The Covid-19 pandemic was not an unexpected event, viral outbreaks of this kind have been predicted by medical and environmental scientists for many years.
The risk of global contagion is increasing as the world becomes more densely populated and interconnected. These risks can be minimised if governments make better preparations for pandemics, both within and between nations.
Cooperation over the production and distribution of vaccines is essential. There are wider factors at play as pandemic risk is intertwined with wider social, environmental and economic challenges.
The Global Preparedness Monitoring Board sets out why the risks of pandemics are rising and explores the actions that governments can take to prevent pandemics and reduce their impacts.
The United Nations Environment Programme’s major Preventing the Next Pandemic report explores the causes of, and how to reduce, pandemic transmission. These include the need for better food systems and greater support for poorer nations suffering an outbreak.
The complex connections between disease, ecosystems and wellbeing are demonstrated by the Disease Scenarios Africa project. Its interactive models explore how factors including population growth, climate change and food prices interact with social change, conflict, and land use to determine pandemic risk.
The majority of new epidemics have zoonotic origins. This means they are caused by germs spreading from animals to humans.
Rising global demand for meat and dairy products are fuelling the destruction of forests and habitats, pushing wildlife into ever-closer proximity to people.
The extensive use of antibiotics in intensive farming is reducing their effectiveness, while climate change is also increasing the spread of animal-born diseases and displacing people into new areas that may already be densely-populated.
The United Nations Environment Programme and the World Health Organisation have concluded in their report Connecting Global Priorities: Biodiversity and Human Health, that most emerging infectious diseases are driven by human activities.
Chatham House interviews experts on how the destruction of nature is making outbreaks like Covid-19 more likely and outlines how protection of the environment is crucial in preventing new disease outbreaks.
Lack of preparation
The Covid-19 crisis has revealed how vulnerable our economies and healthcare systems are to the threat of pandemics. In doing so it has also shown how exposed we will be to any future environmental breakdown.
Britain has been slow to respond effectively, despite extensive prior knowledge of pandemic risk and having developed sophisticated plans. This could partly be explained by a reduced capacity in government after austerity cuts to public spending and the focus on preparations for Brexit.
Health funding is under huge pressure in many low-income countries and there have been acute shortages of healthcare workers. Globally there is a mixed record of cooperation on pandemic or wider disaster risk reduction.
Professor Paul Rogers writes for the Oxford Research Group on how years of austerity have undermined the UK’s ability to effectively respond to pandemics.
The World Health Organisation has a major report on understanding and managing epidemics. It focuses on three key responses: engaging communities; the effective communication of risk; and both treating patients and protecting the healthcare workforce.
The Overseas Development Institute’s Global Reset Dialogue series explores issues of global leadership and resilience after Covid-19. Among its focus areas are how to deliver more effective global cooperation to reduce inequality.
The pharmaceutical sector
High levels of government spending on research and development for new medicines will not always lead to affordable and effective treatments.
It is widely argued that the business models and market structures of the global pharmaceutical industry do not prioritise treating chronic conditions over developing novel drugs.
This means that prohibitive prices of medicines produced can place a strain on health service budgets, particularly in low-income countries.
The lack of focus on new drug development also plays a role in the growing threat of antibiotic resistance. This is made worse by the overuse of antibiotics in many countries and in animal agriculture.
The Lancet’s Commission into Essential Medicines sets out recommendations on how to make medicines affordable and globally available. It focuses on how to ensure the affordability and quality of existing medicines and how to speed up the development of new or missing treatments.
The Institute of Innovation and Public Purpose at UCL has a report that concludes pharma companies are incentivised to set high prices and deliver short-term returns to shareholders rather than focus on riskier innovation that leads to critically needed therapeutic advances.
The New Economics Foundation and Friends of the Earth look at how a lack of effective regulation has increased the threat of antibiotic resistance.
There are few quick fixes for reducing zoonotic transmission of diseases. The causes are linked with the wider impacts of human activity on the natural world. Major global health bodies are calling for a One Health approach, with public health investment being based on the intrinsic connection between the health of people, plant and animals.
A range of policy ideas flow from this agenda. Improving food security, particularly in low-income nations, could stop international markets encouraging environmentally destructive food production.
There are growing calls for companies to do more to prevent deforestation and biodiversity loss. Reducing demand for meat and dairy products could also drastically reduce destruction of nature and improve health globally.
The Soil Association explores the links between zoonotic transmission and intensive farming. It states that pigs in particular are known to be vulnerable to coronaviruses and could be a key vector for transmission.
The Zoological Society of London argues that closing wet markets risks forcing activity into illegal and less regulated markets. The real drivers of zoonotic exposure are biodiversity loss and the unsustainable exploitation of wildlife.
WWF calls for global action to protect people and nature in response to Covid-19. It focuses on the impacts of human activity on the natural world as a driving force in the transmission of zoonotic diseases.
Proposals for improving pandemic planning focus on three areas. First, the better communication of risk, and avoiding “infodemics” of false information, to build public support for timely action.
Second, improving communication across government and ensuring that high impact, high likelihood risks like pandemics can be properly understood, planned for, and acted upon.
Third, international action in recognition of the global causes of pandemics and their disproportionate impact on the world’s poorest. Here, proposals for direct support include ensuring aid is better targeted to build healthcare workforce resilience and cancelling international debt.
The Institute for Government proposes structural changes to the UK government to better handle pandemic risk and responsiveness. In particular it highlights the problems of insufficient internal accountability and the constant movement of key experts between departments.
The United Nations calls for Covid-19 debt relief for the most exposed developing nations. It notes that debt relief was critically important for these countries prior to the pandemic.
The One Health Commission has a rolling list of materials about the benefits of a joined-up One Health approach for responding to Covid, including highlighting the relatively small economic cost of proper prevention versus the devastating economic losses.
Covid-19 has exposed the lack of effective collaboration on vaccine development and distribution, notably by richer governments.
Large rich countries are prioritising the development of vaccines for their own populations first, underfunding and potentially undermining global coordination efforts.
The UN’s attempt to set up an information pooling scheme to share intellectual property around vaccines has been strongly resisted by the pharmaceutical industry.
The Wellcome Trust draws four lessons from past epidemics to guide the search for Covid-19 treatments and vaccines. It cites global coordination as critical.
The World Economic Forum warns that of the four billion Covid-19 vaccines that the world will need, only a few hundred million could be delivered to non-G7 nations in a "best case" scenario.
The Centre for European Policy Studies recommends compulsory licensing for future Covid-19 vaccines whereby other manufacturers would be able to produce generic versions in low or middle income countries.