A Risk Management Approach to Global Pandemics of Infectious Disease and Anti-Microbial Resistance

Area of Science:

• Global Health Security
• Infectious Disease Epidemiology
• Public Health Interventions

Background:

• Pandemics and antimicrobial resistance (AMR) are significant global threats, exacerbated by conflict and climate change.
• The dominant biomedical model and a singular focus on vaccines are insufficient for comprehensive disease control.
• The One Health approach, while valuable, often overlooks essential public health measures and the impact of armed conflict.

Purpose of the Study:

• To critically examine the limitations of the current biomedical paradigm in addressing global health threats.
• To highlight the historical and ongoing importance of non-vaccine public health interventions, such as water chlorination.
• To analyze the impact of armed conflict on infectious disease outbreaks and the challenges for global health organizations.

Main Methods:

• Analysis of historical public health successes (e.g., cholera control with chlorine).
• Case studies of polio, mpox, and drug-resistant tuberculosis, particularly in conflict zones.
• Examination of World Health Organization (WHO) strategies and their limitations regarding AMR and vaccine-derived diseases.

Main Results:

• Traditional public health measures like sanitation and chlorination were highly effective before widespread vaccination.
• The current reliance on antibiotics and a biomedical, vaccination-centric approach contributes to AMR and vaccine-derived polio.
• Attacks on healthcare in conflict zones, including state-sponsored actions, significantly drive disease outbreaks and complicate interventions.

Conclusions:

• A paradigm shift is needed, integrating a broader spectrum of public health interventions with vaccination strategies.
• Increased investment in water chlorination and sanitation is essential for strengthening global health security and reducing disease burdens.
• Tailored, context-specific responses are required to address diverse threats, including those arising from armed conflict and attacks on healthcare.