Climate change is expected to become the single biggest global crisis of this century, and a growing body of evidence suggests that, in addition to the toll it is already taking on the lives of tens of millions of people, it is now also one of the main driving forces increasing the risk of pandemics.
In the coming decades, this could double the chances of future COVID-scale pandemics occurring. Together with climate shocks, this worrying combination of disaster and disease heralds a perfect storm of devastation and disruption — and it means that COVID-19 could just be a taste of things to come.
Yet, despite the significant threat this poses to humanity, the world still appears to be asleep at the wheel. The World Health Organization is working towards a pandemic accord to supplement the International Health Regulations, to ensure member states are better prepared for future pandemics. However, remarkably there is nothing akin to COP28 on the agenda to tackle this and coordinate pandemic preparedness and response efforts at a global level.
Without an international and globally inclusive process, recognised by international law, aimed at driving and monitoring progress towards global solutions, there is a very real danger that we slip back into a dangerous cycle of neglect and panic, ignoring the warning signs and only taking action after disaster strikes. At best efforts will become fragmented, and at worst global leaders revert to thinking of outbreaks of infectious disease as a distant threat and less of a priority.
With infectious disease, this is an all too familiar pattern that we have seen time and again. Takes viruses like Ebola Sudan, where instead of taking pre-emptive action, the world waits until a pathogen threatens global health security before treating it like one. This kind of short-term thinking is always a false economy, coming at great cost, both in terms of the lives that could have been saved and the economic impact.
Consider how differently this pandemic might have played out if there had been a well-funded, comprehensive research effort into universal coronavirus vaccines before COVID-19 struck, given that we had two dry runs with SARS and MERS, such that they were ready for clinical testing and made available to people everywhere at the very start of the pandemic. With the right vaccines and a rapid response, it might have been possible to contain the spread and prevent global escalation. Speculation can only get us so far, but research suggests that more than 1.3 million deaths could have been prevented if COVID-19 vaccines had been shared more equitably during the first year that they became available. The bottom line is that being better prepared save lives.
With more than 13 billion doses of COVID-19 vaccines administered so far, there are huge incentives to develop vaccines for global pandemics. However, there are no commercial incentives to develop vaccines that prevent outbreaks from escalating into epidemics or pandemics in the first place — it's just not as profitable. Similarly, donors are usually reluctant to invest in the research and development of vaccines that may never get used.
Coordinating a response despite competing crises
Given that there is never a shortage of global crises — from the escalating cost of living to the war in Ukraine — leaders will always have more immediate and pressing priorities to deal with and fund. That is why multilateral global solutions are needed, particularly those that are designed to benefit everyone, not just in terms of being part of the global solution, but also because they serve each government's own domestic agenda. During times of crisis, when the world is so fragmented, that is the best way to get everyone to cooperate.
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With this pandemic, COVAX was just such a solution, making equitable access to vaccines possible and delivering nearly 1.9 billion doses of vaccine to 146 different economies. It worked precisely because it served everyone's best interest. But had it been put in place before the pandemic, rather than in the midst of the worst health crisis of a century, then its impact could have been even greater.
So, for future pandemics it is absolutely critical that we create multilateral global solutions now. They must bring stakeholders together to coordinate and drive pandemic preparedness and response. This includes ensuring that there is adequate funding for vaccine R&D, creating publicly subsidised markets for pandemic vaccines and making sure global health agencies have the contingency purchasing and delivery financing needed to rapidly deploy the vaccines.
We don't yet know what form the next pandemic will take, but such solutions will undoubtedly be needed. Just consider the impact that a single virus, SARS-CoV-2, has had: at least 15 million people dead, more than 660 million infected and more than $12 trillion in economic impact.
A focus and opportunity to drive progress
Moreover, it's not just pandemics we need to worry about. Climate change is expected to trigger a surge in a range of infectious diseases, with mosquito-borne diseases like malaria, yellow fever and dengue fever spreading to new regions, reaching as far as northern parts of Europe and Canada.
Similarly, relentless encroachment on natural habitats will continue to drive previously undisturbed animal populations, such as bats, to new regions, making viral spillover to humans increasingly likely. And with the increase in extreme weather events and flooding comes the escalated risk of outbreaks of water-borne diseases. As millions more people are forced from their homes, this will also increase urbanisation, making it easier for infectious disease to spread.
We still have a long way to go before climate change is even close to being solved, and many would argue that COP is a frustratingly slow and even broken means to get there. But for all its flaws, it at least provides a focus and opportunity to drive progress. With Japan taking up the G7 presidency, as a long-standing champion in the fight against infectious disease, this year marks an opportunity for us to create something similar for pandemic preparedness.
Dr Seth Berkley
Chief Executive Officer, Gavi, the Vaccine Alliance
This article was originally published by the World Economic Forum on 16 January 2023.