PAN_5.4_a_47

Economic analyses of return-on-investment for programmes that reduce the environmental changes that lead to pandemics.
Key risk behaviours – in global consumption, in rural communities on the frontline of disease emergence, in the private sector, in national governments – that lead to pandemics.
There are fundamental knowledge gaps on the linkages among biodiversity, anthropogenic environmental changes, and pandemic risk that will be critical to enacting policy changes to prevent pandemics. These are compounded by uncertainties due to the inherent complexity of the socio-ecological systems through which diseases emerge, and the value laden and stakeholder dependent nature of solutions. This section proposes some of the key knowledge gaps but does not consider health research goals such as data on prevalence of disease, spillover rates and disease incidence, that are already addressed in this report around enhancing surveillance, for example.
Efficient policy decisions could be enabled by measures of how much a specific policy would cost, how much it would reduce disease risk, the savings in morbidity, mortality, days off work or school these would lead to, as well as reductions in economic impact. National agencies could support analytical research supported by field-based ground truthing of assumptions for economic damages during outbreaks. Trials of policies/measures could be set up to test their efficacy, cost and the savings and then scaled up for an estimate of return-on-investment. Measurable health indicators could include reduction in disease incidence or seroprevalence of spillover pathogens in a high-risk cohort over time.
Key drivers of disease spillover are activities and behaviors that provide opportunities for increased contact among people, wildlife and livestock. The risk for spillover varies widely within all communities, with some exposed more heavily than others due to occupation, habits and behaviours (e.g. wildlife market workers). These are often deeply embedded in cultures around the world, particularly around food or medicine (e.g. butchering of wildlife, drinking of uncooked blood as a health measure). They represent not only a pathway for disease emergence, but also an opportunity for risk reduction. Qualitative and quantitative social science research into these behaviours would help to identify the incentives that drive high risk activities, so that programs to reduce risk can be designed, trialed and rolled out.