Steps needed to stop the next pandemic

Michael R. Bloomberg and Tedros Ghebreyesus, Tribune News Service

As the First World War wore on, a new scourge erupted: an influenza pandemic that left even more bodies in its wake than the conflict itself. But the 1918 pandemic was overshadowed by the war, and its lessons went unheeded.

One hundred years later, the world faces a similar test. When the COVID-19 pandemic eventually recedes, will we learn the lessons it is teaching us? Or once the emergency subsides and life returns to “normal,” will we carry on the same as before?

Sooner or later, a new virus may emerge or reemerge that could be more transmissible than the COVID-19 virus, more virulent or both. But efforts to identify dangerous new viruses remain limited. The pandemic is at the forefront of everybody’s attention and it’s essential to harness that sense of trauma and urgency and start building the systems that will make us ready for when the next one arrives — because it is not a matter of if, but when.

As this week’s issue details, there are pressing needs, including:

More research: Scientists must engage in a worldwide effort to study viruses circulating in animals that could potentially spill over and infect humans, including mapping pathogen hot spots and working with the animal and human health sectors with a “One Health” approach. Following the West African Ebola outbreak from 2014 to 2016, the World Health Organisation published the R&D Blueprint for epidemics, which prioritised coronaviruses as one of the pathogens that needed more research and development. More research, coordinated at the global level, is still needed urgently to better understand which characteristics of pathogens make them epidemic threats, and to rapidly develop diagnostic tests, therapeutics and vaccines.

More global surveillance: More global surveillance in humans and animals (domestic and wildlife) is needed to rapidly detect new and existing threats. WHO is working with the Food and Agriculture Organization of the United Nations and the World Organisation for Animal Health to improve global surveillance, but investment levels are low and systems remain inadequate.

More domestic data: All countries need to enhance surveillance of infectious pathogens, including genetic sequencing. This allows for robust analyses that can lead to precise and targeted use of measures to prevent the spread of disease, and makes it possible to detect mutations that lead to new virus variants.

More vaccine platforms: As rapidly as drugmakers were able to create COVID-19 vaccines last year, they could have done so faster if novel vaccine platform prototypes, like mRNA and others, had already been taken through Phase 1 and 2 trials to confirm safety and dosage for coronaviruses. Global efforts to create universal vaccines and treatments capable of protecting against broader families of viruses with epidemic potential — coronaviruses, flu viruses and others — are also essential.

More coordination: Collaboration — locally, nationally and internationally — is critically needed to tackle epidemic and pandemic threats. Robust clinical trials that are actionable, coordinated and seamlessly designed are critical for having the information needed to bring products meeting the highest international standards for regulatory and policy decisions.

More community engagement and communication: An “infodemic” has accompanied the COVID-19 pandemic requiring immense response to tackle misinformation and disinformation around all aspects of the virus and the measures used to stop it.

More primary health care: Primary health care, the eyes and ears of every health system, is the foundation for preparing for, preventing, detecting and responding rapidly to emergencies of all kinds, from outbreaks of infectious diseases to epidemics of non-communicable diseases, or NCDs, like cancer, diabetes and cardiovascular disease.

NCDs have been a major factor in COVID-19 hospitalisations and deaths. If more nations had taken more aggressive steps to reduce NCDs, there could have been far fewer deaths during the pandemic. We can’t let that happen again.

There is a wide array of proven policies that local and national governments can use to fight NCDs, from smoke-free public places and graphic warnings on cigarette packaging, to improved food labelling and public awareness campaigns about trans fats and sugary drinks, to bike lanes that promote exercise and reduce air pollution by providing an alternative to cars.

By making important investments that better prepare us for the next pandemic, while adopting policies that will mitigate its impact, we can save millions of lives. And this work must not wait until the threat of COVID-19 has passed. It must begin now.