A new list of viruses and bacteria which pose the greatest threat to public health has been published by health officials to bolster preparedness for any future pandemic.
The “priority pathogen” guide from UK Health Security Agency (UKHSA) is designed to help scientists and researchers focus their efforts, as well as speeding up the development of vaccines when most needed.
The list of 24 pathogen families is also the first to consider global health threats, as well as threats specific to the UK population.
To create the tool, experts assessed the pandemic and epidemic potential of each viral family by looking at the severity of disease, routes of transmission and previous pandemics among known pathogens in the family.
Each group was given a rating of high-, medium- or low-risk based on the opinions of scientists at UKHSA.
Information on whether the risk is sensitive to climate change, if vaccines are available, and if human-to-human transmission is likely is also included in the tool.
Bacterial pathogen families were also assessed for the list based on their sensitivity to climate change and vaccine availability, and were rated based on the concern around their resistance to drugs like antibiotics.
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Among the viral pathogen families classed as high-risk for both epidemics and pandemics are coronaviridae, which includes Covid-19, and the orthomyxoviridae family, which includes avian influenza.
It also includes paramyxoviridae, which causes Nipah virus, outbreaks of which have mostly been found in South East Asia.
The list does not mean what pathogen officials think is most likely to cause the next pandemic, but rather areas that require increased scientific study and investment.
Dr Isabel Oliver, chief scientific officer for UKHSA, said: “We live at the time of increasing challenges and increasing risks from infectious diseases. But at the same time we have got, thanks to scientific advancement, better tools than we’ve ever had to protect health against these threats.
“Having said that there are areas where we still need more or better diagnostics, vaccines and medicines and therapeutics, and this tool has been designed to help inform the work of government research funders, but also our partners in industry and academia who are critical to the development of these tools that we so desperately need.”
Dr Oliver said officials had not ranked the pathogens as the situation is “constantly evolving”, pointing out that UKHSA officials undertake surveillance and monitor threats.
She stressed that UKHSA carries out threat assessment work separately, adding: “What’s different about this tool is that we’ve taken into consideration not just the fact that some of these families have got high potential to cause pandemics or epidemics, but also where there are currently gaps in the availability of either diagnostics, vaccines and therapeutics, or where there are evolving and growing changes around antimicrobial resistance, or where there is a significant sensitivity to climate change, that might mean that this threat evolves or changes more rapidly as a result of that context.
“I think it is fair to say that we are concerned about all of the families in this and not exclusively so. This is an important lesson from the Covid-19 pandemic, […] that it is really important that we consider the breadth of potential threats to health, and that we continue to monitor the situation and flexibly respond to those.
“So our approach is very much to increase our resilience against all families of concern and to work with partners to advance resilience across all of these.”
Among the UKHSA’s concerns is the distribution of disease-causing mosquitoes and ticks due to climate and environmental change, according to Dr Oliver.
“So that means the change in the distribution of mosquitoes and ticks that can carry viruses that cause adverse health effects to humans, and also to animals in some ways, and that is one area that we’re monitoring very closely,” she said.
“The UKHSA maintains surveillance of mosquitoes and ticks, and we work with partners in local government and animal health and other sectors to really understand any changes that might potentially affect our health in the UK.”
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Dr Oliver said that some diseases on the list, like Ebola, may not be present in the UK but have an impact globally.
“Some of these are also of interest, even though they are not currently present in the UK, and may or may not be present in future, but they also have the potential of causing major global epidemics,” she said.
“So for example, as we’ve seen in the past, large outbreaks of Ebola virus have had major impacts globally, including socioeconomic impacts, so we take all those factors into account.”
Robert Read, professor of infectious diseases at the University of Southampton, criticised the move.
“Lists like this have been made for many years, and they represent an effort to prioritise infections for advisory and funding purposes, ostensibly to align research funding as closely as possible to public health need,” he said.
“Unfortunately, pathogens emerge or change constantly, and it is difficult to predict big infectious disease problems coming down the line. For this reason, I think this list is at best pointless, and at worst potentially harmful to the public health.
“Pointless because the list of viruses is so long that it’s tricky to name a significant viral pathogen that has not been included. Potentially harmful because a prescriptive list like this could misdirect funding towards certain infections, and away from problems that need urgently to be solved.”
The work by UKHSA forms part of the Government’s Biological Security Strategy, a plan to protect the UK and its interests from biological risks.
It comes just after the fifth anniversary of the first national lockdown following the coronavirus outbreak, which ended up killing more than 200,000 people in the UK.
Professor Martin McKee, who chaired a scientific advisory committee advising WHO Europe on lessons from the pandemic, told The i Paper although the scientific community is “definitely better prepared” for the next pandemic there are still “major problems” in terms of the resilience of the country as a whole.
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