What We DoIssuesGlobal HealthGlobal Health Resource CenterBeyond Preparedness Metrics: Toward a Global Agenda for Pandemic Risk Assessment
Written by Dr. Cecilia Mundaca Shah & Celynne Balatbat, United Nations Foundation
In 2020, the world learned a painful lesson: pandemic threats are not future hypotheticals – they are unfolding in real time, with new risks emerging faster than ever before. Over the past two decades, the world has faced a steady drumbeat of disruptive outbreaks—SARS, H1N1 influenza, MERS, Ebola, Zika, COVID-19, and mpox. More recently, the resurgence of H5N1 avian influenza and recurring Nipah outbreaks have underscored the growing volatility of the infectious disease landscape. Scientific estimates now suggest that pandemics on the scale of COVID-19 may occur with an annual probability of 2–3 percent—meaning an event of that magnitude could happen again within the next generation.
In May 2025, countries concluded negotiations on the WHO Pandemic Accord, a new international agreement aimed at strengthening pandemic prevention, preparedness, and response through enhanced coordination, equity, and scientific collaboration. The Pandemic Accord includes provisions that call for regular scientific assessments of pandemic risk, underscoring the need for credible, forward-looking frameworks to inform decision-making.
Yet, even with this progress, the world still lacks a coherent way to assess and monitor pandemic threats. While disease modeling, pathogen surveillance, and One Health strategies have advanced, global systems remain fragmented—and largely reactive. What is missing is a robust and sustained scientific effort to understand how risk is evolving, where new threats are likely to emerge, and how this knowledge can inform smarter investment and action.
Too often, pandemic risk assessment is conflated with preparedness metrics or outbreak response systems. But these are fundamentally different tools. While preparedness frameworks measure how well countries can respond to known threats, pandemic risk assessment is about looking ahead—forecasting new threats before they emerge.
Risk assessment focuses on the probability, drivers, and potential consequences of future pandemics. It draws on diverse data—from land use and climate patterns to animal-human interfaces and viral evolution—to estimate the likelihood of a pathogen spilling over, spreading, and causing significant disruption. In doing so, it helps policymakers prioritize surveillance efforts, anticipate resource needs, and implement targeted prevention strategies.
As with climate change, understanding risk is a necessary foundation for effective policy. Without knowing what we’re preparing for, system investments may be misaligned or insufficient. Just as the Intergovernmental Panel on Climate Change provides scientific assessments of climate threats, we need a similarly rigorous and forward-looking process to assess biological threats in our increasingly interconnected and ecologically stressed world.
To help close this gap, the United Nations Foundation, the U.S. National Academy of Medicine (NAM), the Fundação Oswaldo Cruz, and the Global Preparedness Monitoring Board, with support from Pax sapiens and the Skoll Foundation, co-hosted a global workshop in October 2024 to examine the scientific foundations and design considerations for pandemic risk assessment. Building on that momentum, the UN Foundation and NAM convened a follow-on meeting in April 2025 with a smaller group of stakeholders to further explore how a global, science-driven risk assessment agenda could inform future policy frameworks, guide investment decisions, and strengthen pandemic prevention efforts. These conversations have helped surface a shared recognition of the need and have begun to shape a path forward.
The October workshop, held in Rio de Janeiro and titled “Pandemic Risk Assessment and its Intersection with Climate Change: Needs, Opportunities, and Design Considerations,” brought together more than 80 experts and institutional leaders from around the world—spanning disciplines such as virology, climate science, health economics, and global policy.
Participants examined the scientific foundations of pandemic risk, with a particular focus on climate drivers and zoonotic spillover. They explored six core dimensions of risk—including pathogen emergence, transmissibility, and global spread—and identified where the science is already mature and where more research is needed.
The workshop surfaced three clear insights:
These insights have since been captured in a published discussion proceedings and a related commentary by initiative partners. Together, these documents help define a blueprint for action—linking emerging science with the policy imperative to anticipate and mitigate global health threats.
This work comes at a pivotal moment. The recent momentum created by the adoption of the Pandemic Accord offers a pathway to strengthen pandemic prevention at a global scale. At the same time, the lead-up to the 2026 UN High-Level Meeting on Pandemic Prevention, Preparedness, and Response presents a unique opportunity to elevate pandemic risk assessment as a global priority. The work to date can help shape how these provisions are implemented and provide practical pathways for translating science into action.
In the months ahead, there is a need to deepen engagement with technical experts, national representatives, and global institutions. Continued mapping of existing tools and knowledge, identification of user needs, and alignment with relevant policy agendas—such as those of the G20, UNGA, or COP—will be essential. Above all, maintaining momentum and cultivating broad ownership across science and policy communities will determine whether pandemic risk assessment becomes a sustained part of how the world prepares for and prevents future threats.
This is not a call for a new forecasting tool or a duplicative institution. It is a call to align the science we already have, build the systems we need, and ensure that future pandemic preparedness efforts are grounded in a better understanding of where risk is greatest and how it is changing.
To achieve this vision, we need researchers, policymakers, funders, and institutional leaders to come together. Now is the time to invest in the science and systems that can help us detect the next pandemic before it starts—and stop it before it spreads.
Last updated June 30, 2025
Dr. Cecilia Mundaca Shah, the UN Foundation’s Vice President of Global Health Strategy, is a recognized global health expert with extensive experience in health security, pandemic preparedness, and international health policy. With a career spanning leadership roles at the National Academy of Medicine (NAM) and the G20 High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response, she has been instrumental in shaping strategies for global health security, infectious disease surveillance, health systems strengthening, and the integration of displaced populations into global malaria programs. She holds a Doctor of Public Health and Master of Public Health from the Uniformed Services University of the Health Sciences, as well as a Medical Doctor degree from Universidad Nacional Mayor de San Marcos in Peru.
Celynne Balatbat is a Global Health Strategy Officer at the UN Foundation. She supports strategy development, policy analysis, and stakeholder engagement across key issues including pandemic preparedness and response, malaria, and climate and health. Prior to joining the Foundation, Celynne spent nearly a decade at the National Academy of Medicine, where she led initiatives on emerging technologies and helped launch a global research agenda on climate change and health. She holds a B.A. in Neuroscience and Behavior from Vassar College.
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