After the COVID-19 pandemic, the World Health Organization (WHO) and the international community are trying to prepare for the next outbreak. Epidemiologists label this future pandemic as “Disease X,” likely from one of the 25 known virus families; they estimate that it could be significantly deadlier than previous pandemics. Fighting global poverty has been central to how the international community fights against disease.

Preparing for the next pandemic supports people in low- and middle-income countries in two key ways. First, addressing systemic challenges such as pollution, deforestation and limited access to sustainable health care can reduce the likelihood and impact of future outbreaks. Second, the effects of disease tend to be more severe for populations living in poverty. The international community can help by funding existing health initiatives—particularly in tropical regions of the Americas, Africa and Asia—and by supporting efforts like the Coalition for Epidemic Preparedness Innovations’ (CEPI) 100 Day Mission, which aims to accelerate vaccine development and save lives. 

Challenges in Pandemic Planning

Experts suggest that one of the most difficult parts of improving global public health is preparing for the next pandemic before it happens. The major challenge is getting governments to invest ahead of time, despite not knowing exactly when, where or how the next major disease will strike. Caroline Buckee, professor of epidemiology and associate director of the Center for Communicable Disease Dynamics (CCDD), noted,  

“One of the confirmatory lessons for me—it’s not a new lesson—was that governments and people are reactive. And it’s very hard to get significant investment in preparedness. When it comes to pandemics, or epidemics in general, one of the hardest things about preparedness is that if you’re doing it really well, no outbreak—or only a small outbreak—occurs. Proving that you have averted an epidemic is difficult, so politically, how do you justify the investment required? It’s a really hard problem.”

One of the ways epidemiologists prepare for something that is both unpredictable and inevitable is by ranking the likeliest outbreaks to become a major issue, including “another possible Disease X, a term used to describe a currently unknown pathogen with pandemic potential.” 

Tracking Zoonotic Threats

One of the ways health experts accurately prepare is through pathogen rankings like the Priority Zoonotic Disease Lists and the Research and Development Blueprint. The Coalition for Epidemic Preparedness Innovations, in partnership with the University of California, Davis, has developed a new analytical tool called SpillOver to help predict the most likely risks.

SpillOver evaluates the likelihood of animal-to-human spillover among viruses, like the zoonotic transfer that occurred with the 2020 coronavirus pandemic. So far, the project has isolated 12 separate zoonotic diseases that are most likely to infect, ranging from Simian foamy virus to Lassa virus. SpillOver 2.0 will incorporate more data in order to more holistically analyze which diseases we need to prepare for. 

The Impact on Global Poverty

This massive effort of analyzing and preparing for the next pandemic is critical to fighting global poverty for two major reasons. First, pandemics disproportionately harm the global poor. Analysis from The Lancet found that if a pandemic of similar proportions to the 1918 influenza epidemic were to occur in 2025, there would be 62 million fatalities, 96% of which would be in lower-income countries. By contrast, investing in poverty relief helps combat disease spread through improved health systems, increased health education and more effective sanitation. 

Secondly, the fight against poverty and the effort to control pandemics are linked. The wider systemic issues that cause global poverty also increase the risk of a disease outbreak and that same outbreak developing into a full-blown pandemic. The WHO has warned that this next pandemic, labeled Disease X, “could be 20 times more lethal than COVID-19, with very high costs, possibly no vaccines and enormous social and economic impacts.” 

The most likely risk is a zoonotic disease from a tropical region, all places suffering from high poverty rates, climate change and deforestation. These three main factors increase the likelihood of a tropical animal-to-human outbreak turning into the next COVID-19. While deforestation increases the possibility of spillover, combating deforestation not only helps prevent outbreak but also can reduce poverty as well. 

Rapid Response and Vaccine Development

As daunting as this may be for the global poor, the international community and health experts are learning from the last pandemic. CEPI is leading efforts to ensure that life-saving vaccines can be made available across the developing world in as little as 100 days, compared to the traditional five-year timeline. 

Started in 2014 to help combat Ebola, CEPI also played a critical role in reducing the COVID-19 vaccine development timeline to 12 to 18 months. By focusing on increased research, development and mass production, “…CEPI has simultaneously advanced the development of 11 rapid response platforms to deploy against unknown threats, or Disease X.” Being able to predict which diseases may emerge from and affect the developing world is critical to fast-tracking vaccines, which have historically saved an estimated 154 million lives worldwide. 

Looking Ahead: A Shared Global Strategy

While preparing for the next pandemic is difficult and full of uncertainties, expert opinions suggest that focusing efforts will be critical to combating global poverty. By identifying the most likely pathogens as potential future “Disease X” threats, the international scientific community has helped concentrate resources that can be used effectively in the developing world. Hence, fighting global poverty and protecting global health appear to be essential parts of the same strategy.

– Joseph Laughon

Joseph is based in Sacramento, CA, USA and focuses on Technology and Global Health for The Borgen Project.

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