The next pandemic is coming – and the world isn’t ready

Here’s what we need to do to improve lives during ‘peacetime’, as well as to ensure we’re properly prepared for the next global health crisis

None of us want to live through anything like the Covid-19 pandemic again but the reality is that the next pandemic is coming. The bleak fact is that there are plenty of other pathogens out there with the potential to cause even greater destruction.

Three years on from the declaration of the worst pandemic in living memory, we are still feeling the effects. More than 6.8 million people are dead, 1.6 billion students have had their education disrupted, and the global economy will have lost more than $12.5 trillion in 2024, according to IMF estimates published last year. Covid-19 wreaked havoc on incomes, health services, mental health and our children’s education – we must do what we can to make sure this never happens again.

It is a question of when, not if, another pandemic strikes. Modelling suggests we could have a 38 per cent chance of experiencing another pandemic in our lifetime – that is a huge risk to bear. But that risk is simply a matter of timing. Experiencing one pandemic does not reduce the threat of the next or mean that it couldn’t happen this year or next. One thing is clear – despite everything we have learned, we are not ready for the next pandemic and have even seen cuts in our health security infrastructure.

The public agrees. Published on 13 April, polling from YouGov reveals well over half (59 per cent) of the British public think UK politicians aren’t taking the threat of future pandemics seriously.

More broadly, there’s a consensus that world leaders also need to be doing more. In the same poll, more than three-quarters of the British public (77 per cent) said they think governments around the world should be investing more in their own healthcare system’s ability to respond to a future pandemic, while 72 per cent think they should be working more with other governments to prevent diseases spreading around the world.

Baroness Hallett’s inquiry into the pandemic will no doubt yield vital lessons for the future about how public policy was developed in the UK. In the meantime, many of us in public health are already thinking deeply about how we can reimagine our healthcare systems so they can transform to deal with future pandemics.

So, what do we need to do? What we need is an “always on” approach to create more resilient health systems, which have the capacity to deliver routine clinical care in normal times and are able to respond rapidly to deliver a future pandemic response. We can integrate genomic sequencing and surveillance into routine patient care, improve diagnosis and help tailor treatment, whilst also maintaining our ability to proactively identify future pathogenic threats.

We can harness the power of new adult vaccines and prophylactic injectables to prevent disease and save lives, whilst also keeping manufacturing and delivery infrastructure “warm” and ready to pivot to produce novel vaccines for a future pandemic.

Creating an economically sustainable model for global health architecture that is “always on” can improve lives during “peacetime” as well as ensure we’re properly prepared for the next global health crisis.

To deliver on this vision and drive progress, we need to adopt the same mission-focused approach we saw in response to Covid-19 – with clear objectives, funding and resources to support delivery, and endorsement from global government bodies.

The Global Health Security Consortium’s One Shot campaign is an example of this mission-based approach. It aims to create a global disease-prevention programme focused on routine delivery of adult vaccines and novel injectable prophylactics, which have the potential to save up to 10 million lives every year.

And by making greater use of existing and forthcoming vaccines, the campaign will create higher and more predictable demand, leading to a healthy, self-sustaining global vaccine market, with distributed R&D and manufacturing capacity across low- and middle-income countries, which is able to rapidly respond to future pandemic threats.

We need that capacity now to deal with the devastating threats from diseases we already know and understand – and for when new threats from disease inevitably emerge.

This month, with colleagues at the Global Health Security Consortium, we are convening global health experts and political leaders at the Rhodes Policy Summit to examine what this should look like – to make sure the devastating events of 2020 are never repeated.

What can we learn from Covid-19 and its early spread? How do early policy responses compare in different countries? And what were the reasons for the collective failure to fast-track access to life-saving technologies for the most vulnerable populations during this crisis?

An “always on” approach would ensure the world has the right tools, from vaccines to clinical research infrastructure which can predict the spread of diseases – and respond rapidly to save lives.

We need to consider the worst-case pandemic scenarios and stimulate sustained political focus and investment from governments, global health organisations and industry into pandemic preparedness.

In a world where attention is rightly focused on the rising cost of living, international conflicts and the energy crisis, it would be easy for us to concentrate on a return to business as usual, to regard Covid-19 as a once-in-a-generation crisis that is now in the past. Sadly, disease is not so obliging – it is no respecter of time, distance or borders. The good news is that we have advanced our knowledge and ability to spot these threats and respond.

The next pandemic could be even more devastating than the last. We must be in a constant state of readiness for the next big health crisis – if we do not act now, we will not be forgiven.

Sir John Bell is Regius Professor of Medicine at the University of Oxford and chair of the Rhodes Trustees