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FEATURE STORYOctober 24, 2022

One Health Approach Can Prevent the Next Pandemic

A boy rides a buffalo through a rice field.

The number of emerging infectious disease (EID) outbreaks has grown to several hundred per year since 2000. Recent diseases such as SARS, avian influenza, Ebola – and the enormous health, economic, and societal impacts of COVID-19 – have not yet solicited global unity on the importance of preventing pandemics rather than responding to outbreaks as they emerge. What will it take for world leaders, countries, organizations, and communities to understand that prevention is better than cure? The World Bank’s latest flagship report, "Putting Pandemics Behind Us: Investing in One Health to Reduce Risks of Emerging Infectious Diseases," is a clarion call for the universal adoption of an integrated approach to sustainably balance and optimize the health of people, animals, and ecosystems.

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Risk Anywhere Is Risk Everywhere 

Human activity is the main driving force behind new, emerging, and re-emerging diseases. Most pathogens that are infectious to humans are zoonotic – in other words, they cross over from animals to people. 

As human societies extend their footprint and encroach on natural habitats, they disturb the ecological equilibrium, which results in the spillover of animal microbes into human populations. Growing demand for animal-sourced foods has increased the number of livestock on farms, creating more opportunities for crossover of pathogens. Every year, these diseases cause more than 1 billion human infections and 1 million deaths.

The pace of EID outbreaks has increased at an average annual rate of 6.7 percent from 1980 and is compounded by the global movement of goods and people, which enables local outbreaks to spread worldwide. Diseases know no boundary; the next pandemic may already be on the horizon.

Confluence of Nature and Neglect

COVID-19 sparked a global health, economic, and societal emergency unlike any other in recent history. It killed more than 6.3 million people as of June 2022, with true mortality being possibly three times higher and numbers continuing to rise. The IMF projected the cumulative output loss from the pandemic through to 2024 to be about $13.8 trillion. 

The business-as-usual approach to pandemics has been based on containment and control after a disease has emerged. Not only is this short-sighted, but it is also costly and reactive. Meanwhile, there is chronic underinvestment in disease prevention in many countries. And while many of the benefits of prevention accrue at the national and global levels, the costs tend to be borne locally for interventions such as reducing forest fragmentation and deforestation, monitoring wildlife health, and enhancing the biosecurity of livestock farms. 

Pandemic Prevention Is the Ultimate Investment for Humanity

Prevention is a global public good that requires an integrated, risk-based approach to prioritize spillover hot spots, ensure compliance with international health standards, and promote country ownership. The good news is that these investments are highly effective: actions to prevent disease outbreaks carry an estimated rate of return of up to 86 percent, and most of these actions will result in significant co-benefits. 

Putting Pandemics Behind Us: Investing in One Health to Reduce Risks of Emerging Infectious Diseases explores the One Health holistic investment framework that will help governments, international organizations, and donors direct financial resources to prevent pandemics. There is no one-size-fits-all solution and successful implementation will require a set of interventions that speaks to the national and local context.

One Health is an integrated approach that supports a wide range of sustainable development objectives with significant co-benefits in areas such as agriculture, food production, and environmental protection. For example, a One Health approach to prevention by reducing deforestation would generate ancillary benefits of $4.3 billion from lower carbon dioxide emissions. 

Diseases know no boundary; the next pandemic may already be on the horizon.

One Health for Our Future

Many activities that drive EIDs (such as the mining and extractive industries) also contribute to the economic output of a country, as measured by its gross domestic product. This makes it difficult to curtail such activities, particularly in high-risk regions that struggle with low growth and socio-economic disparity. 

Successful implementation of One Health will require improved coordination, communication, and collaboration between sectors, reinforced by capacity building. It requires a shift from largely vertical programs focused on specific diseases to those that can strengthen overall systems, including by engaging stakeholders beyond the health sector such as livestock keepers, park rangers, extractive industries, and communities responsible for environmental stewardship. 

The World Bank report comes on the back of growing consensus on the critical importance of One Health and prevention, and increasing momentum at global, regional, and national levels, especially in the wake of COVID-19. 

There is a strong economic case for One Health: the cost of prevention is moderate compared to the cost of managing and responding to pandemics. The World Bank’s global estimate of prevention costs guided by One Health principles ranges from $10.3 billion to $11.5 billion per year, compared to the cost of managing pandemics which, according to the recent estimate by the G20 Joint Finance and Health Taskforce, amounts to about $30.1 billion per year. There has never been a better time to adopt One Health as an investment in humanity’s future. The World Bank will continue to engage client governments, multilateral organizations, and other stakeholders to embed a One Health approach around the world. 


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