The ongoing COVID-19 pandemic has laid bare our collective weaknesses in being able to effectively respond to the emergence of a highly contagious and lethal microbial threat.  Despite extraordinary advances over the past century in science and unprecedented improvement in global health standards, as evidenced by the COVID-19 pandemic, we still live in a world where the threat an infectious agent can emerge without warning and spread rapidly to every community and every household without regard to national borders or to social and economic standing.

Over the course of the remainder of this century, the likely frequency of epidemics and pandemics will continue to increase, driven to a large extent by demographic trends, including urbanization, and environmental degradation and climate change, persistent social and economic inequalities, and globalized trade and travel.   The burden of these diseases is not equally distributed across the world; the economically disenfranchised, displaced populations and people living with pre-existing conditions are disproportionately impacted.

Importantly, the drivers underlying the emergence of novel disease threats are complex human behaviors and their impact on animal populations and the environment are understood to be central to their emergence.  Changing environmental and climatic conditions have been closely linked to the emergence of novel infectious diseases and the redistribution of those already existing. Their aggregate impact will continue to increase.

While the upgrading of the health security apparatus over the last decade has been welcomed COVID-19 underscores that these processes and institutional arrangements are not sufficient to responding to events such as those caused by SARS-COV 2.  Compliance with the International Health Regulations (2005) that provide a normative framework for surveillance, preparedness, notification and international support and coordination has also been shown to be inadequate.  The experience of the COVID-19 pandemic underscores that new efforts need to be made to craft global strategies, policies and regulatory frameworks that more directly address the multi-sectoral aspects of disease emergence in order to improve our collective capacities to prevent, detect and respond to threats.  Key is strengthening of multi-sectoral systems, increasing policy coherence, including in health technologies access and innovation, and reducing risks of new disease threats.

The failure of the world’s response to the COVID-19 pandemic, however, is not simply about the virus’s biology and its ecology, nor the inadequacies of our multi-sectoral partnerships.  The erosion of support for multilateral institutions and partnerships, a growing mistrust between citizens and their leaders, the increase in ‘nationalism’ and the rise of “anti-science” have further complicated the ability of nations to mount an effective coordinated global response to global events like COVID-19.   We need to thoughtfully examine the causes underlying these trends, including the expanding impact of social media, if we are to understand their impact on our inability to mount an effective response to the COVID-19 pandemic; and based on this insight we urgently need new strategies to re-invigorate our commitment to multilateral partnerships, build more trustful relationships between governments and their citizens, improve global solidarity and re-affirm the centrality of evidence-based solutions to future threats.