Mpox outbreak: How to prevent the next pandemic

The question remains: How many more emergencies does the world need before we finally invest in solutions we know work — health systems that can handle both everyday needs and sudden crises, and provide care for everyone?

Public health emergencies, like outbreaks, are not just onetime events. The world is more at risk now than ever before because of factors like changing environments, social and political issues, and inequities.

But what makes it worse is the world’s failure to solve longstanding problems, such as building strong, resilient health systems that can handle outbreaks, rising burdens of disease, and ongoing battles against diseases like HIV, tuberculosis, and malaria.

Experts say that due to climate change, there is a more than 50 percent chance of another COVID-level pandemic in the next 20 to 25 years. In 2022, a study found 58 percent of infectious diseases are getting worse because of climate change.

As we emerged from COVID, the world seemed poised to embrace investments in health. The Pandemic Fund mobilized billions of dollars in service to preparedness and responsiveness. The economic toll of the pandemic had sent shock waves across political and private sectors as millions died and the global economy was severely disrupted, illustrating the importance of health for strong economies and functioning, safe societies. New paradigms of drug and vaccine manufacturing were being negotiated and inequities seemingly righted in their wake.

Three years later, progress is stalled. Pandemic Accord negotiations are on ice, recent data show the world is losing ground on the Sustainable Development Goals, and there has been limited funding to close the health financing gaps. For example, the latest funding drive for the Global Fund to Fight AIDS, TB, and Malaria fell $2.3 billion short.

The biggest weakness is the world’s piecemeal approach and failure to prioritize strong health systems. What is needed is a well-trained and well-resourced health workforce to provide complete care, resilience, and quick response, no matter the crisis.

It’s time to stop with the empty promises and slow progress. World health leaders must deploy rapid support and flexible funding to countries affected in Africa to stop mpox from spreading further. Training and resourcing health workers in infection, prevention, and control is key and countries must have the resources they need to fight the outbreak.

During the 2022 Ebola outbreak in Uganda, the Ministry of Health was able to quickly shut down the spread by ensuring workers were equipped with necessary knowledge and protective equipment. Additional funding must be made flexible to enable rapid response to changing needs as the outbreak further develops.

There must also be access to vaccines for the populations most vulnerable, without depleting funds for other essential services or at the cost of other critical health protections. Our response is a chance to right the wrongs from COVID.

Nations must strengthen resilient, climate-smart, and pandemic-responsive health systems. All countries are vulnerable to pandemics. Strong health systems founded on a fit-for-purpose, skilled workforce are essential for protecting populations and daily life. To realize them, the international donor community must stop fragmented funding — a little money for vaccines here or funding for a HIV clinic there. Instead, we must support national plans that are focused on universal health coverage and access to services, so we can prevent, treat, and manage all diseases.

Nations must also invest in climate adaptation and resilience for health. Climate change is causing more disease today, not in some distant future. This includes pandemics. An additional 2 billion people will be at risk of deadly dengue — including here in Massachusetts — if temperatures continue to rise. Yet funding for climate response overwhelmingly ignores health and health systems. Only 2 percent of adaptation funding and 0.5 percent of multilateral climate funding is targeted toward health.

Governments, the private sector, and funders need to recognize that health is wealth. They must understand that investing in health is critical to security, economic stability, and our future — not to mention being fair and equitable.

Our actions, political decisions, and investments must shift accordingly. For example, already almost half the US workforce is affected by the health effects of climate change. Leaders must start prioritizing health in terms of public and private expenditure and increase absolute dollars available from governments, multilateral institutions, and the private sector.

We either act now or we keep paying the price. Every death we witness from mpox is a testament of this failure to act and foreshadows the next pandemic as we still recover from the last.

Dr. Vanessa Kerry is cofounder and CEO of Seed Global Health, WHO special envoy for climate change and health, and directs the Global Public Policy and Social Change program at Harvard Medical School.