The ongoing COVID-19 pandemic has laid bare our collective weaknesses in being able to effectively respond to the emergence of a highly contagious and lethal microbial threat. Despite extraordinary advances over the past century in science and in global health standards, we still live in a world where the threat of an infectious agent can emerge anytime and anyplace without warning and spread rapidly to every community and every household without regard to national borders.
Importantly, COVID-19 is not the first pandemic due to an emergent pathogen from wildlife of this century and is unlikely to be the last. Over the last 20 years a number of high impact pathogens have emerged or re-emerged. These include emergence of diseases due to three new coronaviruses (CoV), namely Severe Acute Respiratory Syndrome (SARS) in 2003; Middle East Respiratory Syndrome (MERS) in 2012; and the ongoing COVID-19 pandemic, a number of highly pathogenic influenza A viruses (e.g. H5N1 in 2003; H7N9 in 2013; and the H1N1 pandemic of 2009), the Zika virus as a global health emergency in 2016, and the continuing rise and spread of Ebola in West and Central Africa since 2013.
All these emergent pathogens have jumped from transmission among non-human animals to transmission among humans. Over the course of the remainder of this century, the likely frequency of epidemics and pandemics will continue to increase, driven mainly by demographic trends, including urbanization, and environmental degradation, climate change, persistent social and economic inequalities, and globalized trade and travel.
While upgrading of the health security apparatus over the last decade has been welcomed, COVID-19 underscores that the existing legislation, processes, and institutional arrangements such as the International Health Regulations (IHR) and Global Health Security Agenda (GHSA) are insufficient for early warnings and in preventing impacts of events such as those caused by SARS COV-2. Some countries that were assessed to be well prepared using various indexes and metrics, performed poorly in containment and mitigation during the COVID-19 pandemic. Clearly, there are other components of health emergency risk management and an effective response that have not been well characterized.
The experience of the COVID-19 pandemic, yet again underscores that new efforts are needed to craft global strategies, policies and regulatory frameworks that improve our collective capacities to prevent, as well as rapidly detect and respond to threats. The COVID-19 pandemic, has heightened the sensitivity of the global community to devastating socio-political and economic damage to the planet. This is an opportunity to capitalize on a growing international discussion among political and global health leaders on the need to address future emerging threats to leverage political and financial support, as well as build out its organizational and operational architecture. Making good use of the additional energy in the system will be essential if we are to learn the lessons that we have failed to learn before. We must capitalize on this to guide both near-term and longer term future investments in pandemic preparedness and to expand work to understand new pathogens and where they come from before there are widespread outbreaks.
Understand how current mega-trends are likely to impact the emergence and spread of future infectious disease threats and identify actions to make the world’s social, political and economic systems better able to cope with these changing dynamics.