In his latest annual letter, Bill Gates warned of the imminent threat of a deadly pandemic to the global community. Yet, while his message also lauds the accomplishments of vaccine coverage, he has consistently lacked the emphasis on a crucial element of global health security: If we truly want to prepare for the next pandemic we need to invest in health systems, not just vaccine development.
Gates is not alone. Vaccines as the solution to major global health problems is emerging as a theme for global health in 2017. A new multi-million dollar initiative, the Coalition for Epidemic Preparedness and Innovation (CEPI), is an admirable solution to build an arsenal of vaccines against diseases that may not turn a profit but would protect thousands of lives. In a global health funding environment with an uncertain future due to President Trump’s plans for budgetary cuts, this could be a wise investment. However, pandemics will not be beaten without the participation of the people most affected. And the critical component currently being overlooked is the value of resourcing health systems in countries most under threat.