COVID, mpox, cholera: Is the world prepared for another pandemic?

About 4.5 billion people are currently without adequate access to essential healthcare. Will things change?

Some 4.5 billion people worldwide are currently without adequate access to essential healthcare services, according to the World Health Organization (WHO).

This comes as more than 100,000 cases of mpox and at least 200 deaths have been confirmed globally, according to the European Centre for Disease Prevention and Control, with the WHO declaring it a public health emergency earlier this year.

The ongoing cholera outbreak in Sudan alone has affected almost 15,000 people with at least 473 deaths reported, according to the country’s health ministry.

A new COVID-19 variant has spread across 27 countries, infecting hundreds of people.

At the 2024 World Economic Summit, it was also revealed that antimicrobial resistance (AMR) has become the leading cause of death globally and could kill 10 million people by 2050.

A report titled Quantifying the Impact of Climate Change on Human Health, launched earlier this year, predicts that by 2050, an additional 14.5 million deaths could occur due to climate change as well as $12.5 trillion in economic losses globally.

With healthcare systems across the world already under extra stress, they could face an additional $1.1 trillion burden due to the impact of climate change, the report added.

Al Jazeera spoke to Dr Ahmed Ogwell, vice president of global health strategy at the United Nations Foundation and former deputy director general for the Africa Centres for Disease Control and Prevention (CDC), on the current state of healthcare, the risk of infections and diseases across the globe and whether the world has learned any lessons from the coronavirus pandemic.

Al Jazeera: Let’s start with the general health situation of the world. What risk level are we talking about with infections and diseases?

Ogwell: For the general health of the world, I’d put the temperature at moderate risk right now. We are in the middle of a public health emergency of international concern that is the mpox multi-country outbreak. It means that we need to be in heightened surveillance and ensuring we have the health tools that we need and that we also need to be improving the way we work together as a global community.

Secondly, there are increasing numbers of disease outbreaks – not just disease threats – including mpox, dengue fever, cholera, polio etc. And we still have effects of COVID on health systems. The world is still not comfortable when it comes to health issues.

Finally, the current geopolitical situation. We need to be coming together as a globe to address these issues because they are very international and cross-border in nature. But the situation is still hindering the delivery of a more united front to address global health. The world is at a moderate risk and can go either way, depending on what we do as a global community.

A heightened level of preparedness is required. There is a lot more we can do to make the situation more comfortable.

Al Jazeera: You spoke about preparedness. Is the world prepared for another pandemic? Did we learn any lessons from COVID?

Ogwell: Well, the lessons we should have learned from COVID, we did not. You see how we wore our masks, washed our hands, sanitised and kept our distance during the pandemic. Today, the situation has been completely forgotten. You don’t see anyone really wearing masks even when they are sneezing their heads off. That’s why we are struggling with controlling things we should have been able to.

At the healthcare level, the systems we put in place should have clicked in globally to address the potential outbreak of diseases. These systems were folded up when COVID passed. For example, the temperature scanning machines at airports. It means the very basic screening mechanism of someone who is feverish is not there.

At the policy level, during COVID we had vaccines being processed within six to seven months. But today, mpox has come and you don’t see the same urgency in trying to bring it under control. We have dengue fever and we don’t hear the same urgency. Policymakers are also seemingly not compelled to accommodate the lessons we should have learned from COVID.

Al Jazeera: You mentioned mpox. What is the situation with its spread and how worried should we be?

Ogwell: The risk is still high for spread because of the ease of communication that we have around the world today. The mode of transmission of mpox is close contact. Someone can carry it to another part of the world easily and can transfer it, setting off a chain that results in something bigger than it is right now.

In this world, an outbreak anywhere is a risk of an outbreak everywhere.

We need to put into good use the lessons of COVID, Ebola, cholera. All these outbreaks required solidarity across borders. Those who have the tools, resources and knowledge needed to address the outbreak, they need to provide support.

Al Jazeera: This solidarity, the geopolitical nature of the world today, where wars and conflict are aplenty, does not really work, right? How does this affect the state of global health?

Ogwell: Well, the reality on the ground is very different to a perfect world where the above would have worked well. The presence of humanitarian crises, where you find people living in very unsavoury conditions – being forced to consume very unhealthy water or food, forced to breathe very unhealthy air – the risks are twofold.

The first is the risk of contracting disease for the affected community whether it is IDPs or refugees in a conflict area or warzone. A situation like that becomes a breeding ground for new superbugs to develop. It may be that people there start getting used to difficult situations. When you start developing certain coping mechanisms, the bugs in you will also start adjusting to that new situation. If they get out in communities that are not under similar stressful circumstances, it becomes a new variant or a new type of resistance that developed with those bugs. The rest of the world immediately becomes at risk, whether it is a resistant variant or deadlier variant. And these environments, these conflict areas, can wreak havoc on the rest of the health system across the world.

Al Jazeera: Is climate change also playing its part forming these environments that you talked about?

Ogwell: Health is the face of climate change because it comes in a painful way. Communities that may not have experienced a certain disease are now areas being colonised by diseases that were only found in certain places because of these weather changes.

It is also the [duration] of conditions that gives rise to diseases. When there’s flooding and a lot of water stays for only a few hours, chances are slim that you’ll get water-borne disease. But if it stays for longer, the community may be affected.

As climate change continues to ravage the world, we find communities suffering for a long period. Natural disasters give rise to a situation where a disease can be able to grow.

Also, areas, for example, forests or glaciers, now become exposed to human beings. When we go into caves, forests and ocean depths that we have never been to, there may be bugs and pathogens that the human beings have never been in touch with. Because of the interaction due to climate change, those bugs, pathogens, animals, insects then get into the human population and we start seeing diseases never experienced before.

Al Jazeera: Let’s talk about healthcare. Some 4.5 billion people are currently without adequate access to essential healthcare services. Why is healthcare such a luxury?

Ogwell: It’s because of government investment in the health sector. Most governments have very low levels of investment there and this means that the vulnerable population is unable to access quality healthcare.

The second reason is the commercialisation of healthcare. It has been so heavily commercialised that you find in some jurisdictions the governments actually getting out of health services. You then have a population that is not heavily wealthy and it means the vulnerable are not going to have access to good healthcare, if any at all.

That commercialisation needs to be within certain parameters and boundaries so it doesn’t end up being a burden on the vulnerable.

Cover photo: ‘Contagious diseases running rampant,’ warns doctor