Pandemic Preparedness: How Can Chronic Care Continue?

Why does pandemic preparedness include chronic disease care?

The pandemic agreement process has implications for everyday healthcare. WHO's report about continuing negotiations was published on May 10, 2024; the World Health Assembly subsequently adopted the agreement on May 20, 2025. These are historical milestones, rather than announcements made today. They provide context for a practical preparedness question: how can health systems manage an outbreak while preserving treatment for existing illnesses? [WHO negotiation report](https://www.who.int/news/item/10-05-2024-governments-agree-to-continue-their-steady-progress-on-proposed-pandemic-agreement-ahead-of-the-world-health-assembly), [WHO adoption announcement](https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics).

The COVID-19 experience illustrates the problem. In findings published in June 2020, WHO reported partial or complete disruption to hypertension treatment in 53% of surveyed countries, diabetes and diabetes-complication treatment in 49%, and cancer treatment in 42%. These percentages describe countries reporting disruption; they do not measure the proportion of individual patients who missed care or establish how many deaths resulted. They are historical findings, not estimates of service availability today. Nevertheless, they demonstrate how widely an outbreak can affect care beyond infectious disease wards. [WHO service disruption findings](https://www.who.int/news/item/01-06-2020-covid-19-significantly-impacts-health-services-for-noncommunicable-diseases).

How can health services keep essential treatment available?

WHO's operational guidance identifies ongoing chronic disease treatment, critical therapies and emergency care as priorities during outbreaks. Its recommendations include adapting referral pathways, maintaining essential medicines and using remote consultations where appropriate. The clinical purpose is continuity: changing how care is delivered while preserving access to necessary treatment. [WHO operational guidance](https://www.who.int/publications/i/item/WHO-2019-nCoV-essential_health_services-2020.2).

Remote appointments have limits. They cannot deliver dialysis or an infusion, and some assessments require examination or laboratory testing. WHO also recommends monitoring essential services as conditions change. Tracking medicine shortages and service activity can help managers identify emerging gaps and adjust provision. These are operational recommendations; the guidance does not establish a single numerical survival benefit for the entire package. [WHO operational guidance](https://www.who.int/publications/i/item/WHO-2019-nCoV-essential_health_services-2020.2).

How can people with diabetes prepare for disrupted care?

CDC emergency preparedness advice recommends keeping a record of medical conditions, medicines, pharmacies and clinicians, alongside extra glucose-testing supplies. People using insulin pumps should also record their device information and plan for necessary supplies or batteries. Although this guidance covers emergencies broadly, the same preparations can help when an infectious disease outbreak disrupts appointments or deliveries. Discuss the plan with a family member or trusted contact who may need to help. [CDC emergency preparedness guidance](https://www.cdc.gov/diabetes/php/toolkits/new-beginnings-emergency-preparedness.html).

Medication storage and substitution require particular attention. CDC advises protecting insulin from freezing, direct heat and sunlight, which can reduce its effectiveness. If the usual insulin becomes unavailable, work with a clinician on any change of brand or type; products should not be assumed interchangeable. Planning these details in advance can make an interruption easier to manage, although personal supplies cannot replace functioning pharmacies and healthcare services. [CDC insulin emergency guidance](https://www.cdc.gov/diabetes/articles/managing-insulin-in-emergency.html).