DISINFACTS | Issue 2/2020

KNOWLEDGE Emerging infectious diseases are a global risk The world has been upended by the novel coronavirus. What should not be forgotten while we are focusing on SARS-CoV-2 is that epidemics with emerging pathogens remain an ongoing risk. SARS-CoV-2 will be followed by other pathogens that will make their way to humans somehow, somewhere. And the ‘whenever’ is not so far off according to the WHO report ‘A world at risk’ published last September. From Wuhan to the world The print was barely dry when the warning became a sad reality: ‘The world is at acute risk for devastating regional or global disease epidemics or pandemics that not only cause loss of life but upend economies and create social chaos’, according to the expert report from the Global Preparedness Monitoring Board (GPMB), which was published by the World Health Organization in September 2019 (1). In addition, ‘the world is not prepared for a pandemic with a rapidly moving, infectious respiratory pathogen. High-impact respiratory pathogens, such as an especially deadly strain of influenza, would pose particular global risks in the modern age.’ The reasons for this are now mostly likely familiar to everyone: such pathogens spread easily via droplets. This means that they can very quickly infect many people and move rapidly around the world thanks to today’s transportation infrastructure. The risk remains high This pandemic is now reality. And the risk of another devastating epidemic remains: the perilous initial situation has not changed. Infectious diseases such as SARS, MERS or Ebola are, according to the GPMB report, the ‘harbingers of a new era of high-impact, potentially fast-spreading outbreaks that are more frequently detected and increasingly difficult to manage’. According to the report, the WHO counted a total of 1483 epidemic events across 172 countries between 2011 and 2018. Contact with previously unknown pathogens is fuelled by environmental, economic, political and social changes. Among the factors the report mentions are population growth – there are just under 7.8 billion humans on the planet today (2) – and the globally networked international economy with transcontinental supply chains to the furthermost corners of the world. And people are travelling faster, more often and further than ever before. Climate change is also adding to the mix: ecosystems are changing and driving wild animals (and their viruses!) into the world of humans. Wars and the increasing number of failed states do not make the situation better. The authors also suggest causes that have also led speculation in the current coronavirus crisis: the deliberate release of genetically modified pathogens. The genetic engineering toolkit that is currently available, such as CRISPR gene editing scissors (3), mean that this is even possible for ambitious laypeople. Do your homework! In light of such scenarios, states and international organisations should prepare themselves better for global health emergencies. In the foreword of the GPMB report, Gro Harlem Brundtland, former Prime Minister of Norway and former WHO Director-General, and Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC) warn of the consequences: ‘For too long we have allowed a cycle of panic and neglect when it comes to pandemics: we ramp up efforts when there is a serious threat, then quickly forget about them when the threat subsides. It is well past time to act.’ Adequate investments in, for example, developing innovative vaccines are encouraged. Broad-spectrum antiviral medications and appropriate non- pharmaceutical interventions should also be implemented when it matters. This obviously includes epidemic control and disinfection measures. Compliance with basic hygiene – another lesson from the coronavirus crisis – is the first line of defence against emerging pathogens. Sources: 1 Global Preparedness Monitoring Board. A world at risk: annual report on global preparedness for health emergencies. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Link: https://apps.who.int/gpmb/assets/annual_report/GPMB_annualreport_2019.pdf 2 Worldometer (accessed on 25.03.2020). Link: https://www.worldometers.info/world- population/population-by-country/ 3 Wessels, H., Méndez-Mancilla, A., Guo, X. et al. Massively parallel Cas13 screens reveal principles for guide RNA design. Nat Biotechnol (2020). https://doi.org/10.1038/s41587-020-0456-9 DISINFACTS 2/20 page 7