Monkeypox - a warning and what Bill Gates needs to know NIGEL SIZER PhD

WHAT Bill Gates says matters. He is deeply influential on public health issues and his new book and TED talk have a lot to say about how to prevent future pandemics.

Monkeypox: Dr Chris outlines the main symptoms

His upbeat vision is that new technology can prevent pandemics by more quickly detecting as well as developing vaccines and treatments for new diseases. He is calling on governments to spend billions of dollars annually to achieve this laudable goal. But he can’t see the forest for the trees.

The other half of the solution is that to prevent future pandemics from happening in the first place, we need to reduce the risk of new diseases emerging.

This far more cost-effective course of action is to be found in understanding the relationship between people and nature–over the next few decades, there could be more than 4,000 moments when viruses cross over from other species to infect humans.

All seven major pandemics, back to the Spanish Flu of 1918, were caused by viruses that spread quietly and unnoticed in wildlife until they spilled over into humans.  

Some, like HIV/AIDS, SARS and probably COVID-19, likely moved directly from wildlife to humans because of human consumption and trafficking of animals.  

Others, especially the flus, first infected our livestock, such as chicken or pigs, where they multiplied, evolved, and then from there made their way to us.  

Monkeypox, in the headlines this week, also originates in wildlife and is endemic across Central and West Africa in wild rodents, squirrels and other mammals.

The good news is that scientists know what we need to do to reduce the risk of spillover, and economists have conducted cost-benefit analyses to verify its effectiveness.  

From wildlife to humans... Monkeypox cases are rising

From wildlife to humans... Monkeypox cases are rising (Image: GETTY)

Pandemic prevention... scientists know what we need to do to reduce the risk of spillover

Pandemic prevention... scientists know what we need to do to reduce the risk of spillover (Image: GETTY)

True pandemic prevention comes down to reducing the opportunities for novel viruses to spread from wildlife into humans.

This in turn means stopping the clearing of tropical forests, curbing the commercial trade and consumption of wildlife (especially of species that are high risk as potential sources of spillover), and improving the healthcare provided to people and domesticated animals, particularly in rural communities.  

Better surveillance to detect spillover quickly, and making animal agriculture safer from wildlife contact and spread of viruses when infections occur, would complete the package of public health interventions needed.  

The annual global cost of properly implementing these measures is only about $20 billion, or less than one percent of spending to date by the United States alone to respond to COVID-19.

The bad news is that governments are balking at this cost.  

Worse, influential voices like Bill Gates and other top global funders and influencers in public health refuse to support a more holistic approach and question the science and practicality of true upstream prevention.  

Or they simply suggest that the much-needed actions that lead to spillover prevention should be left to environmental funders and agencies, utterly ignoring the public health benefits.

It is imperative that all governments reduce the risk of spillover of novel viruses.  Wealthier governments, starting with the United States, Europe and Japan, need to finance global efforts to protect tropical forests and wildlife, combat the live animal trade, and strictly regulate and monitor trade in exotic animals for pets and consumption.  

Many of these governments have already committed to doing so in numerous international treaties and United Nations conventions but much more is needed.

All governments should strengthen regulations governing animal husbandry and work on improving domesticated animal health and wellbeing, as well as ensure farmers are trained in reducing contact between livestock and wildlife.  

Governments and businesses must do much more to respect and defend the fundamental rights of Indigenous Peoples to manage and protect the lands and forests they depend upon and have stewarded for countless generations.

These actions come with no regrets.  

They are all things that governments would be wise to do even without regard for pandemic risk – better protecting wildlife and tropical forests, improved animal welfare and strengthening health services for people in rural areas, all make good sense, helping to avert other crises in climate change and biodiversity loss.

Each national government can take steps to implement these measures, they do not need to wait for others to act internationally.  

Wealthier governments can help poorer regions to implement these steps – thereby helping protect everyone from emerging disease risk.

And venues like the Group of 20 major economies (G20) have ongoing processes that enable coordinated funding efforts, reporting and accountability for progress.

If such steps are not taken, then governments will have failed to heed the science and we may well face future pandemics disrupting all our lives again before this decade is over.  

We urge Bill Gates, his foundation, and other influential philanthropists and leaders to see the bigger picture in the need for more comprehensive efforts to reduce the risk of future pandemics.  

Yes, we need more and better vaccines and treatments. And we also urgently need to do a much better job in stewarding nature.

We must bridge the gulf and escape from the siloed thinking that has kept public health, animal and ecological health apart.  

  • Dr. Nigel Sizer is a tropical forest ecologist and Executive Director of Preventing Pandemics at the Source, a coalition of leading health, health rights, and environmental organizations. He is a former adjunct professor of public policy at the City University of New York.
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