This article, first published on 27 December 2022, is part of a series in which OECD experts and thought leaders—from around the world and all parts of society—address the COVID-19 crisis, discussing and developing solutions now and for the future. Aiming to foster the fruitful exchange of expertise and perspectives across fields to help shape Better Policies for Better Lives, opinions expressed on the Forum Network do not necessarily represent the views of the OECD.

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As the—still unfinished—pandemic demonstrates nearly every day, pandemic prevention, preparedness and response is a task for the whole of society, and in every country across the world. Infectious disease outbreaks, which threaten to turn into epidemics or indeed pandemics, rank along with climate change and biodiversity loss as global catastrophic risks for humanity and our planet. Yet while climate change and loss of biodiversity are manmade and can be stopped, infectious disease outbreaks are part of the human condition. Our future well-being and livelihoods depend on our collective ability to address these threats. These three risks are intricately connected, partly exacerbate each other, and need to be tackled in concert.

If we want to protect ourselves, we need to prepare and get ready now.

Entering the Anthropocene era, in which human activity is the dominant influence on climate and the environment, the changes to our environment have already impacted and will continue to impact human health. To name just some examples, the mosquitos transmitting malaria, dengue and zika are already spreading to regions previously too cold to allow them to settle. Loss of natural habitats means wild animals come into increasing contact with humans, risking spillovers of pathogens and new viruses spreading in humans, potentially leading to epidemics. Adverse weather events, drought and higher temperatures result in more infections in animals, possibly meaning more antibiotics in farming, and worsening antimicrobial resistance. Infectious diseases will also spread more quickly among humans, making it harder to contain outbreaks—and avoid pandemics. Add to this humanitarian crises and armed conflicts, as well as the trend towards urbanisation and a growing and increasingly connected global population that has just surpassed 8 billion. If we want to protect ourselves, we need to prepare and get ready now.

There is no silver bullet in pandemic preparedness and response. We need as many layers of effective yet incomplete protection as possible, both individually and collectively.  

First comes prevention, by far the most cost-effective measure, yet typically severely underfunded. Avoiding spillover infections by reducing the human-animal interface, ensuring safe working conditions in farming, banning wildlife trade and reducing deforestation is key. Continued research investments and collaborations also plays an essential role in better understanding, and responding to, emerging pathogens and threats.  

We cannot completely prevent either spillovers or emerging outbreaks, but we can avoid them developing into epidemics. To catch an outbreak as it emerges, early detection and test-and-trace systems are essential. The effective initial response of East and South-East Asian countries during the COVID-19 pandemic aptly illustrates this.

At government and administrative levels, we need to practise procedures during outbreaks. Simulations and exercises—both tabletop and in the field—are extremely valuable to help identify weak points and problems, just as they are essential in fire and crisis management. Once conducted, they need to be evaluated and any shortcomings addressed to ensure their usefulness.

But having only those in key positions practise how to act during health emergencies is not enough, as it is ultimately community level action that will make the difference. To get all of society on board, pandemic literacy is important. Fire safety rules and fire drills are taught in school and beyond, and something similar could also be done for infectious diseases to ensure better compliance and equip people against disinformation. Children could learn basic hygiene aspects and transmission modes. Almost everyone has a vulnerable loved one in their lives, and understanding the basics of hygiene will help protect high-risk groups even beyond pandemics or outbreaks. This may also help to counter mis- and disinformation, one of the bigger challenges in dealing with epidemic responses today in numerous societies.

Measures against airborne or vector-borne viruses only fully work when most people follow them. Good, clear communication and accountability help build trust and confidence in effective, yet cheap and basically unintrusive measures such as masking. In line with this, policy interventions that reflect available evidence should be designed in a way to make it easy for people to understand and implement them—helped again by pandemic literacy.

Our response needs to be fine-tuned to the characteristics of each particular virus or pathogen: will mitigation, suppression or elimination be best? For flu, it is usually mitigation, including vaccination. But for pathogens like SARS and SARS-CoV-2, implementing containment and suppression policies from the start was more successful. This saved lives in countries such as Japan, Vietnam, Singapore and Korea and was also the “cheaper” option, allowing societies and economies to stay relatively open. Compare this to mitigation strategies applied by many European countries, overburdening hospitals and requiring long and strict lockdowns.

Vaccines and therapeutics have an essential role to play but they are the two final lines of defence. Vaccines against COVID-19 have been very effective in preventing severe illness, hospitalisation and death. They have saved countless lives and allowed countries to fully restart public and social life. Vaccines adapted to new Sars-CoV-2 variants are already on the market, further protecting us against current and possibly future variants of the virus causing COVID-19. The fact that safe and effective vaccines became available less than a year after the COVID-19 pandemic began is one of the great success stories of science. It shows that decades of investments in basic research and vaccine development paid off. Ramping up manufacturing and ensuring equitable distribution remain priorities as well. In particular, distributed manufacturing in Africa should ensure more equitable access to vaccines and therapeutics, in general and for future epidemics.

It is important to fund work across this spectrum—from monitoring the emergence of a new virus and its variants to developing and manufacturing its medical countermeasure. All lines of defence are needed to protect citizens across the world. 

Whereas respiratory transmitted viruses are the highest risk for pandemics—in particular corona and influenza viruses—we should equally prepare for other threats, from vector-borne viruses to ebola, and sexually transmitted viruses such as HIV to bacteria.

But we also must think beyond the health sector and government. Consider agriculture and the food industry as part of a “one health” strategy, legal and digital data systems, the transportation and tourism industry, and business in general having been exposed to issues such as supply chain management and human resources disruptions. Digitalisation proves a boon for pandemic preparedness and response, especially due to mobile phones. While data privacy is crucial to open and democratic societies, it needs to be balanced with a state’s duty to keep its citizens safe from preventable epidemics that might require shutdowns when not contained early.

As the illegal invasion of Ukraine and rising inflation has shown, security and the economy rightly are the two “heavy hitters” guiding policy and politics. But pandemics affect both: COVID-19 gravely compromised most states’ biosecurity and defence capacity. It led to one of the steepest reductions in GDP across the OECD since its establishment in 1961. It killed over 20 million people, is continuing to affect the physical and mental health of many more, and has forced countless small- and medium-sized enterprises into insolvency. The effects will be felt for a long time to come. Climate change and biodiversity loss will only exacerbate health risks and make future outbreaks more and more likely. This will pose major security and economic challenges. It is therefore vital to have a sustained effort and whole society approach, breaking the cycle of panic and neglect as we enter the “age of pandemics”. 

Working together, we can rise to the challenge and protect the world from the next pandemic.

The world is taking steps to address this risk, and as health threats do not stop at borders, seeing the promising global and regional initiatives is encouraging. The WHO’s pandemic accord under negotiation brings everyone to the table, and, if ambitious enough, has the potential to greatly improve global co-ordination and response. The G20 launched the Pandemic Fund, based at the World Bank, which will help low- and middle-income countries finance building up their prevention, preparedness and response structures. The Coalition for Epidemic Preparedness Innovations brings together support from philanthropies, the public and governments to speed up vaccine development for emerging infectious diseases. The Africa Centres for Disease Control and Prevention has been further strengthened, and more than proved its value over the past two years. The European Commission’s new Health Emergency Preparedness and Response Authority that has already helped the EU tackle MPOX. The task is now to sustain this work in the face of changing political priorities. These examples, and many more, clearly show that we are beginning to learn the lessons from COVID-19. Working together, we can rise to the challenge and protect the world from the next pandemic.