Why preparations for the next pandemic must begin now

By Sayan Das 

[...]

While everything from bacteria to ticks can cause the next pandemic, the most disruptive health emergencies in recent memory – HIV, H1N1 and H5H1 influenza, SARS coronavirus, Lassa virus, Ebola – were caused by viruses. The Global Virome Project estimates that there are some 1.67 million unknown viral species in the world, of which 827,000 can pose a potential risk to humans. While pathogens to cause pandemics are aplenty, our preventive efforts remain suspect at best, and counterproductive at worst.

[...]

Yet the 2019 Global Health Security Index – a comprehensive score to assess countries’ ability to deal with health emergencies – could find not even a single country adequately prepared for epidemics or pandemics. India ranked an unremarkable 57th out of the 195 countries. Its score, spread across the six categories of prevention, detection and reporting, rapid response, health system, compliance with international norms, and risk environment, was uniformly mediocre, with preventive efforts graded the least. Disaggregated further, India fared even worse across indicators such as zoonotic disease prevention; emergency preparedness and response planning; health system capacity and healthcare access.

[...]

Pandemic preparedness, typically involving surveillance, risk reduction and capacity building, demands considerable effort and commitment. Strengthened surveillance capacity across the district-state-national level, inclusive of the private sector, and strategically intensified in potential hotspots, with capable support from sufficient human resources and diagnostic infrastructure, would be critical to timely identify and respond to outbreaks.

Adopting a ‘One Health’ approach, which recognises sustainable interrelation between people, animals and their shared environment as key to optimising health outcomes, would boost risk reduction and preventive efforts further. A national OneHealth policy will be necessary to maximise synergies between the different sectors dealing with human, animal and environmental health and provide a framework for collaborative action. Some immediate measures may include ensuring health and hygiene standards in food-animal farming, preventing antibiotic misuse therein and strategic integration between human and animal disease surveillance.

[...]

The exact what, where and how of the next pandemic may be less clear, but who it will overwhelmingly affect is almost certain: the poor and the marginalised, dependent most on public healthcare. Absent any tangible benefit from the private sector or the Ayushman Bharat scheme during the pandemic, a robust and universal public health system remains the sine qua non for the health of the public. Strengthening the public health system, building surge capacity to meet health emergency needs and improving the overall social determinants of health will be essential for building back better health systems that are equitable, resilient, and sustainable.

[...]