A century ago the Spanish flu pandemic infected a third of the world's population and killed 50 million people.
"Preparation for pandemic threats calls for high health system capability for prevention, effective surveillance, early detection and containment and appropriate management of any cases".
While some governments and worldwide agencies have made efforts to be vigilant and prepare for major disease outbreaks since the devastating 2014-2016 Ebola outbreak in West Africa, those efforts are "grossly insufficient", the report said.
"The world is not prepared", the report from the Global Preparedness Monitoring Board (GPMB), co-convened by the World Bank and the World Health Organization (WHO), warned.
The chances of a global pandemic are growing - and we are all dangerously under prepared, according to a new report.
The GPMB wrote that numerous recommendations of an earlier report were ignored by world leaders or "poorly implemented, or not implemented at all" and that "serious gaps persist".
"If it is true to say "what's past is prologue", then there is a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people and wiping out almost 5% of the world's economy".
Gro Harlem Brundtland, a ragged WHO head who co-chaired the board, added that most novel approaches to illness and health emergencies are "characterised by a cycle of terror and neglect".
A convergence of ecological, political, economic and social trends, including population growth, urbanisation, globally integrated economy, widespread and faster travel, conflict, migration and climate change has raised the frequency and size of epidemics that cause loss of life, upend economies and create social chaos. "It is well past time to act". The authors said lower-resource communities tend to lack basic health services, clean water, and sanitation - factors that exacerbate the spread of infectious diseases.
The report repeatedly reminds countries that they've adopted the International Health Regulations, a binding 2005 agreement that already requires them to report any "public health emergency of international concern" to the WHO and step up their domestic preparedness infrastructure, and lambastes them for not implementing those regulations to satisfaction.
"The cost would be 2.2% of GDP for even a moderately virulent influenza pandemic". They urged governments to do more to prepare for and mitigate the risks of pandemics.
"Heads of government must commit and invest", "countries and regional organizations must lead by example" (so that reluctant and/or poor countries are persuaded to commit and invest), "all countries must build strong systems" with those investments, "financial institutions must link preparedness with financial risk planning" i.e. budget for spending lots of money on preparedness, "development assistance funders must create incentives and increase funding for preparedness", and "the United Nations must strengthen coordination mechanisms" so the money gets to the right place.