To reduce the risk of global pandemics, we also need better inclusion of one health in impact assessment.

Reuters has worked over the last few years on a significant research about conditions that help viruses jump from bats to humans, and potentially generating the next Pandemic. The “human-animal-ecosystem interface” is at the center of new disease emergence, and the Reuters' case studies describe quite well the risk factors leading to spillover. Human activities linked to land use change, such as intensified farming practices, natural resource extraction, and environmental degradation including climate change, deforestation, and habitat fragmentation. Industrial and agricultural development that do not adequately assess how their activities alter the natural and human environment, increase the risk of spillover and further disease spreading.

The emergence of pathogens is closely linked to geographic “hot spots” as shown very clearly in the different case studies. Reuters found more than 9 million sq km, areas dubbed “jump zones,” where conditions were most suitable for viruses to jump from bats to humans. They are mostly tropical areas rich in bats and undergoing rapid urbanization. Nearly 1.8 billion people, one-fifth of humanity, lived in these jump zones in 2020; the population density in jump zones soared by nearly 40% from 2002 to 2020. Emergence of a pathogenic virus with pandemic potential, as shown in the examples, result from complex, dynamic systems in which biological, social, ecological, and technological processes interconnect. Most of the changes and pathways leading to the emergence and the spread of pathogens are not under control of the health or veterinary sectors. For example, one of the cases studies describes the construction of a new rail link between China and Laos crossing an area of agricultural importance with intense rubber cultivation, but also a popular tourist attraction. The investment also considers the building a?gateway city. The health and veterinary sectors are hardly involved in the planning of these investments. They will eventually deal with the consequences of failed prevention and protection and will attempt to implement response programs at national level although the spread will move from local, to regional, to global.

The COVID-19 pandemic made clear that no single government or institution or sector can address the threat of future pandemics alone. Countries of the World Health Organization (WHO) have finally agreed to negotiate a global accord on pandemic prevention, preparedness and response and ideally should be presenting a draft accord for approval by the World Health Assembly in May 2024. At the same time governments are discussing more than 300 amendments to the International Health Regulations (2005) (IHR) to strengthen those regulations, make the world safer from communicable diseases, and hopefully improve equity in the global response to public health emergencies. These negotiations are lengthy and complex, but respect for human rights and equity should be at the core of the accord to ensure collective action to fight pandemics.

Reuters’ authors have talked with many researchers and specialists during their research, and agreed that at least four measures are crucial to avoiding a sure next Pandemic:

·????????Governments must identify and acknowledge the risks associated with areas densely populated by bats and cooperate to ensure countries, rich or poor, can respond to disease outbreaks around them.

·????????More money: The World Bank and others estimate $10 billion a year is needed to help developing nations cut risk and pounce on outbreaks.

·????????Authorities must create ways to mandate health risk assessments before allowing projects that disrupt bat habitats.

·????????Scientists must continue working to understand bats, the ecosystems around them and how bats behave when people encroach on their territory.

These recommendations and conclusions are valid for bats, as well as for many other species involved in the spreading of pathogens.?It is estimated that, globally, about 2.5 billion cases of human illness and 2.7 million human deaths worldwide occur every year from zoonoses. An estimated 60% of known infectious diseases and up to 75% of new or emerging infectious diseases (EID) are zoonotic in origin. Over 30 new human pathogens have been detected in the last three decades and indeed we have plenty of data demonstrating that EID events are increasing in terms of frequency and impact. Globalization has resulted in the unmatched movement of people, animals and goods across national borders, which in turn has fueled the international spread of zoonotic infections and the simulation presented in the Brazil case study is very telling about the rapidity of the spread. Many of the zoonoses are trans-boundary diseases, they spread across borders from their origin, which is often located in remote geographical areas with poor capacity for animal and human surveillance. As we have been reminded by Dr Tedros Adhanom Ghebreyesus, WHO Director-General “No one is safe, until we are all safe”. Albeit, the concept of collective health security against infectious diseases is not new, as infectious diseases have shaped civilization over time, the solutions proposed by Reuters make clear the measures need diverse levels of geographical focus and the establishment of partnerships across sectors and disciplines. Early detection in animals and in identified geographical hotspots, means better surveillance and prevention of pandemics, but it does require availability of trained staff and laboratories, collaboration across human and veterinary disciplines (among others) to jointly investigate alerts, and improved communication across diverse regions to organize response. Collaborations among multiple stakeholders to manage EID risks already exist, but they are often reactive, localized, and short term. What is required is to move upstream the management of spillover and really invest in risk assessment and strategic design of infrastructure and industrial development.

The One Health approach to prevent, detect, and respond to public health threats is one of those put forward to address this risk. Others approaches and frameworks exist, crucial today is to adopt an integrated process that aims to sustainably balance and optimize the health of people, animals and ecosystems. Considering that several hotspots or “jump zones” are located in area experiencing fast development and poor surveillance capacity, beside the four measures indicated above, additional key measures must be implemented urgently:

???????Projects should undergo a One Health Impact Assessment. Currently, the mandated health considerations in Environmental Impact Assessments are very limited in scope and do not cover this risk. The adequate management of risks start at project design with a comprehensive impact assessment that identifies the eventual drivers of spillover, or the conditions for the spreading of the disease, as well as the most vulnerable populations. This means estimating the epidemiological risk, and propose mitigation, surveillance, prevention, and control measures in the area of influence of the project.

???????The financial industry and Multilateral Development Banks assess and manage environmental and social risks when financing Projects, see for example the Equator Principles or IFC Performance Standards. These frameworks should better address the risk of EID and ensure that a comprehensive one health impact assessment is conducted.

???????If the risk of spillover or spread is identified in the impact assessment, then its management should be multi sectorial and participative. Governments, Private companies, lending institutions must work in synergy. This means mitigation, surveillance, prevention, and control measures in the area of influence of the project should be shared among all partners, based on the respective competences and added value.

Thanks to Helen Reid ?and Reuters team for a great research, amazing case studies, and endless exchanges on possible measures and solutions.?The opinions in the article are personal.

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