What lies behind the concept of prevention?

With the emergence or re-emergence of zoonosis or vector- and animal-borne infectious diseases, public health policies, all over the world, are more and more likely to promote prevention. Prevention is the core of PREZODE, as the initiative acronym stands for PREventing Zoonotic Disease Emergence. Therefore, prevention, in the system thinking approach of PREZODE, requires an understanding of all factors that allow pathogens to cross the species barrier. What lies behind the concept of prevention? How can we assess the prospects of Prevention? To discuss the topic and draw a common understanding, we organized a roundtable.

The event brought together:

Dr Casey Barton Behravesh, Director, One Health Office, Centers for Disease Control (CDC) and Prevention, Member of the One Health High-Level Experts Panel (OHHLEP); Dr Ana Riviere Cinnamond, Pan American Health Organization, World Health Organization Representative in Panama; Dr Osman Dar, Consultant physician in Global Health, UK Health Security Agency and Director, One Health Project, Centre on Global Health Security, Chatham House; Dr Daniel Masiga, Principal Research Scientist, and Head of the Human and Animal Health Theme at the International Centre of Insect Physiology and Ecology (ICIPE). Pr Wim Van der Poel (Wageningen University & Research and member of the PREZODE Steering Committee) will moderate the roundtable.

The discussions covered a range of questions from various viewpoints:

On definition

In a recent publication, members of the OHHLEP underlined that it is crucial to clearly define "prevention of spillover" in preventing disease outbreaks, endemicity, epidemics, and pandemics, to ensure effective and prioritized actions and resource allocation. Currently, the term “prevention” is used in varying ways. It may refer to “primary prevention” - stopping human diseases from occurring altogether and avoiding localized outbreaks from spreading into larger epidemics or pandemics. It may also refer to “secondary prevention” which involves measures like early detection, vaccination, improved healthcare systems, medication, or behavior change promotion….

However, in this acceptance, does the prevention of pathogen spillover from animals to humans also include the risk of emergence?

On Epidemiology and Economics

The panelists will provide answers on the mathematical foundations underlying prevention strategies and the evaluation of their effectiveness and impact.

On Sustainability

The discussions will link the prevention of zoonotic disease emergence to achieving Sustainable Development Goals (SDGs) and addressing socioeconomic inequalities. The panel will especially focus on solutions to balance sustainability with economic considerations, especially in agriculture and livestock management, and on the role of local communities and indigenous populations in the success of these prevention initiatives.