The 2026 FIFA World Cup in the United States, Canada, and Mexico is set to be the largest mass gathering event in the country's history, with over five million tickets sold across 16 cities over 39 days. However, despite the event's significance, the federal government has allocated zero funding for public health, leaving a critical gap in preparedness for potential outbreaks. As an infectious disease physician and epidemiologist, I find this situation deeply concerning and believe it highlights a broader issue with the U.S. approach to public health preparedness.
One of the most striking aspects of this situation is the lack of centralized public health coordination. Every prior mass gathering of this scale has required a single chain of command and real-time data flowing to a central command center. However, the 2026 tournament, spread across three countries, will have no such command structure. This is particularly problematic given the recent history of outbreaks at other large-scale events, such as the 2006 World Cup in Germany, the 2010 Vancouver Olympics, and the 2024 Hajj.
The absence of federal funding for public health is also concerning. The Federal Emergency Management Agency (FEMA) has allocated $625 million for law enforcement and security, but zero for public health. This is despite the fact that health directors in the host cities have confirmed that there is no additional federal public health funding. The Centers for Disease Control and Prevention (CDC) has not conducted a World Cup-specific national risk assessment, and the White House task force has not provided any biological threat briefings to Congress.
The situation is further complicated by the fact that local health departments are being asked to prepare for a massive, extended international event without a dedicated federal public health funding stream. This leaves a significant gap in preparedness, particularly in areas such as rapid case identification and surge capacity. For example, in the New York area, which will host the World Cup final, there are only 26 biocontainment beds across 13 regional treatment centers, which is not nearly enough to handle a potential outbreak.
The lack of coordination and funding is not just a problem for the host cities, but also for the broader public health system. The U.S. has left the World Health Organization (WHO), which has had a negative impact on its ability to respond to global health threats. Additionally, the CDC's Health Alert Network notification took five days to reach clinicians when the Ebola outbreak was declared in early May, while Africa CDC responded the same day. This lag in communication highlights the need for a more robust and coordinated public health system.
Despite these challenges, there are some positive steps being taken. Universities and the U.S. military have stepped in to fill the gap, with Georgetown University building the Health Security Operations Center and the Armed Forces Health Surveillance Division producing country-by-country importation risk maps. However, these efforts are not enough, and the federal government needs to take a more proactive approach to public health preparedness.
In my opinion, the U.S. needs to prioritize public health preparedness and invest in a robust and coordinated system. This includes allocating funding for public health, conducting regular risk assessments, and ensuring that local health departments have the resources they need to prepare for potential outbreaks. Only then can we ensure that the 2026 World Cup is a safe and successful event for all involved.
