The Emergence of Infectious Diseases Threatening Humanity in the 21st Cent
In recent years, the world has been facing the threat of various emerging infectious diseases, including COVID-19. Emerging infectious diseases are newly occurring or mutated infections that are difficult to prevent and treat, and often have a high mortality rate. These diseases can easily spread in modern societies with high population density and mobility, and have serious impacts not only on health but also on the economy and society. So how can we prepare for and respond to emerging and existing infectious diseases? To do this, we need to first identify priority infectious diseases, check the current state of research and development, and strengthen humanity's efforts to prevent the next pandemic.
What are some priority infectious diseases? Since 2015, the World Health Organization (WHO) has been announcing a list of priority infectious diseases every year. The list is selected through expert evaluation and public debate and includes infectious diseases that currently have no or insufficient vaccines or treatments, are important for public health, and require global responses.
The latest list, released in March 2022, includes COVID-19, as well as Ebola, MERS, Crimean-Congo hemorrhagic fever (CCHF), Nipah virus, Rift Valley fever (RVF), and Zika virus, among others. Additionally, priority viruses that require further research include Coronaviridae (e.g., SARS, MERS), Orthomyxoviridae (e.g., influenza viruses), Flaviviridae (e.g., West Nile, Dengue), Paramyxoviridae (e.g., Nipah, RSV), Picornaviridae (e.g., Enterovirus D68), and Togaviridae (e.g., Chikungunya).
Managing Epidemics, key facts about major deadly diseases, WHO, 2018
Research and development to prevent the spread of infectious diseases
What is the current status of research and development to prevent the spread of infectious diseases? During the COVID-19 pandemic, research and development of vaccines, treatments, and diagnostic kits were actively pursued worldwide. The WHO announced research and development topics for ending the COVID-19 pandemic and preparing for the next pandemic in three phases. The most urgent and important among them was the development and administration of COVID-19 vaccines. Currently, over 10 types of COVID-19 vaccines have been approved and used worldwide, and around 30 billion doses of vaccine have been produced (The number of doses are increasing). Through these efforts, we are now moving towards the post-pandemic era and developing international strategies for dealing with the next infectious disease.
Managing Epidemics, key facts about major deadly diseases, WHO, 2018
Research and development of vaccines, treatments, and diagnostic kits for other priority infectious diseases are also underway. For example, two vaccines and three treatments for Ebola virus have been approved and used since 2019, and there are currently vaccines and treatments in clinical trials for MERS virus. Vaccine and treatment development is also underway for Nipah virus and Rift Valley fever virus. However, these infectious diseases may receive less investment and attention for research and development than COVID-19 due to their lower frequency of occurrence and spread rate.
The acceleration and advancement of systems for preventing pandemics
How should humanity make efforts to prevent the next pandemic? COVID-19 has shown us that global cooperation, sharing, and preparedness are essential in preparing for novel infectious diseases. Global cooperation means quickly and accurately identifying the occurrence and spread of infectious diseases and taking joint measures to respond. For example, WHO plays a role in sharing infectious disease information, declaring emergencies, providing guidelines, and providing technical support. Additionally, governments and institutions in each country should support and cooperate with each other in terms of resources and personnel for responding to infectious diseases.
Nationally, it is necessary to predict the possibility and risk of infectious diseases in advance and establish and maintain infrastructure, systems, and personnel for responding to infectious diseases. For example, Korea is preparing mid- to long-term measures to prepare for the next pandemic after COVID-19. These measures aim to quickly block the occurrence and spread of infectious diseases, minimize damage from infectious diseases, and prevent the recurrence of infectious diseases. To achieve this, they propose specific measures such as infectious disease monitoring and prediction systems, strengthening infectious disease response capacity, and supporting infectious disease research and development.
Anticipating Emerging Infectious Disease Epidemics, WHO, 2015
It emphasizes the need to study and understand the characteristics of animal and human health in advance since 70% of emerging infectious diseases are zoonotic diseases. Zoonotic diseases are infectious diseases caused by pathogens transmitted between animals and humans, such as Ebola, Salmonella, avian influenza, and swine influenza. These zoonotic diseases can be affected by animal health and environmental changes and can cause health and socio-economic damage to humans.
Therefore, a 'One Health' approach is needed to prevent and respond to zoonotic diseases, which is an integrated management and cooperation of animal and human health. Research on the epidemiological characteristics and prevalence of free-living animals or domestic animals that determine interspecies transmission is an essential factor in identifying the causes of zoonotic diseases.
The emergence of new pathogens and the need for information sharing and early containment
When a new pathogen emerges, research on its incubation period, distribution, natural history, and mode of transmission is essential, and the development of quantitative and precise analytical techniques is required. In particular, point-of-care testing (POCT) systems can receive high evaluations in terms of speed and practicality, and can achieve continuous growth in this regard.
Regarding infectious diseases, genome sequencing has played a central role in sharing genetic information on COVID-19 through GISAID. Through this, the rapid detection and public release of viral mutations have been useful in pairing with antibodies and antigens for use in point-of-care testing systems, thereby preventing massive damage at an early stage.
To prevent future pandemics, we must deeply understand the causes and characteristics of infectious diseases and actively support research and development of technologies for infectious disease responses. We must adopt an attitude of anticipating, preparing for, and responding to the possibility and risk of disease outbreaks. By doing so, humanity can overcome the next pandemic without succumbing to it.
Reference
WHO. COVID-19 Research and Innovation. Powering the world's pandemic reponse - now and in the future. 25 February 2022.
WHO. Prioritizing diseases for research and development in emergency contexts, 2023.
Korea Centers for Disease Control and Prevention (KCDC). Control of Communicable Diseases, 2019.
WHO. Managing epidemics, 2018
WHO. Anticipating Emerging Infectious Disease Epidemics, 2015
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