientists, ProMED began as an experiment to leverage the internet for spotting outbreaks. From a small listserv, it has evolved into a global network of volunteers, including epidemiologists, clinicians, and veterinarians, who file tips and local articles. Moderators add explanatory information and links to related reports. Anonymity is maintained to protect contributors in countries where governments suppress news. ProMED’s coverage includes human, animal, and plant diseases, addressing the interconnectedness of pathogens and their impact on human health and food security.
WHO and Other Alert Systems
While the World Health Organization (WHO) has systems like GOARN and EIOS, they often fall short. GOARN, the Global Outreach Alert and Response Network, and EIOS, Epidemic Intelligence from Open Sources, gather and translate news reports, using algorithms to highlight important ones. The WHO also relies on the International Health Regulations, which mandate member countries to report outbreaks.
However, these WHO systems have limitations. In the author’s 25 years of covering epidemics, they have rarely been the first source of information. Bureaucracy and political considerations often hinder the WHO’s effectiveness. Reports must pass through multiple levels, and the agency must defer to member countries, even if they are uncooperative. This contrasts sharply with ProMED’s speed and independence. Canada’s Global Public Health Intelligence Network (GPHIN) also suffered budget cuts and restrictions, rendering it ineffective just before COVID-19.
The COVID-19 Example
ProMED’s vigilance was evident during the early stages of COVID-19. On December 30, 2019, Dr. Marjorie Pollack, ProMED’s deputy editor, received information about a mysterious viral pneumonia in Wuhan. She found a Chinese business website confirming the health commission’s report and issued an alert just before midnight. In comparison, the WHO picked up a media report on December 31 but had to query China for confirmation, which didn’t come until January 3. This delay illustrates ProMED’s agility. VPUE, China’s own alert service, failed to report COVID-19 promptly due to pressure from local authorities, who suppressed information to avoid embarrassment during a major political event.
The CDC also faces political constraints. The agency hesitated for two weeks before issuing an alert about Zika in 2015, prioritizing diplomatic considerations over public health. While smaller sites like Flutrackers.com are quick to post reports, their haphazard organization reduces their credibility among experts and journalists.
ProMED’s Unique Value
ProMED’s value lies in its careful screening of reports and quick response to worrying rumors. It requests more information about unexplained events, distinguishing between true threats and false alarms. For instance, a “mystery pneumonia” in Argentina turned out to be Legionnaire’s disease, and deaths after a wedding in West Africa were due to lethal homemade alcohol, not a new virus.
ProMED’s early detection of SARS in 2003 exemplifies its importance. While the media paid little attention until the WHO’s alert on March 12, ProMED began questioning rumors of a mysterious pneumonia in southern China on February 10. A subscriber shared information from a teachers’ chat room in Guangdong, including details about vinegar disappearing from supermarkets, indicating local attempts to combat the mystery pneumonia. The outbreak had started weeks earlier, but local and central authorities were covering it up.
Financial Crisis and Potential Solutions
The fact that ProMED is struggling over $1 million is a tragedy. While NOAA, which predicts hurricanes, has a $5 billion budget, ProMED’s early warnings are crucial in preventing pandemics that can kill far more people. Questions about ISID’s management and finances raise concerns. In 2021, ISID forced out Dr. Lawrence Madoff, ProMED’s effective fundraiser, and moderators earn meager stipends, raising questions about how ISID spends its funds. Despite ISID receiving $4.3 million in donations during the COVID-19 pandemic, ProMED faces financial collapse.
The International Society for Infectious Disease’s other activities pale in comparison to ProMED’s importance. It offers small grants, holds meetings, and publishes a journal, whereas its American counterpart sets clinical guidelines. The critical question remains: What happened to millions of dollars meant for ProMED?
Saving ProMED: A Call to Action
Someone with money needs to intervene to rescue ProMED. Killer epidemics, though infrequent, require constant vigilance. We don’t allow our weather or military early-warning systems to lapse; ProMED deserves the same commitment. ISID and ProMED may need to separate. A subscription model could work, with rates adjusted for affordability in low-income countries. Fair salaries for moderators are also essential, moving beyond reliance on volunteerism. Independence must be maintained, no matter the funding source, to ensure unbiased judgments and prevent political cover-ups.
In conclusion, ProMED’s unique combination of speed, human expertise, and independence makes it an indispensable tool for global health security. Its financial struggles highlight the urgent need for funding and structural changes to ensure its continued operation. A proactive response is essential to safeguard against future pandemics.
The Urgent Need to Save ProMED
ProMED is an indispensable asset in global health security. Its unique combination of speed, human expertise, and independence makes it more effective than bureaucratic organizations. The COVID-19 pandemic exposed the weaknesses of existing systems and underscored the importance of ProMED’s rapid, unbiased reporting.
The financial crisis facing ProMED is unacceptable. Immediate action is needed to secure its future. This may involve separating ProMED from ISID, implementing a sustainable funding model, and ensuring fair compensation for moderators. Preserving ProMED’s independence is paramount to maintaining its credibility and effectiveness.
Ultimately, saving ProMED is an investment in global preparedness. By ensuring its continued operation, we protect ourselves against the devastating consequences of future pandemics. It’s time for philanthropists, governments, and global health organizations to step up and secure the future of this vital early warning system.