“History teaches us that the next pandemic is a matter of when, not if,” warned World Health Organization Director-General Tedros Adhanom Ghebreyesus earlier this year.
How can we prevent a pandemic like this from occurring again? As we confront that subject, we must reflect on the mistakes made with COVID-19, which is understandable. However, learning from what we did well is critical since this epidemic might have been far worse. Our 21st-century style of life heightens this risk. Climate change, intensive farming, and worldwide travel have accelerated disease transmission. The goal before world leaders is to collaborate to guarantee we are better prepared for the next epidemic. That is why the world’s governments must reach an agreement on pandemic prevention, readiness, and response. Negotiators were unable to fulfil the most recent deadline for a deal. They require more time but must also know that time is running out.
Although the coronavirus appears to have emerged out of nowhere, the globe has seen multiple infectious illness epidemics in the last decade, including MERS in 2012, Ebola in 2013, and the Zika virus in 2015. For years, experts have warned that the world will face another epidemic and that greater preparedness is required. David Quammen’s 2012 book, Spillover, describes how viruses spread from wild animal populations to humans as we continue disturbing the natural environment. COVID-19 is a zoonotic illness (like Zika, Ebola, avian influenza, SARS, and MERS) that has spread from animals to people. This is supported by a new study, which discovered that domesticated animals and wildlife, such as bats and rats, are responsible for many zoonotic viruses.
How we eat, live, travel, and use energy impacts our interactions with the rest of nature. According to a Scientific American article, the United Nations Environment Programme (UNEP) believes that deforestation, intensive farming, and climate change are among the primary causes of viral spread into the human population. Many studies have connected deforestation, climate change, and biodiversity loss to economic conditions, global commodity production, and unequal resource allocation between rich and poor countries, all of which can lead to pandemics. New pandemics will emerge unless we prioritise lowering consumption, abolishing the wildlife trade and economic inequities, and developing sustainable production systems for people and the environment.
So far, the discussions have been marred by a schism between the Global North and the Global South—the same gap that hampered the COVID-19 response. Low- and middle-income nations highlight the need for binding pledges to secure the widespread production and distribution of medical innovations in the future. However, they have received criticism from certain wealthier nations even though ensuring equal and widespread access to pandemic-fighting products—from diagnostic tools to vaccines—is in everyone’s best interests.
THE POLITICS OF VACCINATION
Undoubtedly, one of the most significant achievements has been the incredible speed with which vaccinations have been created, approved, and distributed, not only to those who can afford to pay. This has already saved countless lives and concluded that global catastrophe is a realistic possibility. Even still, to avoid a repetition of this calamity, we must figure out how to bypass supply bottlenecks and get there faster; some argue that this implies being able to distribute vaccinations within 100 days of a pandemic being proclaimed. Solving this problem does not require reinventing the wheel. Furthermore, we already have a paradigm for how to treat the flu.
To understand how, consider what we need: the ability to rapidly develop and approve vaccines that protect against an as-yet unknown threat at breakneck speed; to increase and globalise vaccine manufacturing by devolving it from the Global North and building capacity in the Global South, and through increased use of technology transfers, so that we can rapidly produce huge volumes – more than what is usually produced globally in a given year – so people everywhere However, too frequently, after governments have invested public funds in the pursuit of vital medical advances, private pharmaceutical corporations are granted exclusive rights to the ensuing vaccines and therapies. As a result, only nations that can pay expensive costs receive dosages, leaving poorer countries scrambling to obtain immunisations, diagnostics, and treatments promptly. This fatal scarcity is not a flaw in the system but rather a distinguishing trait of private monopolies.
During the AIDS crisis, world leaders were hesitant to identify it. In the late 1990s and early 2000s, 12 million Africans died of AIDS while waiting for life-saving treatments that were readily available in the Global North. Then, the Global South began producing cheaper generic medications, lowering the cost of therapy from far over $10,000 per patient per year to well under $100. Now, three-quarters of HIV patients are receiving the treatment they require to live long and healthy lives. If full access to AIDS treatment is ensured, the world can eradicate AIDS as a public health problem by 2030. Aside from saving millions of lives, this would improve global peace, health security, and economic growth, with high-income nations also benefiting.
One would have anticipated these hard-earned lessons to influence the COVID-19 reaction. They didn’t. Instead, pharmaceutical firms were granted vaccine monopolies, so doses were distributed first to affluent countries, leaving poorer countries unable to get supplies—with terrible consequences. A more equal introduction of COVID-19 vaccines might have saved 1.3 million deaths in the first year alone. This excludes the significant indirect loss of life and health caused by diverting health resources to COVID-19 patients. Beyond the tremendous human costs, there have been severe economic consequences. According to one estimate, vaccination inequities cost the world economy $2.3 trillion. Ultimately, nations in the Global North have been playing a negative-sum game: the enhanced revenues for a few pharmaceutical corporations and wealthy pharmaceutical barons are swamped by the losses for the others.
MINORITY REPORT – BUT FOR VIRUSES
“You can get a long way towards being able to produce something that will target a novel virus before that virus even emerges.” This is how Kate Kelland described the sleuthing work needed to prevent another pandemic of the scale and impact of COVID-19 to Robin Pomeroy on the World Economic Forum’s Radio Davos podcast.
She was previously a Global Health journalist for Reuters, the principal scientific writer of the Coalition for Epidemic Preparedness Innovations (CEPI), and the author of Disease X—The 100-Day Mission to End Pandemics. Kelland went on: “It’s a virus that we don’t know yet, but we do know is out there, and we do know it has the potential to spill over from an animal population potentially into humans, perhaps mutate or adapt itself and then begin spreading and killing people faster than we can contain it.”
CEPI is a non-profit organisation that sponsors vaccine research and development for illnesses that have the potential to become epidemics or pandemics. CEPI, which included the World Economic Forum among its founding members, seed-funded three successful COVID-19 vaccines, including the well-known AstraZeneca and Moderna injections. The group also studies illnesses that may cause the next pandemic to spread. She said that while COVID-19 was a new illness, it was derived from a viral family that the global health community had previously examined. Coronaviruses include SARS, which caused a worldwide health panic in 2003, Middle East respiratory disease (MERS), and several microorganisms that cause the common cold.
Kelland pointed out that, by extension, researching and developing vaccines for known virus “families” that potentially affect humans (of which there are 25) would give humanity a significant advantage over the next pandemic. CEPI pushes for a worldwide vaccination library, the One World Vaccination Library, to put us ahead of the curve. This library intends to increase knowledge about prospective Disease X candidates, conduct preliminary scientific research, and make the findings public when a new virus appears.
LEAVE WILD ANIMALS AND THEIR ECOSYSTEMS ALONE
Mitigating or avoiding the next pandemic includes making our interactions with wild animals less disruptive, minimising wildlife trafficking, eating less meat, and reducing intrusive contact with natural ecosystems. According to Matthew Grey, assistant director of the University of Tennessee Centre for Wildlife Health, a ‘clean trade’ programme, in which private business and government authorities collaborate to implement safer practices, is critical to minimising disease transmission. In a National Geographic story, Jonathan Kolby, who worked for the US Fish & animals Service for a decade, noted that most nations had no legislation mandating disease surveillance for animals entering the country and that most wild animal imports were untested. He also stated that most nations lack government institutions that test animal imports for diseases.
Another critical strategy to reduce or avoid pandemics is to regulate wildlife trade and trafficking. Lee Hannah, senior scientist at Conservation International, suggests that the worldwide animal trade should be prohibited, masks and respirators should be stored, testing facilities should be made widely available, and nature should be protected. This may imply that we limit our interactions with animals and become more aware of the impact of this invasion on natural environments. According to Seth Berkley, CEO of Gavi (the Vaccine Alliance), forecasting epidemics before they occur is also vital. This might include focusing on children’s vaccinations, preventive vaccination programmes, and increasing investment in sanitary facilities. Less developed nations would benefit from a healthcare system capable of performing basic diagnostics and surveillance services, allowing them to detect and respond to outbreaks as soon as feasible.
Another possibility is the World Health Organization’s One Health initiative. It is a public approach that recognises the threat of novel animal viruses and brings together the skills of livestock and wildlife veterinary surgeons, conservationists and ecologists, medical specialists, and researchers to combat it. The One Health strategy is based on the idea that human, animal, and environmental health are interconnected, and it requires collaboration between different fields of expertise and government departments; however, according to professionals working on One Health programmes, this can result in bottlenecks caused by politics and bureaucracy. Governments must work together internationally to curb wildlife trading and fast habitat growth to avoid the next pandemic. If they don’t, we should expect future epidemics that murder innocent people and bring economies to a halt.
PREPARING FOR FUTURE PANDEMICS
The cornerstones of effective pandemic prevention, preparedness, and response are generally understood: essential information and technology must be freely disseminated, and vaccinations, diagnostics, and treatments must be broadly distributed. To do this, adequate funds must be supplied at national and international levels, and intellectual property hurdles that hinder safe, capable producers from participating in the pandemic response must be lifted. More than voluntary action is required. The United States and the European Union have acknowledged this and taken specific steps to exchange technology and know-how. The pandemic pact must go further, with enforceable obligations from all nations to freely exchange necessary resources and expertise during an epidemic.
We cannot rely on the charity of pharmaceuticals to ensure that global health takes precedence above profit. During the COVID-19 crisis, significant public pressure compelled BioNTech and Moderna to commit to launching operations in Africa. It was a tiny concession from firms that, like Pfizer, earned $1,000 per second by giving vaccinations to wealthy countries early. Even that was too much for them: now that the news cycle has passed, BioNTech has significantly reduced its intentions for African manufacturing, while Moderna has completely abandoned its plans. The message is clear: governments can only guarantee access to health items by requiring them.
After living through two horrific pandemics in which we, like so many others, witnessed friends and family suffer and die, it is difficult to conceive of such destruction occurring again. The pandemic deal provides promise for a more egalitarian path forward. To succeed, leaders must back up their high language with unwavering pledges that the response to the next pandemic will reflect what we learnt from the last one.
Aurthor: Amar Chowdhury
