Explore the vast range of titles available.

Most pandemics—eg, HIV/AIDS, severe acute respiratory syndrome, pandemic influenza—originate in animals, are caused by viruses, and are driven to emerge by ecological, behavioural, or socioeconomic changes. Despite their substantial effects on global public health and growing understanding of the process by which they emerge, no pandemic has been predicted before infecting human beings. We review what is known about the pathogens that emerge, the hosts that they originate in, and the factors that drive their emergence. We discuss challenges to their control and new efforts to predict pandemics, target surveillance to the most crucial interfaces, and identify prevention strategies. New mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease. We lay out a series of research and surveillance opportunities and goals that could help to overcome these challenges and move the global pandemic strategy from response to pre-emption.

Expanded viral discovery can improve mitigation Outbreaks of novel and deadly viruses highlight global vulnerability to emerging diseases, with many having massive health and economic impacts. Our adaptive toolkit—based largely on vaccines and therapeutics—is often ineffective because countermeasure development can be outpaced by the speed of novel viral emergence and spread. Following each outbreak, the public health community bemoans a lack of prescience, but after decades of reacting to each event with little focus on mitigation, we remain only marginally better protected against the next epidemic. Our ability to mitigate disease emergence is undermined by our poor understanding of the diversity and ecology of viral threats, and of the drivers of their emergence. We describe a Global Virome Project (GVP) aimed to launch in 2018 that will help identify the bulk of this viral threat and provide timely data for public health interventions against future pandemics.

Tiffany Bogich and colleagues find that breakdown or absence of public health infrastructure is most often the driver in pandemic outbreaks, whose prevention requires mainstream development funding rather than emergency funding.

Politicising and ignoring science has hampered the rollout of timely and effective control measures5 while political conservatism in the US inversely associates with perceived health risk and adoption of health protective behaviours.6 Furthermore, hate speech has triggered anti-Asian racism and xenophobia in the US7 resulting in an increased level of post-traumatic stress disorder among Asian and Asian American young adults, who reported verbal or physical assault.8 Around one million excess deaths occurred in 2020 in 29 high income countries, and men have higher age standardised excess death rates than women in almost all countries.9 A study on excess mortality spanning 79 high, middle- and low-income countries shows that the privatisation of healthcare, an underfunded health sector, and slow covid-19 containment and mitigation actions are key drivers of excess deaths.10 Timely activation of comprehensive responses, adapting health systems’ capacity, preserving health systems’ resources, and reducing health systems’ vulnerability all contribute to effective country responses.11 However, untimely and ineffective containment measures against covid-19 have resulted in surges of cases and have overwhelmed healthcare systems around the world. [...]we must roll out covid-19 vaccination to at least 70% of world’s population by 2022. [...]thinking of the covid-19 pandemic as a syndemic should help us to focus our efforts on minimising the various determinants which exacerbate the consequences of covid-19 on marginalised and underserved populations.

Dennis Carroll and colleagues call for a global early warning system to detect viruses with pandemic potential

Universal and comprehensive measures must be implemented with global oversight to mitigate the risks associated with handling potentially dangerous microbes.

Global cooperation is essential for coordinated planning and response to public health emergencies, as well as for building sufficient capacity around the world to detect, assess and respond to health events. The United States is committed to, and actively engaged in, supporting disease surveillance capacity building around the world. We recognize that there are many agencies involved in this effort, which can become confusing to partner countries and other public health entities. This paper aims to describe the agencies and offices working directly on global disease surveillance capacity building in order to clarify the United States Government interagency efforts in this space.

According to WHO, as of July 2, 2021, the pandemic has resulted in 182 101 209 confirmed cases and 3 950 876 deaths, both undoubtedly underestimates of the real toll. Equally essential will be ensuring that the field workforce, laboratory facilities, and the health-care community can all work under the safest conditions. [...]this pandemic ends, we ask, as we did in February, 2020,1 for solidarity and rigorous scientific data. All of EcoHealth Alliance's work is reviewed and approved by appropriate research ethics committees, the Institutional Animal Care and Use Committee, institutional review boards for biomedical research involving human subjects, P3CO oversight administrators, and biosafety committees, as listed on all relevant publications. JSM is a member of the WHO International Health Regulations Emergency Committee for COVID-19, a member of the One Health High Level Expert Panel that advises the Food and Agriculture Organization of the UN, the World Organisation for Animal Health, the United Nations Environment Programme, and WHO, and a past member of the scientific advisory committee for the Center for Emerging Infectious Diseases of the Wuhan Institute of Virology (2008–11).