How to escape the ‘era of pandemics’

Future pandemics will emerge more often, spread more rapidly, kill more people than Covid-19, and affect the global economy with more of a devastating impact than ever before.

This is the stark warning contained in a major new report on biodiversity and pandemics that calls for a transformative change in how the world deals with infectious diseases “to escape the era of pandemics”. 

Convened by the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (Ipbes) for an urgent virtual workshop about the links between degradation of nature and increasing pandemic risks, the 22 leading global experts behind the report say a “seismic shift” in the approach from reaction to prevention is needed.

The risk of pandemics is increasing rapidly, with more than five new diseases emerging in people every year, “any one of which has the potential to spread and become pandemic”.  

There are an estimated 1.7-million “undiscovered” viruses thought to exist in mammal and avian hosts. Of these, 540 000 to 850 000 could have the ability to infect humans. 

“Covid-19 is at least the sixth global health pandemic since the great influenza pandemic of 1918, and although it has its origins in microbes carried by animals, like all pandemics its emergence has been entirely driven by human activities,” says the report. 

The causes are global environmental changes — the same factors that are responsible for biodiversity loss and climate change. 

These include, among others, changes in land use, entailing deforestation, human settlement in primarily wildlife habitat, urbanisation, as well as the growth of crop and livestock production and agricultural expansion and intensification.

“These drivers of change bring wildlife, livestock, and people into closer contact, allowing animal microbes to move into people and lead to infections, sometimes outbreaks, and, more rarely, into true pandemics that spread through road networks, urban centres and global travel and trade routes.”

In a statement, Dr Peter Daszak, president of the EcoHealth Alliance and chair of the Ipbes workshop says there is no great mystery about the cause of the Covid-19 pandemic — or of any modern pandemic.

“The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment.”

Greater conservation of protected areas and measures that reduce unsustainable exploitation of high biodiversity regions will reduce wildlife-livestock-human contact and help prevent the spillover of new diseases, according to the report.

“Given the timing, this is an extremely important report that will hopefully land with some impact with policymakers,” says Christopher Trisos, senior researcher, at the African Climate and Development Initiative at the University of Cape Town.

“The Covid-19 pandemic illustrates the massive importance of having a healthy climate, a healthy environment and healthy people and how those three things are intimately interlinked.”

This is a clear message for South Africa, Trisos says. 

“It emphasises that nature-based approaches to sustainable development have massive co-benefits for health and livelihoods. For example, it’s showing that things like climate change adaptation in the water sector in South Africa is also health adaptation and pandemic preparedness. If people need to do things like wash their hands to stay safe then you need reliable water supply and with climate change projected to reduce rainfall in the south-west of the country, you need to be acting on climate change to be sure you’re prepared for pandemics.”

The approach to prevent pandemics, says the report, has effectively stagnated. 

“We still rely on attempts to contain and control diseases after they emerge, through vaccines and therapeutics. However, Covid-19 demonstrates that this is a slow and uncertain path, and as the global population waits for vaccines to become available, the human costs are mounting, in lives lost, sickness endured, economic collapse, and lost livelihoods.”

James Irlam, the chairperson of the climate, energy and health special interest group at the Public Health Association of SA, says the report is “timely and powerful.

“These common causes suggest several shared solutions towards greater climate justice and health equity, which are especially important in South Africa as one of the most unequal and carbon-intensive economies in the world,” he says. 

“The costs of reducing risks to prevent pandemics are estimated to be 100 times less than the cost of responding to such pandemics, which run into trillions of dollars, providing strong economic incentives for transformative change.”

Climate change, too, will likely cause substantial future pandemic risk by driving movement of people, wildlife, reservoirs, and vectors, spreading their pathogens, “in ways that lead to new contact among species, increased contact among species, or otherwise disrupts natural host-pathogen dynamics”.

“Given the timing, this is an extremely important report that hopefully really lands with impact with policymakers,” says Christopher Trisos, senior researcher, at the African Climate & Development Initiative at the University of Cape Town (UCT).  “The Covid-19 pandemic illustrates the massive importance of having a healthy climate, a healthy environment and healthy people and how those three things are intimately interlinked.”

This is a clear message for South Africa, Trisos says. “It emphasises that nature-based approaches to sustainable development have massive co-benefits for health and livelihoods. For example, it’s showing that things like climate change adaptation in the water sector in South Africa is also health adaptation and pandemic preparedness because if people need to do things like wash their hands to stay safe then you need reliable water supply and with climate change projected to reduce rainfall in the south-west of South Africa, you need to be acting on climate change to ensure you’re prepared for pandemics.” 

He cites how in the context of Cape Town, the most biodiversity-friendly and cost-effective way to increase water yields is to cut alien vegetation out of river catchments. “That helps protect biodiversity and helps adapt to climate change and also ensures that people can wash their hands because we’ll probably have a better water supply in contrast to sinking that money in trying to build new heavy concrete infrastructure that emits a lot of CO2. At the national scale a rapid transition to renewable energy that reduces the chance species migrate around the landscape and share novel viruses is something that much better than doubling down coal.”

The report’s findings are significant and timely, says Dr Luthando Dziba, the managing executive of conservation services at SANParks, who was a participant of the IPBES workshop. 

“From a South African perspective, it’s important because we are one of the mega-biodiverse countries in the world, and still home to a very large diversity of mammals and birds, in particular. There’s a very strong link between a number of the pandemics in the past and those projected to arise in the future to mammals and birds … 

“We do have situations that may pose a risk especially as populations in communities around protected areas grow, which is where a significant number of our wildlife is. As the contact between wildlife and domestic animals increases, then you have risks of transfer of pathogens from wild to domestic animals – and then to humans.” 

The report recommends taxes or levies on meat consumption and stresses responsible meat consumption. 

“The view generally in the conservation sector is that it is not absolutely only plant-based diets that will lead to improved food security and nutrition, but that we need to consider significant reductions in meat consumption because as populations become more affluent they tend to add more meat protein in their diet and this usually drives the increase in land-use change to produce fodder for animals to feed humans,” he explains.

James Irlam, the chairperson of the climate, energy and health special interest group at the Public Health Association of SA says the report is “powerful and timely.

“These common causes suggest several shared solutions towards greater climate justice and health equity, which are especially important in South Africa as one of the most unequal and carbon-intensive economies in the world.” 

Some of the solutions supported by the progressive public health community include sustainable agriculture to minimise land-use change and improve nutritional status; clean renewable energy and transportation to reduce pollution and climate-changing emissions; sustainable pandemic-ready healthcare with a smaller environmental footprint; and educating healthcare students and workers to protect public health from climate change and pandemics.

“These measures are in line with the WHO’s urgent prescriptions for a healthy recovery from Covid-19 that include a rapid healthy energy transition; promoting sustainable food systems; making cities more liveable; and ending tax subsidies for fossil fuels.”

Access the full report here. 

Policies to help reduce and address risk

• Countries setting mutually agreed goals or targets within the framework of an international accord or agreement — with clear benefits for people, animals and ecosystems.

• Institutionalising the “one health” approach in governments to build pandemic preparedness, enhance pandemic prevention programmes, and to investigate and control outbreaks across sectors.

• Developing and incorporating pandemic and emerging disease risk health impact assessments for land use so that benefits and risks to biodiversity and health are recognised.

• Ensuring that the economic cost of pandemics is factored into consumption, production, and government policies and budgets.

• Enabling changes to reduce the types of consumption, globalised agricultural expansion and trade that have led to pandemics — this could include taxes or levies on meat consumption, livestock production and other forms of high pandemic-risk activities.

• Reducing zoonotic disease risks in the international wildlife trade through a new intergovernmental “health and trade” partnership; reducing or removing high disease-risk species in the wildlife trade; enhancing law enforcement in all aspects of the illegal wildlife trade and improving community education in disease hotspots about the health risks of wildlife trade.