Pandemic planners are, as is their wont, panicking. Specifically, they are worried that, in spite (or, indeed, because) of the Covid-19 pandemic, the global community remains as unprepared as ever for a similar event.

According to Clare Wenham, a well-known professor of global health policy at the LSE, the world “had the biggest pandemic of our lifetimes, and we’re worse prepared than we were when we went in”. One reason for this is that the World Health Organisation’s (WHO) Pandemic Prevention, Preparedness and Response Accord talks have stalled over lower and middle income countries’ (LMICs) concerns about pathogen sharing. Given that these sorts of sharing schemes are crucial to the “preparedness” agenda, this delay has therefore brought members of the pandemic planning community to express grave concerns about its future.

While such questions of equity between the Global North and South are inevitable, it is frustrating that they continue to dominate pandemic planners’ attention at the expense of the more fundamental problems afflicting the agenda of pandemic preparedness.

As an agenda, it is a couple of decades old, dating back to the late 1990s when fears about the possibility of bioterrorism crystallised in policymakers’ minds. It is underpinned by what the medical anthropologist Andrew Lakoff describes as a vision of the “future in which outbreaks of novel diseases continually threaten human life, but catastrophe may be averted if such events are detected and contained in their earliest stages.”

For proponents of pandemic preparedness like Wenham, the threat of infectious disease with devastating epidemic potential is ever looming. In their minds this justifies, among other things, investment in expansive, real-time global disease surveillance systems (involving the pathogen-sharing mentioned above) and a relentless obsession about “the next pandemic” (note that since Covid-19, we have been treated to cycles of fear over monkeypox and now avian influenza).

This sort of monomania, however, is both irrational and pernicious. A recent analysis by academics at the University of Leeds reviews the evidence base that organisations like WHO, the World Bank, and the G20 have used to justify the preparedness agenda and finds that they systematically exaggerate the threat of outbreaks of epidemic potential. In particular, the authors find that these organisations over-estimate the historical burden of epidemic disease, and they fail to properly account for the impact that improvements in disease-surveillance technologies (such as rapid diagnostic tests) have had on our perception of the frequency of such disease events.

These distortions are not benign. For one thing, they risk drawing attention and financing away from health concerns that, despite being less theatrical, need them more. This includes things like the burden of endemic diseases like malaria and tuberculosis or the lack of access to clean water, healthy food, and staples like insulin and penicillin in many LMICs. What’s more, they may reinforce the tunnel vision that made the damaging lockdown-till-vaccine policies possible. If our pandemic planning systems are narrowly focused on infectious disease and are primed to treat every detected outbreak as the possible “next pandemic”, then we are set to be trapped in nauseating cycles of hysteria without ever getting the humane, reasonable public health responses that we need.

To learn from our Covid-19 experience and avoid repeating the same mistakes in future, it is now essential that pandemic planners look beyond pathogen-sharing to critically reexamine the assumptions and policies making up their “preparedness” agenda. Only then will we avoid the mistakes of 2020.