Pandemics: Risks, Impacts, and Mitigation

Authors: Nita Madhav, Ben Oppenheim, Mark Gallivan, Prime Mulembakani, Edward Rubin, Nathan Wolfe


Pandemics can cause significant health, economic, and societal damage. While pandemics have occurred regularly throughout human history, they are rare events, and it is not possible to predict the cause or timing of the next event. However, catastrophe modeling techniques, including exceedance probability curves, can be used to estimate future pandemic event frequency and severity. Historical evidence suggests that influenza represents the greatest pandemic threat. Other zoonotic pathogens emerging from wildlife reservoirs represent additional potential pandemic risks and are more likely to emerge in low- and middle-income countries. Health investments should consider two aspects of a country’s pandemic risk: spark risk (the likelihood of the next potential pandemic originating in the country) and spread risk (the likelihood of a pandemic spark spreading across its borders). Geographic regions with high levels of spark risk, including Central and West Africa, lag behind the rest of the globe in terms of preparedness for a pandemic. Early recognition of sparks is essential for cost-effective mitigation and can be supported by building human and animal disease surveillance systems, effective diagnostics and laboratory systems, as well as investing in well-trained front-line medical personnel. Once a pandemic is underway, effective risk management requires emergency operations centers and appropriate risk communications to the public and health system stakeholders. Residual pandemic risks can be mitigated through risk transfer mechanisms, such as catastrophe risk pools, to create positive incentives for planning, capacity building, and timely reporting.