Pandemic, Coalition for Epidemic Preparedness Innovations, Research, World Health Organization: Preparing for the Next Global Health Crisis
The global community has been starkly reminded of the devastating impact pandemics can have on societies, economies, and health systems. In response to these threats, the World Health Organization (WHO) has released an updated list of over 30 pathogens that have the potential to cause the next pandemic. This comprehensive effort is designed to help organizations prioritize research and preparedness against these looming threats. The list, which includes known pathogens such as influenza A and dengue, as well as new bacterial strains responsible for diseases like cholera and plague, aims to focus global efforts on developing treatments, vaccines, and diagnostics.
Historically, the WHO’s lists, released in 2017 and 2018, included only a dozen priority pathogens. However, the rapid evolution of global health threats necessitated a more extensive evaluation. Over 200 scientists spent two years meticulously assessing evidence on 1,652 pathogen species to determine which ones should be included in the updated list. This rigorous process ensures that the most critical pathogens, those with high transmissibility, virulence, and lack of existing vaccines and treatments, are prioritized for research and development.
The updated list encompasses not just viruses but also bacteria, reflecting the broad spectrum of potential pandemic threats. Influenza A, dengue, and monkeypox are among the viruses included, while five new bacterial strains responsible for diseases such as cholera, plague, and pneumonia have also been added. Notably, the Nipah virus, recently found in India, has been included due to its significant outbreak potential. This inclusive approach allows for a more comprehensive preparedness strategy, ensuring that both viral and bacterial threats are addressed.
The WHO has also introduced a list of prototype pathogens, which serve as model species for research and the development of treatments and vaccines. This strategy of prioritizing entire pathogen families rather than individual pathogens enables a more efficient and proactive response to new and emerging threats. It also prepares for the possibility of unknown threats, referred to as ‘pathogen X,’ which represents unidentified pathogens with the potential to cause public health emergencies or pandemics.
The ultimate goal of the WHO’s updated list is to prevent and prepare for future pandemics. By informing research and decision-making, this list helps minimize the impact of these pathogens and ensures that global health systems are better equipped to respond to potential crises. The importance of remaining vigilant and prepared for potential global health threats cannot be overstated, and this updated list serves as a crucial tool in guiding global efforts in pandemic prevention and response.
In parallel, the Global Pandemic Preparedness Summit (GPPS) held in Brazil underscored the significant gaps in global preparedness. Climate change is exacerbating disease outbreaks, and the world remains largely unprepared for another pandemic. The summit aimed to reinvigorate momentum for pandemic preparedness and response, highlighting global shortcomings in collaborative surveillance, diagnostic tools, and finance. Speakers emphasized that climate change is amplifying half of all pathogens, increasing the risk of transmission across continents.
The destruction of environments and human migration have further facilitated the spread of pathogens between animals, humans, and the environment. The WHO is currently responding to 42 graded emergencies, with 15 requiring international assistance, and managing 168 ongoing health emergencies at the national level. This high level of connectivity and exposure to diseases underscores the urgent need for improved diagnostic readiness and fast, equitable access to diagnostics, vaccines, and treatments.
The Coalition for Epidemic Preparedness Innovations (CEPI) CEO, Dr. Richard Hatchett, emphasized the importance of rapid and equitable diagnostics in responding to emerging pandemics. The Pathogen Diagnostic Readiness Index (PDXRI) was launched to evaluate diagnostic preparedness, aiming to achieve the ‘100 days mission’—developing vaccines, tests, and treatments within 100 days of an outbreak and ensuring access to them. However, significant disparities in access to vaccines and treatments remain, as highlighted by South Africa’s Deputy Director-General of Health, Anban Pillay, who criticized the pharmaceutical industry for charging higher prices for COVID-19 vaccines in certain regions.
The Pandemic Fund, which has raised $2 billion in seed capital from 28 contributors, faces high demand for funding, with proposals worth $7 billion but only $850 million available. This funding gap highlights the need for continued investment and collaboration to maintain momentum in pandemic preparedness. Brazil’s Ambassador Tovar da Silva Nunes expressed confidence in reaching an agreement on a pandemic pact before the next World Health Assembly, emphasizing the importance of greater collaboration between the Global North and Global South to overcome disparities in access to health tools and countermeasures.
The Rio de Janeiro Declaration, signed by attendees from the Global South at the summit, calls for enhanced collaboration and equitable access policies. It urges global health partners to prioritize research, establish alliances for regional and local production, and support innovation to bolster pandemic preparedness and response. Addressing health equity is crucial to ensuring better pandemic preparedness, as highlighted by Pan American Health Organization Director, Dr. Jarbas Barbosa, who stressed the role of health in reducing inequality and breaking the cycle of poverty and disease.
Trust is the foundation of global disease surveillance, and countries must feel confident that their expectations will be met. Joy Phumaphi, co-chair of the Global Preparedness Monitoring Board, emphasized the importance of equity in consultation, responsibility, access, and outcomes. While the world is better prepared for pandemics than before COVID-19, there is still much work to be done. Improved genomic surveillance and the creation of a pandemic fund are positive developments, but more efforts are needed to translate concepts like One Health into concrete actions, integrating human, animal, and environmental health for early detection and response.
The Coalition for Epidemic Preparedness Innovations (CEPI) and the WHO have urged for increased global research to prepare for future pandemics. This includes focusing on whole families of pathogens rather than just individual infectious microbes. The WHO’s ‘Pathogens Prioritization’ report, involving over 200 scientists from 50 countries, evaluated evidence related to 28 viral families and one core group of bacteria. Emphasis is placed on expanding research to encompass entire families of pathogens, using prototype pathogens as a guide, to ensure readiness for both anticipated and unanticipated threats.
The report notes that although thousands of viruses and bacteria can infect humans, only a small number have caused pandemics or large-scale epidemics. Family expert groups were established for 28 viral families and one for bacteria to allow for consensus and prioritization. This approach aims to create knowledge, tools, and countermeasures that can be quickly adapted to emerging threats. Additionally, the strategy aims to speed up surveillance and research to better understand how pathogens transmit and infect humans, ensuring a more robust global response to future pandemics.