Gaps in health security related to wildlife and environment affecting pandemic prevention and preparedness, 2007–2020

Part 1.
Introduction

Improved health security is crucial for global and national
health systems to counter infectious disease epidemics and
their wide-scale socioeconomic consequences. The importance
of a One Health multisectoral and collaborative approach – one
that recognizes the connection between the health of humans,
animals and ecosystems – has been acknowledged for years fol-
lowing introduction of the term in the early 2000s.1
Although
significant advancements in multisectoral coordination have
been made over the past decade, the overwhelming focus has
been on human and domestic animal health; scant attention
has been paid to the risks and impacts of zoonotic diseases at
wildlife–human or wildlife–livestock interfaces, or to the role
of changing environmental conditions.2,3
The consequences
of this neglect have been costly and deadly with thousands of
known zoonotic disease outbreaks in recent decades linked
to wildlife, for example: human immunodeficiency virus and
acquired immunodeficiency syndrome, Lassa fever, Ebola
virus disease, highly pathogenic avian influenzas, Nipah virus
disease, severe acute respiratory syndrome and coronavirus
disease 2019 (COVID-19).4–6
The exclusion of wildlife and environmental issues from
global health policies is especially concerning as growing
pressures on biodiversity and ecosystems facilitate new or
increasing exposure to wildlife, and high mobility through
trade and travel enables the rapid spread of pathogens.6–8
A
recent analysis based on global change trajectories projected
an increase by up to threefold of Ebola virus spillover events
and epidemics by 2070.9
With an estimated million-plus
mammalian viruses still undiscovered, overlooking wildlife
health leaves a critical void in health security efforts and a
global vulnerability to accidental and intentional sources of
biothreats.10,11
Country-level mandates for environmental health are
often split across multiple government agencies, with a
high potential for fragmentation and gaps, and national
funding directed to wildlife health is extremely limited or
non-existent.3,12 A review of 18 national action plans on
antimicrobial resistance documented the limited integration
of environmental considerations, noting that an incomplete
application of the One Health approach may miss a key
driver and hinder effective control strategies.13 This omission
for antimicrobial resistance reflects what is perceived as a
larger systematic under-representation of the environment
sector in health security as a source of unaddressed risks and
potential solutions.
National One Health coordination platforms may offer
mechanisms to address persistent capacity and implementa-
tion needs from all relevant sectors. Doing so will require
practical, targeted entry points to integrate environmental
expertise and other resources to monitor and manage
pathogen spillover risks.14 We review relevant national-level
assessments and action plans to determine areas of cover-
age and gaps, and to identify opportunities to integrate the
environment sector into global and national health security
efforts. We also offer practical recommendations for global
and national action to enhance the surveillance of emerg-
ing diseases and to improve pandemic prevention and
preparedness.