Dr. Neil Vora has spent much of his career chasing and treating infectious disease outbreaks, from the Ebola epidemic in West Africa to COVID-19 in New York City.
His prescription for stopping the next one: Protect nature.
Vora, an epidemiologist at Conservation International, believes that public health institutions often privilege treatment over prevention. This is a mistake, he says, because nearly two-thirds of emerging infectious diseases are caused by pathogens that originate in animals that have jumped into people — often as a result of environmental changes, such as deforestation.
In other words: Human health, animal health and environmental health are interconnected.
In an article published today in the Lancet, Vora and his colleagues argue for an approach to pandemic threats that embraces “One Health.” He hopes this idea will be foundational to next week’s World Health Organization negotiations, aimed at forging a global agreement to prepare for — and prevent — the next pandemic.
Vora spoke with Conservation News to talk about this approach, his article in the Lancet, and his personal experiences facing down some of the world’s most virulent diseases.
Question: To start with, what is this “One Health” movement?
Neil Vora: One Health is the idea that human health is inextricably linked to the health of other animals and the environment. The term has really taken off in recent years, including in the highest levels of global policy making, such as the World Health Organization and the Convention on Biological Diversity.
But this is a concept that many Indigenous cultures and traditional cultures around the world have understood implicitly for hundreds, if not thousands, of years: The well-being of communities is linked to the well-being of their surroundings. It’s finally gaining traction in modern scientific circles, because we are seeing the fallout of our planet in distress — in the form of more pandemics, chronic disease flare-ups and worsening mental health.
Q: Have you already seen changes in your patients?
Vora: My personal experience mirrors much of what the science shows: an increasing prevalence of new infectious diseases and the stubborn persistence of historically devastating infectious diseases.
On the former, any of us who have read the news are familiar with diseases like Ebola, Zika, COVID, mpox and avian flu. But I think the latter goes underdiscussed. I have the honor of being a doctor in a public tuberculosis clinic in New York City. People might not know that tuberculosis is the biggest infectious disease killer in the world; it kills more than a million people every year. Every single one of these deaths is preventable, which makes each one an even greater tragedy.
As the world faces a growing number of climate disasters each year, the medical community is finding its ability to deliver care to patients is being impacted. For example, in the United States we’re seeing how wildfires are exacerbating asthma, which slams emergency rooms with patients. We have to recognize that all of these threats are interconnected, and investment in conservation can prevent some of the downstream health consequences.
Q: Let’s look ahead to the WHO meeting. How do you implement a One Health framework into pandemic prevention?
Vora: We know that most new infectious diseases are caused by pathogens that originate in animals and then jump into people; we call that process spillover. And spillovers are on the rise because of human activities, particularly in the form of deforestation, the commercial wildlife trade and unsafe practices when raising farm animals. Climate change is in the backdrop of all of this. When we address these activities head on, we can then reduce the risk of pathogen emergence in the first place.
In the upcoming WHO pandemic negotiation, there are two articles that are focused on pandemic prevention and One Health. If this agreement is adopted, it would represent the first binding international agreement on One Health. And this will open the door to so much more collaboration around the world to make people, animals and nature healthier.
Q: What will success look like?
Vora: We live in an interconnected world. It's sometimes convenient to think that we can isolate ourselves from what's happening all around us. But in today’s world, a health threat anywhere is a health threat everywhere. Within hours, a person with a new infectious disease can travel to the other side of the planet carrying that infectious disease with them.
That's the importance of this pandemic agreement: trying to correct global governance around public health threats. Some of these gaps were identified very clearly during the COVID pandemic, and we still have not fully overcome them. But the world is rapidly shifting right now. We are facing threats to multilateralism and global cooperation. If this agreement is adopted, it will also be a sign that multilateralism still can persist. And it'll be a testament to a global community of people that are working together to create a better world.
Max Marcovitch is a senior writer at Conservation International. Want to read more stories like this? Sign up for email updates. Also, please consider supporting our critical work.
