The biosecurity bet
Rees Calder · 6 May 2026 · 7 min read
COVID-19 cost the world approximately $12.5 trillion in direct economic losses, according to IMF estimates. About 7 million people died, officially. Excess death estimates put the real figure closer to 15-20 million. The pandemic wiped out a decade of poverty reduction progress in the span of two years.
Philanthropic funding for pandemic preparedness globally runs at about $1-2 billion per year.
That ratio — somewhere between 6,000:1 and 12,000:1 in expected harm to prevention spending — is what the effective philanthropy community calls a "neglected cause." It is, by any honest accounting, one of the stranger failures of collective human attention.
What the money actually buys
Pandemic preparedness isn't one thing. The field has distinct layers, and the philanthropic leverage varies dramatically between them.
Surveillance infrastructure. Most pandemic response failures start the same way: a novel pathogen spreads for weeks or months before it's identified and reported. The gap between a virus emerging and a government issuing a public health alert can be measured in averted deaths. Organisations like the Global Health Security Index track which countries have functional early warning systems, and the answer in most of Africa, South Asia, and parts of Latin America is: not really.
The Coalition for Epidemic Preparedness Innovations (CEPI) allocates a portion of its budget here, as does the Wellcome Trust's pandemic preparedness work. The marginal cost of improving surveillance in a high-risk spillover zone (dense human-animal interaction, low testing capacity, weak public health infrastructure) is low. The expected benefit is enormous and hard to quantify, which is partly why this work is underfunded.
Vaccine platform development. CEPI's headline mission is reducing the time from pathogen identification to a deployed vaccine from the historical 10+ years to 100 days. They came close with COVID (about 326 days for the first regulatory approval). The 100 Days Mission is technically ambitious but the target isn't arbitrary: in a fast-spreading respiratory pandemic, 100 days vs 300 days likely determines whether a pandemic is contained regionally or becomes global.
CEPI raised about $1.5 billion in pledges as of 2024 and estimates it needs $3.5 billion for its next five-year plan. That funding gap is real and specific. A pledge to CEPI is a relatively unusual thing in philanthropy: a bet on infrastructure rather than direct service delivery, with plausible counterfactual impact.
Policy and international coordination. The WHO's pandemic treaty negotiations have dragged for years. National health ministries have short time horizons and respond to visible crises, not statistical expectations. The work of organisations like the Nuclear Threat Initiative's biosecurity program and the Johns Hopkins Center for Health Security (now folded into the Bloomberg School of Public Health after funding cuts in 2024) is primarily about building the policy infrastructure and norms that make global coordination possible when a pathogen emerges.
This is unglamorous, hard to evaluate, and genuinely important. It is also the kind of work that private philanthropy can sustain in ways that government funding cannot, because it requires continuity across election cycles.
Why this is classified as neglected
There's a standard framework in effective philanthropy for assessing whether a cause area deserves more attention: scale, neglectedness, and tractability. Pandemic preparedness scores unusually well on all three.
Scale: Pathogens are among the few risks capable of killing millions of people in a short time frame. Beyond the death toll, the economic and social disruption of a major pandemic is civilisation-scale. This isn't speculation — it's the observed historical record, from the 1918 flu to COVID.
Neglectedness: Global health philanthropy is heavily concentrated in a few cause areas: HIV/AIDS, malaria, tuberculosis, maternal health. These are important and well-served. Pandemic preparedness competes with them for attention and funding and usually loses, because prevention is invisible and treatment is legible.
Tractability: We know what the interventions are. Surveillance infrastructure, vaccine platform technology, international coordination frameworks, stockpile management. These aren't research questions; they're funding and execution problems.
Open Philanthropy, the largest EA-adjacent funder, has committed roughly $300-400 million to biosecurity and pandemic preparedness over several years. That's large in absolute terms and a rounding error against the expected losses from the next pandemic.
Who is doing the work
The field is smaller than it should be, which makes it easier to map.
CEPI (Coalition for Epidemic Preparedness Innovations) is the most directly fundable via public giving. It accepts donations and is one of the few organisations in this space with a legible theory of change and measurable deliverables.
Resolve to Save Lives (founded by Tom Frieden, former CDC director) works on epidemic preparedness in lower-income countries, specifically on cardiovascular disease and pandemic preparedness at the intersection. Funded partly by Bloomberg Philanthropies and Open Philanthropy.
NTI Biosecurity (Nuclear Threat Initiative) focuses on the policy and governance layer — biosecurity indices, treaty frameworks, laboratory safety standards. Not directly fundable by most donors but produces the research and policy advocacy that shapes what governments do.
Johns Hopkins Bloomberg School of Public Health (absorbed the Center for Health Security in 2024) is the main academic hub in the US for pandemic preparedness research. Losing the CHS as a standalone entity with its own brand and funding was a setback; the work continues but with less visibility.
Wellcome Trust is the largest private funder in global health and has pandemic preparedness as an explicit priority. Not fundable by individuals but worth tracking for the state of the field.
The honest caveats
Biosecurity philanthropy is harder to evaluate than bednet distribution or vitamin A supplementation. The counterfactuals are invisible by design: if the next pandemic is contained to a few thousand cases because surveillance caught it early, you'll never read about the 10 million people who didn't die. The field runs on expected value reasoning, which is correct but uncomfortable.
There's also genuine scientific uncertainty about what the next pandemic looks like. Respiratory RNA viruses are the historical worry (influenza, coronaviruses). Engineered pathogens are a newer and harder-to-model concern. The interventions that help with natural pandemic risk (surveillance, vaccine platforms) also help with engineered risk, but not symmetrically.
For donors who want something measurable and tractable within their own lifetimes, pandemic preparedness is a harder psychological fit than GiveWell's top charities. You are betting on the absence of a catastrophe, and wins in this space don't feel like wins.
What to do with this
If pandemic preparedness fits your risk tolerance and worldview, CEPI is the most direct giving vehicle for individuals. Founders Pledge has done detailed analysis of this cause area and recommends CEPI and Wellcome Leap as the most cost-effective vehicles for donor giving.
If you want to stay informed without giving: the Johns Hopkins Bloomberg School, Resolve to Save Lives, and the NTI biosecurity program all publish accessible research. The Global Health Security Index tracks country-by-country preparedness, updated every two years, and it's grimly readable.
The field needs more funders. The expected value of being one of them is hard to overstate and easy to ignore right up until it isn't.
Sources used
- IMF World Economic Outlook: COVID-19 economic impact estimates ($12.5T, 2021-2022 data)
- CEPI 100 Days Mission: technical targets, funding gap ($3.5B five-year plan)
- Open Philanthropy biosecurity grant portfolio (public grant database)
- Global Health Security Index 2023 (Johns Hopkins Bloomberg School / NTI)
- Founders Pledge "Pandemic Preparedness" cause report (2021, updated 2023)
- Resolve to Save Lives annual reports
- WHO excess mortality estimates COVID-19 (2022, updated 2024)
- Nuclear Threat Initiative Biosecurity program overview