Comment
Offline: The origins story—towards a Deep Ecology
Whatever the precise origins of SARS-CoV-2, one doesn’t
have to wait for the definitive source of COVID-19 to be
identified before important lessons are learned—lessons
that the global health community presently seems to
be ignoring. There are four immediate priorities. First,
countries must strengthen public health surveillance
to deliver a globally robust early warning system for
pneumonias of unknown aetiology. The Independent
Panel for Pandemic Preparedness and Response, chaired
by Helen Clark and Ellen Johnson Sirleaf, made this
recommendation in their May, 2021 report to the World
Health Assembly. They also recommended that WHO
should be empowered to investigate suspected outbreaks
with pandemic potential in all countries at short notice;
that declarations regarding public health emergencies
of international concern should be based on the
precautionary principle; and that WHO’s IHR Emergency
Committee should be more transparent. Progress on
these proposals has ranged from slow to non-existent. A
$100 million “hub” for pandemic intelligence has been
established in Berlin. A first meeting to discuss possibilities
for an international treaty on pandemic preparedness
concluded in December, 2021. But there is little sense of
urgency. The glutinous bureaucracy of global health once
again threatens to dampen any impetus for action.
*
A second lesson concerns the divisive debate around the
origins of SARS-CoV-2. Accusations thrown at countries,
institutions, and individuals have harmed conditions for
trusted cooperation among scientists and governments.
Yet a productive environment for collaboration is an
essential prerequisite if we are to improve our collective
response to a future pandemic. The confrontational
approach taken by some politicians, policy makers, and
journalists has poisoned the atmosphere for cooperation.
China has been a particular target for criticism. It is
sometimes hard to be a friend of China when one
examines the long list of concerns levelled against
the government—the plight of Uighurs in Xinjiang;
repression of freedoms in Tibet; military manoeuvres
over Taiwan; Hong Kong’s fearsome National Security
Law; quadrupling of the country’s nuclear stockpile by
2030; and the assertive erasure of criticism of officials
from an already constrained public sphere. But without
in any way wishing to diminish those concerns, our
shared future health security depends on the full and
welcome participation of all countries, including China, in
cooperative international efforts to respond to pandemic
dangers. Now is not the moment to blame China over the
origins of COVID-19. On the contrary, now is a moment
to strengthen our solidarity with China in the face of a
common global threat. Third, the debate over a laboratory
leak has had at least one positive outcome. It has focused
a spotlight on those laboratories that are authorised to
handle some of the world’s most dangerous pathogens.
It is no exaggeration to say that these laboratories exist in
an almost complete vacuum of regulation. There should
be swift action to create an independent inspection
regime for the 59 Biosafety Level 4 laboratories spread
across 23 countries in the world today—in Europe (25),
North America (14), Asia (13), Australia (4), and Africa
(3). Alarmingly, only a quarter of nations hosting these
facilities score highly on measures of biosecurity.
*
Finally, there are lessons for One Health—the linkages that
exist between human and animal health. SARS-CoV-2
is most likely the product of ecological conditions that
our species has created. Our numbers, density, and
connectivity. And specifically our interactions with
animals, interactions that are growing as the climate crisis
diminishes the availability of resources, so forcing people
and animals to occupy increasingly crowded spaces. Just as
an appreciation of the importance of climate to health has
triggered an environmental turn in global health, so the
pandemic should precipitate an ecological turn. The living
conditions of organisms interacting with one another and
their surroundings will be critical for improving pandemic
preparedness. And here the writings of Arne Naess might
be informative. Naess was a Norwegian philosopher
who died in 2009. He coined the term Deep Ecology to
represent a view of the biosphere that emphasised the
intrinsic value of both human and non-human life. It’s
a Deep Ecological turn that we urgently need today—a
radical transformation in our conception of health,
habitat, and humanity. The most important lesson of all.
Richard Horton
richard.horton@lancet.com
www.thelancet.com Vol 399 January 8, 2022
129