Abstract

Abstract Socio-economic, environmental and ecological factors, as well as several natural hazards, have repeatedly been shown to drive emerging infectious-disease risk. However, these drivers are largely excluded from surveillance, warning and response systems. This paper identifies, analyses and categorises 64 warning and response systems for infectious diseases. It finds that 80% of them are “reactive” – they wait for disease outbreaks before issuing an alert and implementing mitigating strategies. Only 6% of the warning and response systems were “prevention-centred.” These both monitored and were linked to strategies that addressed drivers of disease emergence and re-emergence. This paper argues that warning systems’ failure to conceptualise emerging infectious diseases as part of an integrated human, animal and environmental system stems from inadequate multi-sectoral collaboration and governance, compounded by barriers to data sharing and integration. This paper reviews existing approaches and frameworks that could help to build and expand prevention-centred warning and response systems. It also makes recommendations to foster multi-sectoral collaboration in governance and warning systems for infectious diseases. This includes proposing solutions to address compartmentalisation in international agreements, developing One Health national focal points and expanding bottom-up initiatives.

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