Global health as a foundation for world peace: preventing the “next” pandemic

There can be no peace on Earth until there is peace with the Earth. This holistic concept of peace encompasses present and future generations of human beings and all other living beings. The new coronavirus that is currently wreaking havoc and death on human societies of all countries and peoples, demonstrates this reality.

On the centennial of the 1918 influenza pandemic, we learn once again that pathogens can infect humans quickly, powerfully and fatally.  Too many stylists view a disease like COVID-19 as an “act of God” or an unpredictable event. Such mistaken beliefs ignore the scientific evidence that humans created the disruptions in nature that unleashed viruses on human communities. A century of scientific research has produced the ecological knowledge that has established how bacteria and viruses can live safely in nature without spilling over to infect humans. Ecology also teaches that if we disrupt natural habitats, we dislodge pathogens that seek new homes within us. Since the 1980s, virology has taught us how new coronaviruses work and spread. For example, when humans push development into forests, without knowing the consequences, they trigger diseases. See, for example, Bloomfield, L.S.P., McIntosh, T.L. & Lambin, E.F., “Fragmented habitat, subsistence behaviors, and contact between people and nonhuman primates in Africa.” Landscape Ecol 35, 985-1000 (2020). https://doi.org/10.1007/s10980-020-00995-w.

Unfortunately, governments largely ignore what we know today.

The “COVID-19” pandemic is a stark reminder to people around the world that human health is only assured when the environment is healthy. When humans pollute their air and water, they get sick. When humans allow their food to become contaminated, either through the inappropriate use of pesticides on crops or through the bioaccumulation of dangerous chemicals in the food chain, they get sick. Similarly, when a virus like SARS-CoV-2 infects every country on Earth, we are faced with a public health emergency that results from human misconduct that harms the health of nature.

The fact that the Covid-19 pandemic has broken out is a signal of “too little, too late.” What can be done to prevent such a calamity? What should be done after Covid-19? The Normandy Chair for Peace, which focuses on justice for future generations and for species in addition to humans, explores the jurisprudence that can prevent another pandemic like the one that will ravage humans across the Earth in 2020. Let’s explore how this pandemic unfolded.

On New Year’s Eve, the World Health Organization was informed of a cluster of pneumonia cases in Wuhan, China. The source was quickly identified as a new coronavirus, soon identified as “SARS-CoV-2”. Scientists gave the name “severe acute respiratory syndrome” or SARS to the new coronavirus that emerged in 2002. The second iteration of this virus is more complex and more harmful to humans. On January 30, the WHO director general declared a “public health emergency of international concern.”  Then, on March 11, 2020, the WHO declared the disease a pandemic.

Not all nations were prepared for the speed and power with which SARS-CoV-2 spread. Many political leaders said they were surprised. However, such viruses are not uncommon. Humans and animals naturally harbor and travel with a multitude of pathogens, including viruses. Viruses can infect their carriers, causing illness and eventually death. They can also be harmless. When human activity dislodges a virus from its natural animal host, it seeks out a new “reservoir host.” The new host may appear unperturbed, and may then transmit the virus to humans or other animals who then become ill, infected with the virus. When conditions permit, viruses present in animals can spread to humans, multiply and, in rarer cases, be transmitted from human to human. This is what is happening with SARS-CoV-2.

This phenomenon is known as zoonosis. Ecologists, virologists and veterinarians know that zoonosis is an integral part of life on Earth. It is always present, and is not an isolated or one-time event, like a pandemic. Governments tend to treat rare disease outbreaks as isolated public health emergencies, rather than as the result of ongoing interactions of natural systems that humans can manage or overlook. Science journalist David Quammen brilliantly explained zoonotic diseases in his book Spill Over – Animal Infections and the Next Human Pandemic (2012). We all neglect zoonotic diseases at our peril, as COVID-19 teaches us.

At about the same time that the influenza pandemic of 1918 struck populations around the world, the new science of ecology was being established. Since World War II, advances in ecological studies have shown the collateral damage that is caused when humans disturb intact natural systems, whether in forests, rivers, or seas. More recently, in the 1970s and 1980s, the science of virology was born. The pandemic that began with HIV-1 and HIV-2 in Africa became the global HIV/AIDS crisis. We contained the SARS epidemic in 2003 and Ebola in 2013, but governments did not take the warning that these zoonotic diseases presented.

In 2018, the WHO feared the emergence of another new coronavirus and set up global “surveillance” for the as-yet-unknown pathogen called “X.”   In April 2000, WHO created the Global Outbreak Alert and Response Network (GOARN). This is a network of technical and public health institutions, laboratories, non-governmental organizations (NGOs) and other institutions that cooperate with organizations to conduct surveillance to discover and respond to new diseases. 

WHO was prepared to respond to the emergence of a new coronavirus as a feared pathogen “X”, but most national governments did not. Cooperative systems were too few and too new.  Few countries funded the WHO, and its resources were meager. Some governments, such as President Trump’s administration in the United States, cut funding to WHO and the UN system.  Virtually no government is funding the ecological studies needed to detect and manage the virus reservoirs that animals harbor in the wild. This blind spot is significant. Most human diseases have a zoonotic root.

Since January 2020, many research groups have struggled to identify the reservoir and possible intermediate hosts of SARS-CoV-2. As Wuhan’s live meat markets were quickly cleared after the outbreak was recognized, host identification became a potentially impossible task.  A coronavirus closely related to SARS-CoV-2 had already been identified in a horseshoe bat in Yunnan, and subsequent analysis revealed that multiple lines of pangolin harbored a coronavirus similar to SARS-CoV-2. The rush to find possible host animals for SARS CoV-2, however, is diverting attention to preparing for actions to prevent further such outbreaks of the next “X” virus. During the SARS outbreak of 20o3-4, frightened governments killed large numbers of masked palm civets (Peguma larvata), a small mammal mistakenly thought to be the source of the infection. Subsequent ecological research traced the virus to fruit bats, but no effort was made to safeguard bat health and habitats.

The urgent search for a “culprit” for SARS-CoV-2, or the massive global effort to find a vaccine for COVID-19, distracts attention from building effective government systems to manage zoonotic diseases. The virus has been found to reside safely in an endangered species, the pangolin (order Philidota), which is illegally caught and traded throughout Asia. The IUCN classifies the pangolin as endangered. Many have sought to blame SARS-CoV-2 on the Pangolin and make it a scapegoat, as happened with the Civets. But this response does a disservice to both animals and people. Instead of reacting to crises, we need to maintain constant surveillance of wildlife to understand their habits, protect the natural areas where they live, and ensure wildlife health…for the sake of protecting human health.

In the midst of COVID-19, it is becoming clear that new governmental systems are needed to manage the super-interface between multiple wildlife species, domestic animals, and humans. See N.A. Robinson and C. Walzer, “How Do We Prevent The Next Outbreak?”, Scientific American (March 25, 2020), at https://blogs.scientificamerican.com/observations/how-do-we-prevent-the-next-outbreak/ . Human-animal “linkages” exist in many agricultural contexts with domestic animals, as well as in animal markets and consumption patterns in China and other Southeast Asian countries, Africa, and elsewhere. They exist when humans bring “development” to the forests of the Amazon or the Congo, or in their own years. While governments ignore zoonotic diseases, “nature” does not stand still. Viral systems continue to function, and viruses may even evolve. Relationships between humans and animals allow viruses to seek out new hosts, expand their range, and spread disease.

When humans travel, they spread the coronavirus. Humans are now infecting each other. Covid-19 has spread rapidly around the world, even as public health officials work overtime to detect, track, isolate and treat new cases.  Scientific papers on this coronavirus are being published with unprecedented speed. Government labs and pharmaceutical companies are working around the clock to find a vaccine for this virus. Recovery for millions of sick people is slow and problematic. Human deaths are tragic. No nation is spared.

The economic cost of this pandemic continues to rise. As early as February 11, 2020, the head of the U.S. Central Bank (the U.S. Federal Reserve), Jerome H. Power, noted the “disruption in China that is impacting the rest of the global economy.” Virtually all factories and commercial systems have been shut down to prevent the spread of the virus. Unemployment is at a record high. It will take a few years to repair the disruption to global trade. Past coronavirus outbreaks have been costly. In 2003, SARS spread to 29 countries and cost $40 billion. In 2014, Ebola cost $54 billion, and its spread beyond Africa was prevented in large part by U.S. contributions of $2.34 billion in personnel and equipment. The human and economic costs of COVID-19 continue to be accounted for. In March 2020, the U.S. Congress enacted a $2.2 trillion fiscal stimulus bill, the Coronavirus Aid, Relief, and Economic Security (CARES) Act, designed to offset losses to businesses and households in hopes of easing the economic recession. Even when passed, the CARES Act proved insufficient. Additional funding is needed in the United States to support the operations of state and local governments. Similar economic crises have occurred in countries around the world. There is an economic pandemic that corresponds to the health pandemic.

Virtually no funding – in the U.S. or elsewhere – is provided to address zoonotic diseases, or to provide resources for essential long-term ecological studies and to restore and maintain healthy habitats for wild animals and their associated viruses. Virtually no funding is devoted to international cooperation in this area. Are we getting our money’s worth? Governments pay a lot of money to try to find a vaccine, but not to prevent the disease in the first place.

Instead of initiating scientific studies on the environmental origins of COVID-19, political, social and even governmental authorities are jumping at the chance to launch conspiracy theories or “blame” each other for not acting soon enough, or conjure up fanciful ideas and possible stories about the new coronavirus and how it so mysteriously appeared in humans. Despite the countless impacts of COVID-19, ignorance about this coronavirus abounds.  The WHO has referred to the spread of misinformation as an “infodemia.” It is going viral, spreading on social media like a virus!  Social media amplifies misinformation. We should all know better. The WHO estimates that 61% of all viruses that infect humans come from animals. This phenomenon is a “zoonosis”. The WHO finds that 75% of new diseases in the last decade are zoonotic.

It is essential to educate humans in all communities, worldwide, about the fact that zoonotic spillovers are not one-time events found only in distant countries. They exist in both South and North America, Asia and Africa, Europe and Eurasia, in fact everywhere. Humans ignore and fear a large number of diseases, without knowing their zoonotic origins: rabies, West Nile virus, plague, Zika, dengue, Chikungunya, salmonellosis, hantavirus or Lyme disease. Humans try to avoid these zoonotic diseases. Lyme disease, which is transmitted from small mammals and birds to humans, is just one of many tick-borne zoonotic diseases in North America. Mosquitoes infect humans with Zika and other diseases from a large number of potential animal reservoirs. Zika does not yet have a vaccine, and its range is expected to expand as warmer winters no longer freeze mosquito populations. Climate change makes it all the more urgent to take steps to restore and maintain the health of wild ecosystems everywhere.

Zoonotic viruses are widespread in the animal kingdom. What can we do to prevent infection by the next coronavirus? What would we give today to avoid the HIV/AIDS pandemic, a lentivirus that has been traced to human contact with infected chimpanzees and sooty mongooses in West Africa?  The SARS epidemic in 2002 began with human contact with a mammal, the civet cat, which bats had infected with the coronavirus.

Ben Franklin advised in 1736 that “An ounce of prevention is worth a pound of cure”. Don’t we all wash our hands often to avoid contact with viruses? Doesn’t our global society need to do even more for the “germs” that plague us? Viruses, which inhabit wild animals, infect domesticated animals and likewise livestock diseases can decimate the last remaining wild animal populations. African swine fever is now wiping out pig production throughout Asia and threatening farms in Europe and North America. For the highly endangered wild pig species in Southeast Asia, this virus could be the final straw. Avian flu is decimating chickens and can infect humans. Much of the world still lacks global health standards for the production and trade of animals and animal products. Large-scale urban consumption of wild animals has no standards and can never be considered healthy and safe.  Humans everywhere are at risk.

What is needed is a more widely understood and accepted vision of environmental justice.  Animal welfare and animal rights are not a separate legal domain. Recognition of the rights of nature is not a unique jurisprudential quest. The field of public health and ensuring water for all through the application of human rights is not isolated from the broader field of the environment.  They are facets of holistic justice. The Normandy Chair for Peace’s challenge is to make this unity clear, and to understand through research and analysis how it works, or is prevented from working.

The COVID-19 pandemic highlights this unity. Only by adopting a “One Health” approach for humanity to care for the Earth’s natural environment can each country defeat the SARS-CoV-2 virus and avoid or mitigate the next viral infection, which is lurking around the corner.

To prevent epidemics, humans must work to prevent pathogens from leaving the animal kingdom in the first place.  What should be done? There are prescriptions for a “One Health” approach to environmental management. Ironically, they were unveiled in 2019, on the eve of the COVID-19 pandemic.

In October 2019, the Wildlife Conservation Society and the German government recommended strong action to strengthen global health. The Berlin Principles for “One Planet, One Health, One Future” outline ten practical steps, prescriptions for healthy communities. Governments at all levels should consider these guidelines. They can be found at https://oneworldonehealth.wcs.org/About-Us/Mission/The-2019-Berlin-Principles-on-One-Health.aspx . The first principle is clear: “Maintain the essential health links between humans, wildlife, domestic animals and plans, and all of nature. By adhering to the Berlin Principles, communities can better “integrate the understanding of human and animal health with the health of the environment.”

On April 2, 2020, German Federal Environment Minister Schulze stated that once the emergency phase of the pandemic is over, “there will be a post-pandemic world. By then, at the latest, we must have understood the causes of this crisis, so that we can better prevent a similar scenario in the future. Science tells us that the destruction of ecosystems makes the occurrence of diseases, including pandemics, more likely. This indicates that the destruction of nature is the underlying crisis of the coronavirus crisis. Conversely, it means that a good nature conservation policy that protects our diverse ecosystems is a vital preventive health care measure against new diseases.” Environmentalists and international organizations such as the Convention on Biological Diversity (CBD), the International Union for Conservation of Nature (IUCN), the United Nations Environment Programme (UNEP), and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) have a role to play in defining the steps governments will need to take to implement this “One Health” approach.

As post-pandemic governments seek to avoid the “next” pandemic, they will also find additional guidance for taking a multisectoral, “One Health” approach to zoonosis. Also on the eve of the COVID-19 pandemic, in March 2019, the World Health Organization, the Food and Agriculture Organization of the United Nations, and the World Organization for Animal Health issued guidelines similar to the Berlin Principles. They are contained in a book, “A Tripartite Guide to Addressing Zoonotic Diseases in Countries” https://extranet.who.int/sph/docs/file/3524 . This guide reinforces the consensus that all nations reached in 2015, in the United Nations Sustainable Development Goal 15: “Protect, restore and promote the sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss.” Until SDG 15 is achieved, the human world will be at greater risk of zoonotic diseases. As the International Union for Conservation of Nature (IUCN) has made clear since 1948, nature conservation is essential. Although maintaining the Earth’s natural environment is among the most important responsibilities of governments, too many economies treat this role as an “externality. If such ignorance could be excused before now, after the COVID-19 pandemic, it would be the height of irresponsibility. There is only one “health” on the whole earth.

Now, and certainly after the pandemic subsides, there is no need to wait for the UN or regional government to act. As René Dubos advised, “Think globally and act locally”.  The Normandy Chair for Peace can encourage action and research in this direction. City parks, wetlands, woods and backyards are home to animals. At the local level, in Normandy and around the world, steps can be taken to restore and maintain healthy local ecosystems to avoid disease release. For example, to keep West Nile virus at bay, local mosquito populations must be managed in a very precise and permanent manner. Waiting for a disease to infect a human being before acting is too late. Reacting then by blasting pesticides on flora and fauna is a “biocide,” in Rachel Carson’s words, which is also ineffective and can increase susceptibility to disease. Provincial and local governments should support strong and ongoing enforcement of environmental laws that protect endangered species, such as the pangolin, and should ensure humane care for domestic animals and animals raised for the market. In doing so, they also protect us.

Much can be done to advance “One Health.” Any environmental impact assessment (EIA) should strive to advance the health of nature to the greatest extent possible. Too often, governments completely ignore their EIA duties. The regression in environmental protection that we are experiencing in many countries, as Michel Prieur has wisely warned, must stop. If we continue to regress, mankind will suffer as we are currently doing with COVID-19.

“One Health” studies must teach how to respect nature and manage our exposure to zoonotic diseases. For example, park and wildlife managers at all levels of government are as essential to our public health as are hospitals and doctors, or police and security services. They must be funded accordingly. To avoid the next epidemic, governments at all levels should create and increase cross-sector funding to improve health through environmental investments. Such investments nourish us in many ways. John Burroughs, a beloved 19th century naturalist in New York City, where I live along the Hudson River, summed up a “One Health” approach to peace with the Earth in these words:

“I go into nature to be soothed and healed, and to have my senses put in order.”

Healing Nature heals us. 

Nicholas A. Robinson *

* Professor Nicholas A. Robinson joins Tony Oposa as a Distinguished Scholar in the Normandy Chair for Peace. Tony Oposa as Distinguished Scholar in the Normandy Chair for Peace. He is the Executive Governor of the International Council of Environmental Law and is Kerlin Distinguished Professor of Environmental Law at the Elisabeth Haub School of Law at Pace University (New York).