This article is based on content originally published on our partner platform Seerist, the augmented analytics solution for threat and risk intelligence professionals.
Global drivers sustain high likelihood of another pandemic
The World Health Organization (WHO) Independent Panel for Pandemic Preparedness and Response on 18 June reported on the political complacency and geopolitical fragmentation that hobbles global pandemic preparedness. We assess international institutions’ current pandemic planning response, as well as the multiple drivers that are increasing both the likelihood and anticipated impact of infectious disease outbreaks.
- Recent outbreaks of preventable diseases highlight the need for continued vigilance and the importance of preparedness for future pandemics within governments and commercial organisations.
- Climate change, urbanisation and deforestation combined with economic pressures and geopolitical tensions will sustain global vulnerability to infectious disease outbreaks, including another pandemic, in the coming years.
- We assess that the global response to the next pandemic is likely to be as fragmented as the response to COVID-19 and recent communicable disease outbreaks.
- Businesses should incorporate the threat and anticipated impact of future pandemics into long-term scenario planning. They should also map supply chain exposure to the rising likelihood of endemic disease outbreaks.
“No Time to Gamble”
The WHO panel, established in 2020 to generate lessons and recommendations from the COVID-19 pandemic, criticised the lack of political momentum for pandemic planning strategies, including disease surveillance, information sharing and financial investment. Instead, it found that governments are focusing on short-term political issues, often dictated by domestic public opinion. It also noted that lower-income countries face a far higher debt burden than they did in 2019, and this limits their ability to invest in pandemic preparedness and healthcare capacity. Geopolitical fragmentation accelerated during the COVID-19 pandemic and has further undermined a global approach to the ambitious pledges made in 2020-21.
The painful, drawn-out and ongoing negotiations on a global pandemic treaty emphasise the challenges in reaching a consensus on pandemic response. After nine rounds of negotiations failed, the deadline for agreeing the first pandemic treaty was pushed to May 2025. The core of the treaty would be a new pathogen access and benefits sharing (PABS) system, where countries would share information about emerging disease in exchange for access to vaccines and medicine. The core disagreement is between higher-income countries (and the pharmaceutical sector) and-lower income countries over the extent of technological and intellectual property (IP) transfer, as well as financial and vaccine commitments.
Trends and drivers
Climate change, urbanisation and deforestation will continue to drive a rising frequency in infectious disease outbreaks in new areas, especially zoonotic diseases (those transmitted from animals to humans). According to a study by Bloomberg and a disease data collection company, more than 40 countries or territories have reported at least one infectious disease resurgence that is ten-fold or more over their pre-pandemic baseline. Dengue is surging in several regions, particularly in Latin America. Cases of mosquito-borne diseases in Europe and other non-endemic countries demonstrate that rising temperatures will continue to drive the spread of such diseases globally.
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The recent shift of H5N1 avian flu to mammals – including new human cases transmitted in Australia, Cambodia and the US – highlights the persistent threat of zoonotic pandemics. The WHO in April warned that the outbreak is of “enormous concern”; however, there is no evidence that it is spreading between humans. In the US, there are 12 states with outbreaks, including five human cases, but testing of herds remains mostly voluntary, except for interstate transport.
Critically, the only authorised test for H5N1 for humans in the US is from the US Centres for Disease Control and Prevention (CDC) where testing is contingent on the potential case being symptomatic with a history of contact with another positive case; as a result, only 60 tests have been performed this year. The voluntary requirements and the high testing thresholds indicate that the actual number of animal (and human) infections is likely to be much higher. It further highlights the sustained challenges in disease surveillance, including in compliance and testing capacity, that will likely persist in the coming years.
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Another contributing factor driving pandemic risks is the decline in vaccine uptake since the onset of the COVID-19 pandemic, driven by supply chain disruption in 2020-21 as well as rising anti-vaccination sentiment. A key bellwether of overall vaccination trends is measles – which requires about 95% vaccination coverage for effective disease suppression in a community. About 83% of the world’s children in 2022 received one dose of measles vaccine by their first birthday through routine health services – the lowest percentage since 2008. Furthermore, measles outbreaks in the UK, Europe and the US since 2023 underscore the weaknesses emerging in vaccination compliance. Another holdover of COVID-19 was the pause in the natural spreading of pathogens among people due to social distancing measures. Recently, a spike in streptococcal toxic shock syndrome (STSS) cases in Japan is suspected to be linked to a decline in natural immunity.
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Vaccines: supplies, innovation and countering misinformation
It’s likely governments will increasingly seek to bolster vaccine stockpiles as a stop-gap measure for emerging disease outbreaks. For the avian flu, the US Department of Health and Human Services (HHS) in May agreed to purchase 4.8m doses of a H5N1 avian flu vaccine. The European Commission on 11 June procured 665,000 doses of the same. For dengue, the WHO on 15 May cleared a new vaccine – which was already approved in Indonesia, Thailand, Argentina, Brazil and the EU. Brazil has been one of the worst affected countries for dengue – infections hit a new annual record of 5m by May. The Brazilian government in February announced a mass vaccination campaign.
However, populations without access to effective vaccines are more vulnerable to severe illness, potentially encouraging governments to rely on more stringent non-pharmaceutical interventions (NPIs), such as lockdowns. As the global stockpile for cholera vaccines is almost fully depleted amid the worst global cholera outbreak in two decades, some countries have opted for NPIs, in combination with a limited vaccine rollout. For instance, Zambia since December 2023 has banned street vending and public gatherings in parts of the country.
Global vaccine production will likely remain broadly concentrated in a limited number of regions, mainly Europe, North America and India, sustaining a vulnerability to supply chain disruption in the coming year at least. Purchasing power as well as concentrated supply chains will perpetuate vaccine inequity between higher- and lower-income countries. That said, there have been some modest developments in diversifying vaccine supply chains since 2020. German company BioNTech in December 2023 said that it planned to start production in its new Rwanda facility in 2025. The WHO and South Korea in 2023 signed a deal to make South Korea a global training hub to help low- and middle-income countries produce vaccines and other medicines. Advances in AI will likely facilitate timely and efficient vaccine development in the coming years.
Anti-vaccination sentiment will likely re-emerge as a barrier to robust and smooth vaccine rollouts in future pandemics. The proliferation of conspiracy theories during the COVID-19 pandemic prompted a significant backlash among members of the public, and in some cases politicians, that has ultimately damaged trust in healthcare and vaccines. Anti-vaccine sentiment has remained in the broader political discourse – albeit not as prominently as in 2020-22. In the US, both former president Donald Trump and independent presidential candidate Robert F Kennedy Jr have sustained their vaccine scepticism during the US presidential election campaign. Anti-vaccine activists also continue to target healthcare facilities, though at lower levels than during COVID-19. In New South Wales (Australia), anti-vaccine protesters confronted pharmacists in January.
Business response
A fractured approach nationally, regionally and globally to pandemic controls, containment and surveillance will probably persist in the coming year at least. These fragmented approaches, vaccine inequality and climate impacts will likely increase the threat of future pandemics and the intensity of related operational disruption.
Companies should consider ways to mitigate disruption and increase resilience to disease outbreaks. These may include detailed supply chain reviews to understand criticalities and single points of failure. For instance, it will be critical for companies to assess the geographic spread to anticipate the likelihood of endemic disease flare-ups (such as dengue) that may prompt business disruption and/or new healthcare requirements.
Companies should also review the response of employee stakeholders and the general labour market to disease outbreaks, including around areas such as health benefits and travel policies. Healthcare capacity and access for workers in the event of a fast-moving health crisis will need to be considered.
Finally, companies should consider using a future pandemic scenario to stress test crisis management systems and review changes put in place since 2020.