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How does globalization influence the spread of infectious diseases, and what insights can we draw from historical pandemics to inform future health policies?

CID Faculty Affiliate Pol Antràs and co-authors Stephen J. Redding and Esteban Rossi-Hansberg developed a theoretical and empirical framework to analyze the relationship between globalization and pandemics, showing how international trade and business travel facilitate the spread of infectious diseases. Using historical data from the medieval plague, the 1957–1958 influenza, and the COVID-19 pandemic, the authors demonstrate that trade accelerates disease transmission and introduce a model where economic integration influences the dynamics of pandemics.

Key Findings:

• Trade and Disease Spread: Historical and modern pandemics show a strong link between trade intensity and disease transmission. Cities and countries that are more integrated into trade networks experienced faster disease diffusion.
• Business Travel as a Key Mechanism: The study finds that the effect of trade on disease transmission operates through international travel. When controlling for the movement of people (including business travelers, migrants, and tourists), trade alone ceases to predict disease spread.
• Trade Costs and Pandemic Severity: Lower trade costs increase international interactions, which can either intensify or mitigate pandemics. While increased travel raises exposure risks, substituting domestic for foreign interactions may reduce infections in high-risk locations, depending on the relative disease burden across countries.
• General Equilibrium Social Distancing: Countries with worse health conditions experience relative wage increases due to labor supply shocks from illness and deaths, leading to reduced trade and travel to those locations. This creates an endogenous form of social distancing, shifting economic activity toward healthier regions.
• Behavioral Responses Reduce Trade: If individuals internalize infection risks, they reduce travel to infected areas, leading to an initial sharp decline in trade relative to output. This pattern was observed with COVID-19, where world trade dropped faster than world production before rebounding.

Policy Impact and Relevance:

This study provides a reassessment of the relationship between globalization and public health, showing how trade and travel networks act as conduits for pandemics while also shaping economic resilience. In an increasingly interconnected world, these findings underscore the need for policymakers to design health and trade policies that acknowledge the role of economic integration in disease transmission. Rather than relying on reactionary border closures or trade restrictions, which often come with high economic costs, governments should develop strategies that enhance pandemic preparedness while maintaining global economic stability. This includes investing in disease surveillance at international travel hubs, strengthening cross-border health cooperation, and designing adaptive mobility policies that target high-risk interactions without unduly disrupting global commerce.

Beyond its immediate implications for pandemic response, the study also contributes to broader discussions on the resilience of global supply chains and economic interdependence. The COVID-19 pandemic exposed vulnerabilities in international trade, with supply chain disruptions revealing the fragility of current production models. The paper’s insights suggest that future crises—whether health-related or otherwise—will be shaped by the ways in which countries and firms balance economic efficiency with the risks of exposure to global shocks. As nations consider diversifying trade partnerships, re-shoring critical industries, or building more flexible supply chains, understanding the interaction between globalization and systemic risks is crucial for designing sustainable economic policies.

At a geopolitical level, the research highlights the delicate balance between international integration and national self-sufficiency. The uneven impact of pandemics across countries—driven by differences in public health capacity, institutional responses, and economic structures—suggests that global coordination is essential to managing future health crises effectively. While trade and travel restrictions can temporarily slow the spread of disease, long-term solutions require a more holistic approach, integrating economic, health, and mobility policies. By bridging insights from international trade and epidemiology, this study offers a framework for policymakers, business leaders, and global institutions to navigate the complex trade-offs between economic openness and public health security in an era of increasing global risks.