The planet is on the brink of disaster: the risk of a new pandemic, even more devastating than previous public health emergencies, has skyrocketed; but investment and measures to address a threat of this magnitude have stagnated or diminished. According to a group of experts from the World Health Organization (WHO), who analyzed the level of anticipation and response to epidemic outbreaks following the Ebola crisis a decade ago, “global preparedness is not keeping pace with the pandemic risk.” The situation is “alarming,” they conclude: the pandemic risk is worsening, public trust is eroding, and inequality is becoming entrenched. “The world is no safer,” they stated. Their warnings came precisely 24 hours after the WHO declared a global emergency again due to a new Ebola outbreak in the Democratic Republic of Congo and Uganda.
The Global Preparedness Monitoring Board (GPMB), the WHO group that authored the report, A World on the Edge: Priorities for a pandemic-resilient future, was created eight years ago to “help ensure the world would never again experience a devastating crisis like the West African Ebola epidemic,” they explain. That health emergency highlighted shortcomings in preparedness for epidemic outbreaks and spurred reforms to address potential pandemics. But the investment and measures deployed in recent years have been insufficient. Since the 2016 Ebola crisis, the world has suffered five major public health emergencies, including Covid-19, the largest pandemic of this century.
In recent years, initiatives and mechanisms have emerged to respond to new health challenges, such as the Pandemic Fund and the WHO Pandemic Arrangement, but the experts acknowledge that we live in “a world of greater volatility, uncertainty, fragmentation and interconnected shocks with far-reaching consequences” than a decade ago. And there is “alarming evidence” that, despite recent investments, “resilience could be weakening rather than strengthening.”
Scientists observe that infectious disease outbreaks are becoming more frequent and more impactful (with more cases and deaths), the short- and long-term economic impact of health emergencies is growing, and, moreover, equity in access to health measures to respond to epidemics is diminishing. “A worrying ‘equity fatigue’ is emerging, marked not only by reduced political and financial commitment, but by diminishing action to sustain equitable access as a global priority,” the report states.
The global effort to tackle the Covid-19 pandemic, which spurred funding to develop a vaccine in record time, for example, was merely an illusion of long-term unity. In fact, according to experts, development aid earmarked for health has returned to 2009 levels. “Investments in preparedness have strengthened since the Covid-19 pandemic, but shifting geopolitical priorities now threaten to undermine this progress,” the authors emphasize.
According to the experts, current trends paint a picture of “a future in which pandemics and other public health emergencies may become more frequent, more disruptive, and harder to manage, in a world that is more vulnerable, more uncertain, and marked by declining trust and widening inequities.” Scientists believe that without a radical shift in the capacity of healthcare professionals to address the drivers of pandemics and a genuine commitment to equity, “the world risks entering a cycle of accelerating health crises, where each new shock further erodes resilience and widens existing fractures.”
The authors note that the One Health approach, which recognizes the interconnectedness of environmental, animal, and human health, is being neglected. They emphasize that trust and equity, the foundation of disease prevention and control, are being eroded. Therefore, they advocate for immediate action to “foster broad and lasting trust,” promote “sustainable equity,” and even combat misinformation.
How to do all this? The authors propose creating “an independent pandemic risk monitoring mechanism,” ensuring equitable access to health measures against emerging health crises, a “sustained and unwavering political commitment” to pandemic preparedness, and sustainable funding for the so-called “Day 0,” referring to the first day a new health emergency appears.
A growing threat
The hantavirus outbreak that began a couple of weeks ago on a cruise ship crossing the Atlantic put the entire world on alert and raised the specter of a new pandemic. The infectious episode, which is now apparently contained, served as a reminder of a threat that looms ever larger over humanity: zoonotic infectious diseases, those transmitted from animals to humans, have skyrocketed in recent decades, fueled, to a large extent, by climate change and human pressure on animal ecosystems.
The scientific community estimates that, like hantavirus, there are 10,000 viruses — the vast majority still unknown and circulating silently in wild mammals — that have the capacity to infect humans. Not all of them will have pandemic potential, but just one minimally efficient virus — as was the case with SARS-CoV-2, the virus that causes Covid-19 — is enough to bring the entire planet to its knees.
The WHO has a dozen viruses in its sights, either because of their pandemic potential or the lack of measures to combat them: these include Covid-19, Crimean-Congo hemorrhagic fever, Ebola, Marburg virus, Lassa fever, Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome (SARS), Nipah virus, henipavirus, Rift Valley fever virus, and Zika. The last spot on the list is reserved for “Disease X,” referring to a potential scenario where a still-unknown pathogen causes a serious international epidemic.
“Viruses need a host to live in. And they mutate, they evolve. It can happen that one jumps to humans and causes disease, or that it doesn’t produce symptoms. There can also be a jump from an agent we don’t know about. That can happen, but we have to live with it without being scared. The crucial thing is to maintain surveillance and response systems,” says María Paz Sánchez Seco, a researcher at Ciberinfec in the National Center for Microbiology of the Carlos III Health Institute in Madrid.
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