Introduction
In just two decades, the world has faced a relentless barrage of deadly infectious disease outbreaks— SARS in 2002, H1N1 in 2009, Ebola in 2014, Zika in 2016, and COVID-19 in 2020. Each crisis has cost lives, destabilized economies, and exposed vulnerabilities in global health systems. The COVID-19 pandemic alone resulted in over 15 million excess deaths and an estimated $16 trillion in economic losses (Cutler and Summers, 2020). Yet, despite these staggering costs, the world remains dangerously unprepared for the next pandemic.
The frequency and severity of infectious disease outbreaks are rising—driven by climate change, increasing socioenvironmental and economical challenges, untrammeled urbanization, and global interconnectedness—underscoring the urgent need for robust pandemic risk assessment frameworks. The emergence of zoonotic diseases, such as SARS-CoV-1, MERS-CoV, Ebola, Influenza H5N1, and SARS-CoV-2 has become more frequent, signaling an accelerating pace of pandemic threats (Meadows et al., 2023). Globalization and rapid urban expansion facilitate disease spread, while deforestation, habitat destruction, and climate change increase ecosystem stress and human-wildlife interactions, creating more opportunities for pathogen spillover.
Future pandemics pose a significant and underappreciated risk to human lives and livelihoods, and the expected economic losses from pandemic risk are estimated to be comparable in scale to economic damages from climate change (Fan et al., 2018). Yet relative to climate science, pandemic risk remains poorly understood, with fragmented research and limited assessment tools. While experts agree on high-risk pathogens, much viral diversity remains unmapped. Evidence shows that human activities—including climate change, intensive agriculture, and wildlife trade—are driving spillover events and amplifying pandemic risks (Baker et al., 2022). However, critical gaps persist: How quickly is pandemic risk evolving? Which human activities most directly drive spillover? How will climate change shape disease emergence and spread? The current disease surveillance model and still limited and fragmented data collection further hinder accurate risk assessment.
The absence of a systematic approach to monitoring and assessing pandemic risk leaves policymakers unprepared and populations vulnerable. While international efforts like the Global Health Security Agenda and the Joint External Evaluation aim to strengthen preparedness, they must be paralleled by ongoing comprehensive risk assessments: after all, it is impossible to assess preparedness if we do not understand what we are preparing for. To improve pandemic preparedness, we must shift from a reactive response model to risk-informed preparedness anchored in ongoing assessment. Establishing a structured, interdisciplinary pandemic risk assessment framework will allow global stakeholders to anticipate, mitigate, and manage future pandemics more effectively (Oppenheim et al., 2021).
To address this critical gap, the United Nations Foundation (UN Foundation), in collaboration with the US National Academy of Medicine (NAM), Fundação Oswaldo Cruz (Fiocruz), and the Global Pandemic Monitoring Board (GPMB)—with support from Pax Sapiens and the Skoll Foundation— hosted a workshop in Rio de Janeiro, Brazil, on October 28−29, 2024. This convening, Pandemic Risk Assessment and its Intersection with Climate Change: Needs, Opportunities, and Design Considerations, aimed to advance a global risk assessment agenda for pandemics and infectious disease hazards. Specifically, the workshop focused on evaluating current risk assessment systems, addressing the challenges of integrating climate and health data, and identifying actionable steps to enhance global capacity for estimating pandemic risk, quantifying key drivers, and monitoring shifts in risk levels over time.
The Need for Continuous Pandemic Risk Monitoring
A core outcome of the workshop was a consensus on the necessity of continuous, systematic pandemic risk monitoring. Policymakers from ministries of health, international financial institutions, and multilateral health agencies emphasized the importance of ongoing systems to monitor pandemic drivers and anticipate changes in pandemic risk.
The scientific community has the tools to assess pandemic risk, but fragmentation limits their effectiveness. Scientists at the workshop discussed a range of key dimensions necessary for a comprehensive risk assessment framework that include the following: evaluating spillover risk, its drivers and their change over time, evaluating post-emergence risk factors that can facilitate disease transmission, strengthening viral risk assessment through genomic surveillance, other innovative approaches and data equity, improving evidence on prevention and risk mitigation strategies, and advancing predictive models that can estimate risk (in terms of health and economic impacts) in a holistic fashion that also addresses uncertainty. Moreover, while some aspects of pandemic risk assessment are well-established, others, like integrating climate-driven disease risk projections, require further development in terms of both basic science and available data. Participants agreed that while many aspects of pandemic sciences are still maturing, the rapid development in these fields necessitates building on well-established scientific areas while advancing research in emerging domains. Addressing these gaps requires stronger interdisciplinary collaboration including scientists from diverse fields, as epidemiologists, biologists, social scientists, climate scientists, ecologists, computational modelers, and policymakers to develop predictive tools that inform global health security strategies effectively.
Advancing Scientific Methods for Risk Assessment
The workshop sessions underscored the need for stronger and more coherent and cumulative scientific approaches to pandemic risk assessment. Discussions examined the limitations of current risk assessment systems, identifying gaps in existing frameworks and highlighting the importance of aligning tools with end-user needs. Finally, the workshop emphasized the importance of synthesis and collaboration, advocating for the establishment of regional and global data hubs, and ongoing interdisciplinary and data science research initiatives.
Next Steps: Building a Standing Risk Assessment Mechanism
Building on the momentum of the October 2024 workshop, partners are now exploring the development of a longer-term initiative to strengthen pandemic risk assessment at the global level. This effort aims to support sustained scientific coordination, improved risk modeling, and the integration of data across disciplines— including climate science, public health, ecology, and economics. Informed by ongoing consultations with key stakeholders, this effort may explore opportunities to map existing tools and frameworks, identify critical gaps, and advance methods for quantifying and monitoring pandemic risk in real time. Ultimately, this work seeks to ensure that risk assessments translate into concrete preparedness strategies and inform decision-making at national, regional, and global levels.
The Long-Term Vision: Toward a Global Pandemic Risk Assessment Framework
A long-term vision for addressing pandemic risk requires a more integrated, coordinated, and science-driven framework that supports sustained, evidence-based decision-making at all levels. However, the global health landscape continues to evolve rapidly, posing significant obstacles to realizing this vision.
Fragmentation remains a significant issue, as a range of scientific research groups and networks work on different facets of pandemic risk, without mechanisms to coordinate, cumulate, and share scientific knowledge. Political uncertainty and challenges to multilateralism, including the recent announcements by the United States and Argentina to withdraw from the World Health Organization and reductions in foreign aid, pose risks to global scientific coordination. Furthermore, while certain aspects of pandemic risk assessment, such as genomic surveillance, are well-developed, other areas—including the integration of climate and pandemic data—demand further research and investment.
To create a robust global risk assessment framework, future efforts must prioritize three essential elements. First, the framework must be science-driven and globally recognized, establishing a comprehensive mechanism that spans upstream risk assessment to actionable preparedness measures. This approach must translate scientific evidence to ensure that risk assessments are directly linked to policy decisions. Second, the framework must be interdisciplinary and data-driven, grounding pandemic risk assessment in rigorous data and analytic methods. Finally, sustainability must be a priority, with continuous engagement, periodic assessments, and knowledge-sharing platforms ensuring that pandemic preparedness remains a global focus.
From Lessons Learned to Future Preparedness
The COVID-19 pandemic laid bare the vulnerabilities in our global health architecture, but it also provided an opportunity to rethink how we assess and prepare for emerging threats. By developing a structured, science-driven pandemic risk assessment framework, we can move from crisis-driven responses to proactive, evidence-based strategies that anticipate and mitigate the risks of future pandemics.
This is not just an academic or policy exercise—it is a global imperative. Without systematic, continuous risk assessment, the world will remain vulnerable to the next pandemic. The time for action is now.
Join the Conversation!
New from #NAMPerspectives: The Imperative of a Global Pandemic Risk Assessment Framework. Read now: https://doi.org/10.31478/202506a
A new #NAMPerspectives commentary from [@theNAMedicine (X) or @nam.edu (Bluesky)] illustrates a long-term vision for addressing pandemic risk. https://doi.org/10.31478/202506a
Download the graphic below and share on social media!
References
- Baker, R. E., A. S. Mahmud, I. F. Miller, M. Rajeev, F. Rasambainarivo, B. L. Rice, S. Takahashi, A. J. Tatem, C. E. Wagner, L. F. Wang, A. Wesolowski, and C. J. E. Metcalf. 2022. Infectious disease in an era of global change. Nature Reviews Microbiology 20(4):193–205. https://doi. org/10.1038/s41579-021-00639-z.
- Cutler, D. M., and L. H. Summers. 2020. The COVID-19 pandemic and the $16 trillion virus. JAMA 324(15):1495–1496.https://doi. org/10.1001/jama.2020.19759.
- Fan, V. Y., D. T. Jamison, and L. H. Summers. 2018. Pandemic risk: How large are the expected losses? Bulletin of the World Health Organization 96(2):129–134. https://doi.org/10.2471/ BLT.17.199588.
- Meadows, A. J., N. Stephenson, N. K. Madhav, and B. Oppenheim. 2023. Historical trends demonstrate a pattern of increasingly frequent and severe spillover events of high-consequence zoonotic viruses. BMJ Global Health 8(11):e012026. https://doi.org/10.1136/ bmjgh-2023-012026.
- Oppenheim, B., K. Brown, and R. Waldman. 2021. The world needs an intergovernmental panel on pandemic risk. Nature Medicine 27(6):934. https://doi.org/10.1038/s41591-021-01374-x.
The Imperative of a Global Pandemic Risk Assessment Framework
Maria de Lourdes Oliveira Aguiar
Joy Phumaphi
Introduction
In just two decades, the world has faced a relentless barrage of deadly infectious disease outbreaks— SARS in 2002, H1N1 in 2009, Ebola in 2014, Zika in 2016, and COVID-19 in 2020. Each crisis has cost lives, destabilized economies, and exposed vulnerabilities in global health systems. The COVID-19 pandemic alone resulted in over 15 million excess deaths and an estimated $16 trillion in economic losses (Cutler and Summers, 2020). Yet, despite these staggering costs, the world remains dangerously unprepared for the next pandemic.
The frequency and severity of infectious disease outbreaks are rising—driven by climate change, increasing socioenvironmental and economical challenges, untrammeled urbanization, and global interconnectedness—underscoring the urgent need for robust pandemic risk assessment frameworks. The emergence of zoonotic diseases, such as SARS-CoV-1, MERS-CoV, Ebola, Influenza H5N1, and SARS-CoV-2 has become more frequent, signaling an accelerating pace of pandemic threats (Meadows et al., 2023). Globalization and rapid urban expansion facilitate disease spread, while deforestation, habitat destruction, and climate change increase ecosystem stress and human-wildlife interactions, creating more opportunities for pathogen spillover.
Future pandemics pose a significant and underappreciated risk to human lives and livelihoods, and the expected economic losses from pandemic risk are estimated to be comparable in scale to economic damages from climate change (Fan et al., 2018). Yet relative to climate science, pandemic risk remains poorly understood, with fragmented research and limited assessment tools. While experts agree on high-risk pathogens, much viral diversity remains unmapped. Evidence shows that human activities—including climate change, intensive agriculture, and wildlife trade—are driving spillover events and amplifying pandemic risks (Baker et al., 2022). However, critical gaps persist: How quickly is pandemic risk evolving? Which human activities most directly drive spillover? How will climate change shape disease emergence and spread? The current disease surveillance model and still limited and fragmented data collection further hinder accurate risk assessment.
The absence of a systematic approach to monitoring and assessing pandemic risk leaves policymakers unprepared and populations vulnerable. While international efforts like the Global Health Security Agenda and the Joint External Evaluation aim to strengthen preparedness, they must be paralleled by ongoing comprehensive risk assessments: after all, it is impossible to assess preparedness if we do not understand what we are preparing for. To improve pandemic preparedness, we must shift from a reactive response model to risk-informed preparedness anchored in ongoing assessment. Establishing a structured, interdisciplinary pandemic risk assessment framework will allow global stakeholders to anticipate, mitigate, and manage future pandemics more effectively (Oppenheim et al., 2021).
To address this critical gap, the United Nations Foundation (UN Foundation), in collaboration with the US National Academy of Medicine (NAM), Fundação Oswaldo Cruz (Fiocruz), and the Global Pandemic Monitoring Board (GPMB)—with support from Pax Sapiens and the Skoll Foundation— hosted a workshop in Rio de Janeiro, Brazil, on October 28−29, 2024. This convening, Pandemic Risk Assessment and its Intersection with Climate Change: Needs, Opportunities, and Design Considerations, aimed to advance a global risk assessment agenda for pandemics and infectious disease hazards. Specifically, the workshop focused on evaluating current risk assessment systems, addressing the challenges of integrating climate and health data, and identifying actionable steps to enhance global capacity for estimating pandemic risk, quantifying key drivers, and monitoring shifts in risk levels over time.
The Need for Continuous Pandemic Risk Monitoring
A core outcome of the workshop was a consensus on the necessity of continuous, systematic pandemic risk monitoring. Policymakers from ministries of health, international financial institutions, and multilateral health agencies emphasized the importance of ongoing systems to monitor pandemic drivers and anticipate changes in pandemic risk.
The scientific community has the tools to assess pandemic risk, but fragmentation limits their effectiveness. Scientists at the workshop discussed a range of key dimensions necessary for a comprehensive risk assessment framework that include the following: evaluating spillover risk, its drivers and their change over time, evaluating post-emergence risk factors that can facilitate disease transmission, strengthening viral risk assessment through genomic surveillance, other innovative approaches and data equity, improving evidence on prevention and risk mitigation strategies, and advancing predictive models that can estimate risk (in terms of health and economic impacts) in a holistic fashion that also addresses uncertainty. Moreover, while some aspects of pandemic risk assessment are well-established, others, like integrating climate-driven disease risk projections, require further development in terms of both basic science and available data. Participants agreed that while many aspects of pandemic sciences are still maturing, the rapid development in these fields necessitates building on well-established scientific areas while advancing research in emerging domains. Addressing these gaps requires stronger interdisciplinary collaboration including scientists from diverse fields, as epidemiologists, biologists, social scientists, climate scientists, ecologists, computational modelers, and policymakers to develop predictive tools that inform global health security strategies effectively.
Advancing Scientific Methods for Risk Assessment
The workshop sessions underscored the need for stronger and more coherent and cumulative scientific approaches to pandemic risk assessment. Discussions examined the limitations of current risk assessment systems, identifying gaps in existing frameworks and highlighting the importance of aligning tools with end-user needs. Finally, the workshop emphasized the importance of synthesis and collaboration, advocating for the establishment of regional and global data hubs, and ongoing interdisciplinary and data science research initiatives.
Next Steps: Building a Standing Risk Assessment Mechanism
Building on the momentum of the October 2024 workshop, partners are now exploring the development of a longer-term initiative to strengthen pandemic risk assessment at the global level. This effort aims to support sustained scientific coordination, improved risk modeling, and the integration of data across disciplines— including climate science, public health, ecology, and economics. Informed by ongoing consultations with key stakeholders, this effort may explore opportunities to map existing tools and frameworks, identify critical gaps, and advance methods for quantifying and monitoring pandemic risk in real time. Ultimately, this work seeks to ensure that risk assessments translate into concrete preparedness strategies and inform decision-making at national, regional, and global levels.
The Long-Term Vision: Toward a Global Pandemic Risk Assessment Framework
A long-term vision for addressing pandemic risk requires a more integrated, coordinated, and science-driven framework that supports sustained, evidence-based decision-making at all levels. However, the global health landscape continues to evolve rapidly, posing significant obstacles to realizing this vision.
Fragmentation remains a significant issue, as a range of scientific research groups and networks work on different facets of pandemic risk, without mechanisms to coordinate, cumulate, and share scientific knowledge. Political uncertainty and challenges to multilateralism, including the recent announcements by the United States and Argentina to withdraw from the World Health Organization and reductions in foreign aid, pose risks to global scientific coordination. Furthermore, while certain aspects of pandemic risk assessment, such as genomic surveillance, are well-developed, other areas—including the integration of climate and pandemic data—demand further research and investment.
To create a robust global risk assessment framework, future efforts must prioritize three essential elements. First, the framework must be science-driven and globally recognized, establishing a comprehensive mechanism that spans upstream risk assessment to actionable preparedness measures. This approach must translate scientific evidence to ensure that risk assessments are directly linked to policy decisions. Second, the framework must be interdisciplinary and data-driven, grounding pandemic risk assessment in rigorous data and analytic methods. Finally, sustainability must be a priority, with continuous engagement, periodic assessments, and knowledge-sharing platforms ensuring that pandemic preparedness remains a global focus.
From Lessons Learned to Future Preparedness
The COVID-19 pandemic laid bare the vulnerabilities in our global health architecture, but it also provided an opportunity to rethink how we assess and prepare for emerging threats. By developing a structured, science-driven pandemic risk assessment framework, we can move from crisis-driven responses to proactive, evidence-based strategies that anticipate and mitigate the risks of future pandemics.
This is not just an academic or policy exercise—it is a global imperative. Without systematic, continuous risk assessment, the world will remain vulnerable to the next pandemic. The time for action is now.
Join the Conversation!
New from #NAMPerspectives: The Imperative of a Global Pandemic Risk Assessment Framework. Read now: https://doi.org/10.31478/202506a
A new #NAMPerspectives commentary from [@theNAMedicine (X) or @nam.edu (Bluesky)] illustrates a long-term vision for addressing pandemic risk. https://doi.org/10.31478/202506a
Download the graphic below and share on social media!
References
Dzau, V. J., M. de Lourdes Oliveira Aguiar, and J. Phumaphi. 2025. The imperative of a global pandemic risk assessment framework. NAM Perspectives. Commentary, National Academy of Medicine, Washington, DC. https:// doi. org/10.31478/202506a.
https://doi.org/10.31478/202506a
Victor J. Dzau, MD, is President, National Academy of Medicine; Maria de Lourdes Oliveira Aguiar, PhD, is Vice President of Research and Biological Collections, Oswaldo Cruz Foundation, Brazil; Joy Phumaphi, MA, is Co-chair, Global Preparedness Monitoring Board
None to disclose.
DISCLAIMER
The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.
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