As the World Moves on from COVID-19 and Risks of New Pandemics Rise, Global Team of Experts to Design Action Plan for Stopping the Next Contagion Before it Starts
Experts from around the world to lay out how to reduce risks of virus transmission between animals and humans, the origin of most pandemics
Governments have largely erased pandemic threats from their list of priorities, despite continued surges in the spread of animal-to-human diseases. Against this backdrop of neglect of one of humanity's top threats, The Lancet and the Coalition for Preventing Pandemics at the Source are convening a commission on the prevention of viral spillover.
The Lancet-Preventing Pandemics at the Source Commission on Prevention of Viral Spillover will examine and provide guidance on policy, practice, research and law to address viral spillover threats and lessen the risk of future pandemics. This Commission is the most ambitious, diverse and global expert body dedicated to addressing this under-studied and under-funded area.
"Most pandemic prevention efforts focus on containing a disease outbreak through personal protective equipment, vaccines and other measures," said Sonila Cook, co-founder of Preventing Pandemics at the Source (PPATS) and CEO of Dalberg Catalyst. "This Commission is instead focused on preventing disease outbreaks from occurring in the first place, which is far more equitable and cost-effective and brings many other benefits for people and our planet. Through the work of this Commission, we will be better positioned to prevent another crisis instead of merely reacting to it."
The work necessitates convergence and collaboration among many fields — health, ecology, conservation, veterinary science and traditional Indigenous knowledge. The goal of the Commission is to draw global attention to the topic and deliver a major report on viral spillover prevention in two-three years.
Led by three co-chairs, the Lancet-PPATS Commission on Prevention of Viral Spillover is made up of 28 experts from a wide range of disciplines, including epidemiology, microbiology, ecology, human medicine, veterinary medicine, One Health, food systems management, anthropology, behavior, economics policy, and working with Indigenous knowledge systems. With balance between genders and the Global North and South, the Commission members will maintain a constant focus on equity in developing prevention strategies.
Studies have shown that the spillover of pathogens is exacerbated by livestock practices, wildlife hunting and trade, and land-use change such as deforestation. Climate change is also shrinking habitats and forcing animals to migrate to new places, creating opportunities for pathogens to enter new hosts.
Yet, until now, little has been done to tackle the daunting challenge of developing a global action plan to pinpoint what can be done to prevent the domino effects that lead to a regional epidemic or a pandemic. The Commission will conduct original research and pull from the latest science and examples on the ground of how spillover prevention measures can merge with other considerations — such as food security and healthcare — to help to prevent pandemics.
"The basic origins of all the most recent epidemics are clear: They emanate from wildlife," said Cornell University Professor Dr. Raina Plowright, co-chair of the Commission. "And yet, spillover prevention is a topic that is poorly understood and largely unaddressed by major institutions working in public health. Our Commission will improve our understanding of disease threats. We need to shine a bright spotlight on this problem and then provide a strategy to solve it."
The Commission will work with input from many other experts to address the following objectives:
Evaluate and synthesize the evidence on the drivers of viral spillovers;
Identify and evaluate strategies and interventions to prevent viral spillovers;
Provide recommendations for research investigating viral spillovers;
Examine the equity benefits of viral spillover prevention;
Assess the co-benefits and trade-offs of viral spillover prevention;
Identify social, economic, and political challenges and opportunities for implementing viral spillover prevention; and
Develop recommendations for viral spillover prevention that can be adopted and adapted by governments and other stakeholders.
"Many countries struggle to navigate the often-conflicting demands of generating economic development and maintaining an affordable supply of food for growing populations while safeguarding the health of rural populations," said Dr. Latiffah Hassan, Commission Co-chair and a Professor with the Faculty of Veterinary Medicine at the Universiti Putra Malaysia. "It is these communities who face the greatest risk of emerging pandemic threats. Like every other part of our global society, they have a right to decent healthcare. Preventing spillover protects everyone everywhere."
The Commission will assess evidence on spillover prevention strategies, including the following strategies that have been proposed:
Curbing deforestation and forest degradation, especially in tropical and subtropical forests;
Improving domestic animal health, strengthening veterinary care and biosafety in animal husbandry;
Ensuring that risks from the trade and consumption of wildlife — an essential source of protein and income for some communities — are addressed;
Enhancing primary healthcare and alternative livelihoods for communities living close to wildlife; and
Enhancing integrated surveillance for zoonotic viruses at the interface between humans, domestic animals and wildlife.
Budget estimates for effective pandemic preparation vary, with the World Bank and World Health Organization determining it would cost $41.6 billion annually to build and implement an effective prevention system. Estimates of the economic impact of the COVID-19 pandemic, in contrast, find that the first year alone cost more than US$2 trillion, equivalent to a 3.4% decrease in global GDP.
"Preventing pandemics is so much cheaper than responding to pandemics and will save countless lives," said Commission Co-chair Dr. Neil Vora. "Remarkably, it seems like global leaders are already forgetting the terrible lessons we learned during the COVID-19 pandemic. We urgently need dedicated resources to prevent pathogen spillovers, such as an international financing source dedicated to protecting tropical forests. The stakes are too high for the world to implement more incomplete solutions to pandemics. We need investment in both preventative measures to pandemics alongside response measures."
The Commission will emphasize the scientific and cultural expertise of researchers from the Global South, including in its work on inequities.
"So many people are behaving as if the COVID-19 pandemic never happened — and in doing so, they fail to apply the lessons from COVID-19," said Dr. Nigel Sizer, a member of the commission and Executive Director of Preventing Pandemics at the Source which is co-convening the commission with The Lancet. "This Commission will help protect everyone from pandemics by evaluating the science, designing interventions, and presenting policymakers with a roadmap to guide future actions."
Additional quotes:
Anne-Claire Amprou, French Ambassador for Global Health, French Ministry for European and Foreign Affairs
"France is deeply committed to supporting scientific research to help prevent pandemics before they can even start. The Commission on Prevention of Viral Spillover being launched today will complement the important work of the PREZODE partnership. We very much welcome the multi-disciplinary approach and appropriate inclusion of many scientists from the Global South in the commission."
Robyn Alders, AO, PhD, DipVetClinStud, BVSc, BSC (Vet), Honorary Professor, Development Policy Centre and Institute for Climate, Energy and Disaster Solutions, Australian National University and Senior Consulting Fellow, Global Health Program, Chatham House, London.
"In an increasingly small world, where national budgets must tackle multiple challenges, it is crucial that we identify pressure points that can be relieved through policy and technical interventions to yield multiple benefits. Preventive actions taken to reduce the risk of another pandemic have the potential to support sustainable food and nutrition security, mitigate climate change and strengthen national economies. Our Commission aims to collaborate with governments and diverse communities to develop feasible recommendations that will help to prevent the next pandemic and also deliver improved health and wellbeing for all."
John H. Amuasi, MBChB, MPH, MS, PhD, FWACP, Head, Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana and Leader, Research Group Global One Health, Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
"This Commission will provide a much-needed focus on how important viral spillovers are to the risk of pandemics. The complexity of factors which influence spillovers and further transmission needs to be unraveled in such a way as to clearly identify and measure the tradeoffs, inform interventions, and measure their impact. Tough decisions need to be taken globally but should be based on shared ethos and reliable evidence, and The Lancet-PPATS Commission on Prevention of Viral Spillover will make a significant contribution to this".
Sarah Cleaveland, PhD VetMB MRCVS FMedSci FRSE FRS, Professor of Comparative Epidemiology, University of Glasgow, UK.
"Preventing pandemic threats at source will require us to be disruptive. We are going to have to be bold and creative to challenge the status quo so that we can identify new solutions and embrace new paradigms. Any change poses many challenges, but the potential wins are enormous. It is not only our health that is at stake – we have the potential to derive major gains in mitigating impacts of climate change and biodiversity loss, support healthy and sustainable food systems, and address critical issues around global inequities."
Wolfram Morgenroth-Klein, PhD, Head of Pandemic Prevention, Pandemic Preparedness and One Health Division, German Federal Ministry for Economic Cooperation and Development, Berlin, Germany.
"Germany's Federal Ministry for Economic Development and Cooperation strongly supports more work on the scientific underpinnings of pandemic prevention. As such we applaud the launch of this new commission on prevention of viral spillover convened by The Lancet and the Coalition on Preventing Pandemics at the Source. While many people understandably have put COVID-19 behind them, we must increase efforts to reduce the risk of spillover events."
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Osondu Ogbuoji MBBS, MPH, ScD, Assistant Research Professor and Deputy Director at the Center for Policy Impact in Global Health at Duke Global Health Institute, Duke University.
"The absence of a strong preventive focus in our national, regional, and global pandemic preparedness and response plans underscores a critical gap. Investing in the prevention of pandemics as a global public good holds immense potential to enhance both our health and economic well-being."
Dirk Pfeiffer, DrMedVet, PhD, MANZCVSc, DipECVPH, FHEA, Chow Tak Fung Chair Professor of One Health, City University of Hong Kong and Professor of Veterinary Epidemiology, Royal Veterinary College, London, UK.
"We still have a poor understanding of the complexity of the inter-relationships and feedback loops within and between the diverse ecosystems on our planet, including the impact of humanity and of its actions. An important problem is that even though humanity is an integral part of these ecosystems, we usually behave as though we are not, particularly in urban societies. Effective and sustainable pandemic prevention will only be possible, if we adopt a holistic approach to risk assessment and its management that truly integrates knowledge about nature with that about culture, which is what our Commission is aiming for."
Benjamin Roche, PhD, Research Director, Research Institute for Sustainable Development (IRD), Montpellier, France.
"Envisioning these prevention strategies is challenging, because they depend on the local context, which needs to be connected at an international scale to have truly a global impact. Through its geographic and disciplinary diversity, this is exactly what this commission aims to develop -- Inventing a new way to co-develop and implement primary prevention of zoonoses."
John E. Scanlon AO, Chair, Global Initiative to End Wildlife hosted by ADM Capital Foundation and former Secretary-General, CITES.
"Let's never forget that, when left alone, wild animals pose no risk to human health; the risk comes from how we, as people, interact with wildlife. That's something we can manage but our system is not oriented towards preventing the next pandemic. Human memories are short. To give humanity its best shot at preventing the next outbreak we need to hard-wire prevention into our international legal framework."
