How America built the best pandemic response system in history – and threw it away

The islands of Qinghai Lake, more than 10,000 feet above sea level in north-western China, are well known to people who study pandemics. Each year they provide a resting point for hundreds of thousands of birds as they migrate along the Central Asian and East Asian flyways. Diseases brought here by birds can travel across these great migration routes, which join other flyways to span the globe.

Laurie Garrett had been at the Council on Foreign Relations for less than a year when, in 2005, she was told that a “mutational event” had occurred on Qinghai Lake. A type of avian influenza was infecting bar-headed geese, a species that migrates thousands of kilometres, crossing the Himalayas from the Tibetan plateau to reach as far as southern India.