The recent COVID-19 pandemic has confirmed predictions that all nations and the global population as a whole are vulnerable to epidemics and pandemics. History teaches and the future is relatively predictable.

Starting with the Spanish flu in 1918 which was associated with very high mortality, several epidemics and pandemics followed, such as swine flu (H1N1), MERS and SARS but also smaller local epidemics such as Ebola in West Africa.

At the end of 2019, the new coronavirus SARS-CoV2 appeared, which developed into a pandemic with the well-known effects on human lives, high morbidity and serious effects on the economies of states. The message from the historical data is clear and boils down to the fact that the next pandemic is predetermined, we just cannot clearly determine the time and nature of the virus or bacteria that will cause it.

The international scientific community has given the designation “Disease X” to this unknown pathogen that will lead to the next pandemic and for which we must be more prepared but also identify the exact causes that will lead to it.

The first priority is to describe the conditions that may favor these states. The main aggravating factor is the uncontrolled urbanization of forests and the displacement of wild animals and birds from their natural habitat. The interaction of humans with wild animals leads to mutated viruses that can then survive and multiply in a new host, such as humans. This process is achieved through close contact resulting from hunting, food preparation and the trade of wild animals.

Climate change and the overpopulation of large cities is the second main reason for the development of pandemics. The increase in temperature and heavy rainfall favor diseases caused mainly by the overpopulation of mosquitoes, resulting in local outbreaks of rare viral diseases even in large cities in North America and Europe where normally these infections are not endemic (e.g. an epidemic of of West Nile disease in New York). Finally, the ease of movement favors dispersion, as was done for example in the evolution of the COVID-19 pandemic, where within a few weeks of the appearance of the disease, cases appeared in all regions of the planet.

All of the above emphasize the value of prevention and environmental protection. The latter requires a long-term commitment by states, and time is now counting down, as it will take decades to see real results. The scientific community, governments and international organizations must prepare for the next epidemic-pandemic. This means that we have to identify the pathogens of high interest, i.e. viruses and bacteria that can under certain conditions lead to pandemics. This is done by identifying these pathogens, their genetic material but also their mutation potential. The use of modern technology, such as artificial intelligence (AI), is helpful in this endeavour. Monitoring is also needed in organisms that harbor a multitude of viruses, such as bats and mosquitoes, while finally ensuring food safety and limiting the illegal trade in animals with criminal clauses will complete the key initiatives required.

The creation of safe and effective vaccines is a cornerstone of this effort. The WHO’s goal is to create and produce effective vaccines within 100 days of the start of a pandemic. The expertise is available and there was a good response to the recent pandemic, with a vaccine available in less than a year.

The experience from COVID-19 was invaluable. What we have learned is that the combination of political will, abundant financial resources, the cooperation of scientists from all corners of the globe, the diffusion of information and the use of technology constitute the safest approach to a potential new threat.