Innovation cannot prevent disease---the world needs major reorganization

Societies are diverse and it is impossible to implement the same international regulations everywhere. Besides, anthropogenic factors leading to disease emergence vary from one society to another. They vary depending on culture, history and geography but they can all lead to an accidental coincidence of events opening the way to the emergence of a disease. However, the chain of events might be different depending on the society. The only way to prevent future pandemics from happening is to properly organize each society to block the chain of events and prevent the accidental event of emergence to occur, based their respective traits. This endeavor must be coordinated at the international level but actions must be designed and implemented locally to match national and local specificities. WHO will open in September 2021 in Berlin, a Hub for Pandemic and Epidemic Intelligence which will, according to WHO, be in charge of “quickly analyze data to predict, prevent, detect, prepare for, and respond to risks worldwide” and “be able to detect pandemic signals earlier than current systems” (WHO, 2021). However, these early pandemic signals are, according to UNO and WHO, mostly climate changes, early case detection and fast communication (UNO, 2021). Diseases have always emerged in human populations, long before the current issue of climate change. Climate change is only marginally affecting the potential for disease emergence mostly by influencing animal species movements and geographic range. The influence of climate change is on the circulation of pathogens through host mobility and replacement not on the process of emergence itself. On the other hand, as previously said, the early detection of cases is particularly complicated since the pathogens involved are not known, the associated pathologies have not been identified yet and the rate of asymptomatic cases is usually high. Early detection of emerging pathogens could be envisioned at two levels: a search for the pathogen in i) animal species or ii) human populations. An exhaustive and permanent screening of every human or wild animal populations for viruses is non-realistic. It would not only be logistically impossible and economically extremely costly, but it does not yield any information since it is impossible to identify a potential threat before it has spread through the population and already went out of control. International regulations and measures against epidemics taken after Influenza, SARS, MERS or even Ebola did not help preventing the emergence of COVID-19. This hub might well be unable to prevent the next pandemic if relying only on the speed of relaying information and signs of epidemics because when these signs become visible it is already too late. Actions, i.e. proper organization, must be taken before these signs become visible. Furthermore, there is also a risk of deleterious effect as it will direct all efforts and attention on reactions instead of prevention, leaving thus the society totally vulnerable and unprepared for the next emerging virus.