Future perspectives: preventing the next pandemic

Pandemics have claimed the lives of millions of people throughout history. Over the last millennium, different respiratory pathogens have caused several global pandemics. The Black Death that killed ∼50 million European people, the Columbian Exchange with an estimated 48 million people dead, the Spanish influenza, which had an estimated death toll of 50–100 million, and COVID-19, which killed 7 million people, are foremost examples. Far from being past threats, future pandemics by emerging or re-emerging pathogens are expected. Factors such as increasing global trade and international travel, climate change, loss of biodiversity, the excessive use of antibiotics, exposure to animal, social and economic problems, and mounting health inequalities are the backbone of pathogen spillover and rapid zoonotic dissemination associated with a high latent pandemic potential against which we should prepare at both national and global levels. The SARS, Ebola, MERS, H1N1 and COVID-19 outbreaks, among other recent viral outbreaks, have directed global organisations such as the WHO to lead new programmes on preparedness in the face of new pandemics. In this chapter, we discuss the foundations of pandemic prevention and preparedness, from local easily applicable measures to global intersectoral strategies.