With the emergence of COVID-19 and the recent surge in monkeypox cases, scientists and doctors who specialize in infectious disease are issuing increasingly dire warnings, saying wealthy countries can no longer afford to ignore small outbreaks abroad.
For decades, diseases that primarily affected lower and lower-middle income countries were relegated as “neglected” diseases, having less funding, fewer resources and little attention. Monkeypox, for example, has been smoldering quietly in Western Africa since 2017. Now, scientists are increasingly warning that global infectious disease outbreaks could become the new normal.
“I think it’s very clear that we’re living in a new age of pandemics,” said Dr. Jay Varma, a professor of population health sciences at Weill Cornell Medicine.
“We’ve been dealing with infectious diseases since we appeared on this planet,” said Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security. Although the advent of antibiotics, vaccines and basic sanitation measures have helped control infectious diseases, the acceleration of international travel in recent decades has unleashed viruses that may have otherwise been contained in one region.
“What’s occurring in one geographic area may not remain in that geographic area [because] a pathogen can travel by the speed of a jetliner,” says Adalja.
Experts say people tend to focus on problems closer to home, and tend to be unaware of diseases spreading beyond their borders.
“There’s sort of this false sense of security, that when something is spreading somewhere where you don’t live and don’t know anyone, it’s easy to think that it will just sort of continue that way,” says Stephen Kissler, Ph.D., a research fellow at the Harvard Department of Immunology and Infectious Diseases.
Oftentimes, officials work to limit travel to slow the spread of disease, as occurred globally during the COVID-19 pandemic or the Zika outbreak in the United States. But that strategy rarely halts the transmission of a virus.
“One of the important lessons of public health is that diseases don’t respect administrative borders and they certainly don’t carry passports or request visas,” said Varma.
Historically, less funding has existed to study viruses that primarily thrived outside U.S. borders.
“Public health [is underfunded]. Infrastructure is underfunded. And that’s especially true in resource poor settings where infectious disease burden is significant,” said John Brownstein, Ph.D., an ABC News contributor and chief innovation officer at Boston Children’s Hospital.
Now, there is evidence that pandemics are picking up pace. In the past 15 years, 7 emergency declarations have been made by the organization — H1N1, Ebola (twice), Poliomyelitis, Zika, COVID-19, and just recently, monkeypox.
“Ultimately, these declarations are helpful, because they unlock resources, support, visibility, and education that are important in the sort of response to an emerging infectious disease,” Brownstein said.
But not every virus — or every country — gets such resources. Just this last week, scientists have been monitoring a few dozen cases of a new virus in China called the Langya virus (LayV). Because there’s limited evidence of LayV spreading between people, experts are not overly concerned at this time, but they note that dealing with new infectious diseases is not uncommon.
“We still see the sort of power architecture of the world, to be heavily imbalanced, towards countries that have historically, over the past 200 years, held the most power and political way. And that’s primarily countries in Europe and the United States,” said Varma.
In responding to COVID-19 — a truly global pandemic — governments scrambled to protect their own citizens first. The COVAX initiative aimed to share COVID vaccines equitably around the world, but never reached its full potential, experts say.
“When you have a sort of gift to the world, like the development of highly effective COVID vaccines, they’re immediately gobbled up by the countries that have the most power and wealth, leaving the rest of the populations around the world which don’t benefit from that wealth behind,” said Varma.
Pharmaceutical companies also serve as the lifeline for many that depend on vaccines or medications to protect themselves and their loved ones. Yet, the incentive to combat neglected diseases is limited — especially early in an outbreak, when very few people are sick.
“[Neglected diseases] are a small market compared to what a pharmaceutical company might be going after like high cholesterol or heart disease or something like that, that’s much more lucrative,” said Adalja.
Experts noted that the global health community increasingly works together to stop the spread of emerging diseases. But funding remains a consistent hurdle to ensure that outbreaks are contained quickly and efficiently.
“I do think that there’s always a window of opportunity, with any emerging outbreak, to do something and potentially prevent it from spreading more broadly,” said Kissler.