Preparedness for emerging epidemic threats: a Lancet Infectious Diseases Commission

Abstract

At any time, an emerging, lethal, and highly transmissible pathogen might pose a risk of being spread globally because of the interconnectedness of the global population.1, 2 Emerging epidemic threats are occurring with increasing scale, duration, and effect, often disrupting travel and trade, and damaging both national and regional economies.3, 4 Even geographically limited outbreaks such as the Ebola virus disease in Africa might have a global effect. Preparing for epidemic threats is not a static or binary (prepared or unprepared) exercise, but a dynamic state reflecting the constantly changing world. Countries prepare in different ways based on their interpretation of disease risks and international agreements such as the International Health Regulations (IHR). The IHR were introduced in 1969 to prevent spread of specific serious diseases between countries and set out preparedness measures at international borders to stop disease spread. The 2005 revisions to the IHR reflect changes across multiple dimensions, requiring countries to develop preparedness capacities to detect and respond to outbreaks where and when they occur, supported by international partners to respond when outbreaks cannot be contained locally.5 However, disruptive factors have emerged at a greater pace over the past decade, creating a new ecology that requires novel strategies for preparedness. These factors include dealing with the increasing human population density and connectivity, harnessing novel data streams and new technological advances to manage epidemics, mitigating false information on social networks, to creating informal technical networks that can work together when political forces fail to do so. without epidemiological and clinical surveillance data is insufficient to show whether new SARS-CoV-2 variants are more transmissible, more lethal, or more capable of evading immunity, including vaccine-induced immunity.