There’s Still Time to Avoid the Next Global Pandemic

Public health under pressure. Ahead healthcare systems around the world, funding is shrinking, exhausted professionals are leaving the field and US state legislatures they withdraw the necessary legal authorities. At the same time, outbreaks of diseases such as measles and dengue are on the rise, adding even more urgency and responsibility to this work. In 2025, these pressures will begin a transformation in epidemiology, prompting the field to adopt innovations to become more efficient and effective in controlling outbreaks.

The Covid-19 pandemic history has been unusually challenging for the public health workforce responding to pandemics. The protracted crisis has revealed numerous gaps in a labor force under great strain.

Unfortunately, the pandemic will not be the first or last public health threat to overwhelm our defenses. Historically, major infectious disease threats emerge on average every two years. and now bird flu A(H5N1) has been expanding its geographic footprint and host species for years. According to some estimates, the world is now closer to a flu pandemic than at any time in recent memory.

Public health has no choice but to adapt to these pressures. Although new technologies such as mRNA vaccine platforms and home testing expand our arsenal against epidemics, we cannot rely solely on these biomedical countermeasures.

The most important untapped source of innovation is in public health practice itself. The most promising development arising from these challenges is the adoption of high reliability principles as the new operating standard. These principles come from industries that exhibit zero tolerance for accidents and errors, such as space exploration and commercial aviation.

Public health, particularly epidemiology, is beginning to move away from bespoke approaches to epidemic response versus the structured processes typical of high-reliability industries. A commitment to continuous improvement, data- and metric-based monitoring of performance, and implementation of standardized operating procedures are hallmarks of high reliability. These practices enable organizations to maintain security and efficiency even in complex and high-risk environments.

Although we are in the early days of this transformation, the pressures of the past five years will accelerate the adoption of high reliability in the year ahead. Some early successes are already evident. For example, a program at the CDC is responsible for responding outbreak of foodborne diseases has achieved important achievements. They have aggressively pursued whole-genome sequencing to identify the sources of outbreaks and developed a set of model best practices to support state and local officials in their investigations. This transformation has led to an increase in successful investigations, meaning that the sources of outbreaks are now more likely to be definitively identified. In contrast, before these changes, the origins of many epidemics remained unresolved.

Epidemiology is at a critical point. Faced with dwindling resources, depleted workforces and a growing epidemic of disease, the field is being driven to innovate. Adopting high reliability principles from industries where failure is not an option is emerging as a promising solution. As with foodborne disease research, this change is already paying off. By adopting structured and continuously improving processes and advanced technologies, public health will improve its ability to identify and control disease outbreaks. This transformation promises a more efficient and effective approach to protecting public health in the face of evolving threats.