Image credit: CDC/Aaron Sussell, PhD, MPH

While the headlines are filled with news about the Zika virus, global health experts warn that the mosquito-borne disease is just the tip of the iceberg when it comes to infectious diseases spreading around the world.

In late May, World Health Organization (WHO) Director-General Margaret Chan, MD, cautioned during WHO’s 69th World Health Assembly that the world is not doing enough to prepare for coming pandemics. Recent outbreaks of Ebola, MERS coronavirus, Zika, and urban yellow fever signaled a “dramatic resurgence of the threat from emerging and re-emerging infectious diseases,” a threat the world is not ready for.

Other infectious-disease specialists are issuing their own warnings.

In an opinion piece published online in The Journal of the American Medical Association (JAMA), Georgetown University Medical Center professors Daniel Lucey and Lawrence Gostin highlighted the growing yellow fever epidemic in Angola. As of June 9, 328 people had died from the virus, with nearly 3,000 confirmed infections. The virus has since spread to China, the Democratic Republic of Congo, Uganda, and Kenya, with Sao Tome and Principe, and Ethiopia reporting suspected cases.

With vaccines in short supply, Lucey and Gostin warned of the “health security crisis” that would occur if the disease spreads within Africa, Asia, or the Americas, and called on WHO to “urgently” convene an emergency committee to coordinate an international response.

A week later, the Red Cross warned that that the vaccine shortage, cross-border travel, inadequate disease surveillance, and poor sanitation could “turn a national outbreak into a global crisis.”

WHO on May 19 convened an emergency committee on yellow fever. The committee determined that the outbreaks were a “serious public health event which warrants intensified national action and enhanced international support.” However, it did not declare it a Public Health Emergency of International Concern, as it did during the 2014-2016 Ebola outbreak in West Africa and the current outbreak of Zika virus.

In a separate article published in the New England Journal of Medicine, authors Victor J. Dzau, MD and Peter Sands, MPA posited that “the painstaking building of perhaps unglamorous capabilities related to disease surveillance, diagnostics, emergency preparedness, and infection-control protocols that will save the most lives and minimize economic disruption.” Dzau and Sands served on the National Academy of Medicine Commission on a Global Health Risk Framework for the Future, which argued that “stronger public health capabilities at a national level are the essential first line of defense against potential pandemics.”

In her World Health Assembly remarks, Chan made a stark assessment of the global community’s response to recent outbreaks, as well as its preparedness for future epidemics, including yellow fever. “Above all, the spread of Zika, the resurgence of dengue, and the emerging threat from chikungunya are the price being paid for a massive policy failure that dropped the ball on mosquito control in the 1970s. The lesson from yellow fever is especially brutal. The world failed to use an excellent preventive tool to its full strategic advantage,” she observed.

In looking ahead, Chan added, “You cannot trust the past when planning for the future. Changes in the way humanity inhabits the planet have given the volatile microbial world multiple new opportunities to exploit. There will always be surprises.”