Grappling with (re)-emerging infectious zoonoses: Risk assessment, mitigation framework, and future directions

Abstract

Low-income countries (LICs) in Africa, southeast Asia, Latin America, and the Caribbeans constitute potential hotspots for future outbreaks of infectious zoonoses. A comprehensive framework on risk drivers, assessment, and mitigation in LICs is lacking. This paper presents the nature, history, risk factors, and drivers of zoonoses in LICs. A Quantitative Microbial Risk Assessment and Hazard Analysis of Critical Control Points are proposed for assessing human health risks. The mitigation framework entails: (i) learning from the COVID-19 pandemic, (ii) the precautionary principle, (iii) raising public and stakeholder awareness, and (iv) the One World, One Health concept. Future perspectives are discussed on: (i) curbing poaching and illicit wildlife trade, (ii) translating the ‘One Health’ concept to practice, (iii) the dilemma of dealing with wildlife hosts of zoonoses, including the morality and ethics of culling versus non-culling, (iv) the challenges of source tracking and apportionment of zoonoses, and (v) decision-making scenarios accounting for the high human health risks and the high uncertainty in current evidence. Future directions on zoonoses include: (i) the occurrence of antimicrobial resistance, (ii) environmental reservoirs and hosts, (iii) the development of tools for source tracking and apportionment, and (iv) host-receptor-pathogen interactions. Funding models and the application of novel tools, i.e., game theory, genomics, shell disorder analysis, and geographical information systems are also discussed. The proposed framework enables a better understanding of the key risk drivers, assessment, and mitigation in LICs. Further work is needed to test and validate the framework and develop generic lessons for risk assessment and mitigation in LICs.