May 12, 2022
As world leaders gathered Thursday for a second White House-led coronavirus summit, a group of conservation, public health, and infectious disease experts called for a collaborative global effort focused on preventing--as opposed to just containing--the world's next pandemic.
"We have solutions already available at our fingertips--which carry massive return on investment--that would immediately help lower the risk of pandemics."
A suite of four recommendations is laid out in the experts' new commentary published Thursday in the journal Nature, which calls on policymakers to seize an "opportunity--to finally address the factors that drive major disease outbreaks, many of which also contribute to climate change and biodiversity loss--[that] might not present itself again until the world faces another pandemic."
The commentary's authors include Dr. Aaron Bernstein, the interim director of the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health, which last year launched a task force focused on preventing pandemics at the source.
At specific issue in the paper are so-called "spillover events," or when pathogens spread from animals to people.
\u201cSpillover is the spark that ignites pandemics. World leaders must urgently act to prevent pandemics before they start & not solely rely on measures to limit disease outbreaks after they occur. \n\nRead our 4 recommendations for #PandemicPrevention in @Nature https://t.co/wL9ADxwPVY\u201d— Dr. Aaron Bernstein (@Dr. Aaron Bernstein) 1652360642
The paper notes that the threat of such diseases will exist long after Covid-19 moves out of pandemic phase, pointing to recent research projecting a potential several-fold increase in the yearly probability of pandemics, thanks to human's ravaging of the natural world.
But with an annual investment of $20 billion--"a small investment compared with the millions of lives lost and trillions of dollars spent in the Covid-19 pandemic"--the experts say humanity could see that threat greatly reduced.
The current focus on containment measures are insufficient when used alone, the researchers write, noting for example the 21 million lives lost globally to Covid-19 thus far, as well as the stark inequity of global vaccine and treatment access.
A first and key proactive measure, the paper states, is the protection of tropical and subtropical forests. The researchers reference studies showing land use changes in those areas is potentially "the largest driver of emerging infectious diseases of zoonotic origin globally." What's more, the loss of those areas is contributing to the climate crisis, which may push animals into areas with more human contact.
A second step echoes one called for by the World Health Organization last year: the banning or strict regulation of markets with live wild animals, ensuring that such restrictions don't trample on the rights of local Indigenous communities.
Improved surveillance and care of farmed animals is also detailed as a key step to spillover prevention. "Poor health among farmed animals increases their risk of becoming infected with pathogens--and of spreading them. And nearly 80% of livestock pathogens can infect multiple host species, including wildlife and humans" the researchers note.
As a further measure, policymakers must act to strengthen people's economic situation and health. That's because "people in poor health--such as those who have malnutrition or uncontrolled HIV infection--can be more susceptible to zoonotic pathogens," and, once infected, can allow for such pathogens to further mutate.
To implement the suite of recommendations, the paper points to three main avenues, all of which can provide "fresh chances to shift this mindset" of focusing on pandemic containment over prevention.
With existing funds to deal with spillover sorely insufficient, the researchers say a global pandemic fund is key "to ensuring that the wealth of evidence on spillover prevention is translated into action."
This funding, they add, must be sustained for decades into the future and focused on regions of the world at greatest risks, including Southeast Asia, the Amazon, and Central Africa.
The pandemic-focused agreement currently under discussion at the World Health Assembly, the WHO's decision-making body, offers an additional avenue for global coordination on the prevention steps, as it could "require countries to create national action plans for pandemics that include reducing deforestation and closing or strictly regulating live wildlife markets," the paper states.
Another tool lies in the framework under works by the Convention on Biological Diversity, which, thus far, the experts lament, "fails to explicitly address the negative feedback cycle between environmental degradation, wildlife exploitation, and the emergence of pathogens."
A new approach to pandemics focused on prevention, the researchers stress, is urgent.
"With all the stressors now being placed on the biosphere--and the negative implications this has for human health--leaders urgently need to apply this way of thinking to pandemics," they write.
In a Twitter thread sharing the new paper, lead author Neil M. Vora, a public-health physician and policy fellow at Conservation International, referenced the 2021 film "Don't Look Up," a satire that takes on the crisis of climate denialism.
"The status quo of investing in incomplete solutions to pandemics is unacceptable," he wrote. "All too often, from the WHO to the G20 to the Biden administration, pandemic prevention is sidelined in favor of preparedness and response. This is fatally dangerous, and inequitable."
"Bottom line," he said, "is that we need to #Justlookup. We have solutions already available at our fingertips--which carry massive return on investment--that would immediately help lower the risk of pandemics. These solutions also help to mitigate climate change and biodiversity loss."
Co-author Dr. Susan Lieberman, vice-president of international policy at the Wildlife Conservation Society, added in a statement that "there is much discussion of pandemic preparedness and response, but the most cost-effective and equitable approach is to prioritize prevention at source."
"The science is clear on actions needed to prevent pathogen spillover," she continued. "Business as usual cannot be an option."
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