As the novel COVID-19 coronavirus swept the planet in early 2020, researchers scrambled to find effective treatments and vaccines. Within a year, there was a clarion call from heads of state, the World Health Organization (WHO) and other agencies to create an international “pandemic preparedness and response” treaty. WHO noted that COVID-19 offered “a stark and painful reminder that nobody is safe until everyone is safe” from zoonotic disease outbreaks.

While these actions are extremely important, a new study in the journal Science Advances emphasizes the critical, largely overlooked need to prevent disease outbreaks before they occur. The average yearly cost in human lives and lost productivity can be in the trillions. These researchers show, in hard numbers, that boosting surveillance and curbing high risk human activities, such as the destruction of tropical forests, will save many lives and vast sums of money.

“We are grossly underestimating the economic harms [of pandemics], and prevention is far cheaper than a cure,” says lead author Aaron Bernstein, a pediatrician at Boston Children’s Hospital and a researcher at Harvard University’s Center for Climate, Health and the Global Environment.

In this new analysis, an esteemed cadre of doctors, epidemiologists, economists, ecologists, and conservation biologists point out that the current pandemic fight rests squarely on “post-spillover actions.” It’s a reactive approach, with action only after a pathogen has jumped from wild animals, infecting humans with a newly emerged zoonotic disease. COVID-19 is believed to have resulted from a spillover event, as did HIV, Ebola, SARS, avian flu and others — each with astronomical societal costs. But preemptive efforts, Bernstein and his coauthors warn, are severely underfunded, putting the world at grave risk.

Major health initiatives consistently overlook humanity’s key role in aiding pathogens in their quest for new hosts — specifically by razing forests; by enormously expanding agribusiness, especially in the tropics; and by a massive, poorly regulated global trade in wildlife.

“Our alterations to the ecosystem and the environment are what’s causing these outbreaks,” says Colin Chapman, a conservation scientist at George Washington University and public policy fellow at the Wilson Center. COVID-19 wasn’t a surprise, he says. “We knew the pandemic was coming. But we didn’t have the will to do something to slow down the chances of an emergence.”

The new study delves deeply into the economic costs of human deaths and lost productivity. It examines the increasing frequency of major epidemics over the last century and calculates how much it would cost to lower future risks. Protecting forests, wildlife, and limiting contact between wild animals, humans and livestock in regions of concern “could save us innumerable human lives and trillions of dollars, but it also goes hand in hand with fighting climate change and preventing mass extinction,” says Les Kaufman, a conservation biologist at Boston University.

This groundbreaking research answers key questions for humanity, including, “How much should we be spending to prevent disease emergence and reduce pandemic risk,” says Bernstein. “And what are the best things we can do right now?”

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