As the world continues to deal with the devastating effects of COVID-19, the World Bank is releasing a new report that proposes actionable solutions to end the cycle of devastating pandemics. Policymakers, governments, and the international community are urged to invest in pandemic prevention and to move away from the business-as-usual approach based on containment and control after a disease has emerged.

The report states that pandemics are mainly the result of human activity, which is shaping the interactions among humans, animals, and the environment.

Even after experiencing this cycle for recent diseases such as SARS, avian influenza, and Ebola and the enormous health, economic, and societal impacts caused by COVID-19, the report regrets that few leaders recognize the critical importance of pandemic prevention, which means stemming a local outbreak before it becomes a pandemic.

This report articulates an alternative approach that addresses pandemic risk at its source and is grounded in One Health strategies of systems thinking whole-of-society planning, and collaboration across disciplines at the human-animal-ecosystem interfaces as a central path to global health security. It highlights three main entry points to transition to this more effective approach.

First, timing. Now is the opportune time to push for this transition, when the ravages of COVID-19 are still ongoing and there are high-level discussions about designing an international accord on pandemics and a new financing mechanism for pandemic prevention, preparedness, and response.

Second, the report highlights the relatively modest cost of prevention compared to crisis response. Prevention guided by One Health principles is estimated to cost between approximately US$10.3 billion and US$11.5 billion per year. This includes $2.1 billion per year to bring public veterinary services up to international standards, US$5 billion to improve farm biosecurity, and US$3.2-to-$4.4 billion to reduce deforestation in higher risk countries. Prevention costs are less than 1 percent of the cost of responding to COVID-19 pandemic in one single year, 2020. And the fact that prevention done right would de-risk investments in preparedness and reduce the need for subsequent response related costs.

Third, the report emphasizes the many co-benefits of investing in prevention and One Health for sustainable and human development. These include reduction in CO 2 emissions, climate adaptation, improved food safety and nutrition, reduced economic burden from animal diseases,
increased access to markets, and strengthening resilience of health systems by boosting awareness and multisectoral action.

To break the cycle of panic and neglect, the report proposes a One Health Investment Framework for national, regional and global stakeholders to adopt.

A One Health investment framework needs to be adopted and implemented at the country level based on alignment with each country’s prioritized national action plans, risk factors and vulnerabilities for EIDs, and existing resources and programs in areas for which there is overlap with the One Health agenda from public and private sources.

It stresses that, to support countries, there is an important role for technical agencies and financial institutions to coordinate global, regional and local activities by the public sector (for ublic goods such as public health systems, public veterinary systems, ecosystem management and protection, and surveillance data systems), the private sector (for livestock farmers, loggers, forest-based communities, and land developers) and the civil society.

The report concludes that investing in One Health based prevention is the best way forward to break the cycle of panic and neglect—once and for all. If we fail to act now, we will be destined to become like Sisyphus, forever rolling a boulder uphill to manage the response to the next pandemics.