Draft of WHO Pandemic Agreement plays down primary prevention

• Published in: The Lancet (British edition) Vol. 403; no. 10426; pp. 525 - 526
• Main Authors: Alders, Robyn, Amuasi, John H, Ashraf, Sania, Becker, Daniel, Bukachi, Salome A, Burza, Sakib, Cleveland, Sarah, El Omrani, Omnia, Erondu, Ngozi A, Ferreira, Juliana Machado, Hassan, Latiffah, Li, Binbin, Lloyd-Smith, James, Loch-Temzelides, Ted, Markotter, Wanda, Ogbuoji, Osondu, Peiris, Malik, Pfeiffer, Dirk, Plowright, Raina K, Popp, Alexander, Redvers, Nicole, Roche, Benjamin, Scanlon, John E, Sizer, Nigel, Vale, Mariana, Vora, Neil M, Walzer, Chris, Worah, Sejal, Mettenleiter, Thomas C, Winkler, Andrea S
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 10.02.2024; Elsevier Limited
• Subjects: Agreements; Animal human relations; Animal welfare; Avian flu; Biodiversity; Biodiversity loss; Bird populations; Climate action; Climate change; Community involvement; Community participation; COVID-19; Deforestation; Disease transmission; Domestic animals; Economics; Environmental monitoring; Environmental protection; Indigenous peoples; Industrialized nations; Livestock; Pandemics; Pathogens; Prevention; Social interactions; Traditions; Urban areas; Urban environments; Wildlife; Wildlife management
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(24)00066-7

The draft text includes language to promote a holistic One Health approach,2 which should be expanded to highlight the importance of primary prevention as emphasised by the Quadripartite's One Health High-Level Expert Panel.3 One Health recognises the inextricable interconnections between human, animal, and ecological health, and the need to address the drivers of pathogen spillover.4 Factors thought to increase spillover risk include livestock management practices associated with particular production systems; certain illegal, regulated, and unregulated wild animal trade; wild animal consumption in urban and non-urban settings (while stressing the importance of respecting traditional and Indigenous Peoples’ traditions and rights); climate change; and loss of natural ecosystems and biodiversity (mainly deforestation).5,6 Effective implementation of a One Health approach requires adequate resourcing, particularly from high-income countries. Compared with the cost of containment and response following an outbreak, the relatively small annual investments needed for spillover prevention could reduce loss of life and economic disruptions caused by a potential future pandemic.5 Such actions include financing workforce and preventive action capacity for domestic animal and wildlife health, community engagement, monitoring, environmental protection, and enhanced research and innovation on primary prevention that target the core drivers of these emergencies. [...]highly pathogenic avian influenza H5N1 virus, which has devastated poultry industries and global wild bird populations and currently threatens numerous mammalian species, could accrue traits enabling sustained spread in humans, with high levels of mortality and social and economic disruption.7 The measures needed to reduce these threats also come with important co-benefits such as helping to address climate change, biodiversity loss, equity, and animal welfare.