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      Epidemisches Versagen: Warum Staaten und internationale Organisationen wiederholt bei der Bekämpfung von Epidemien scheitern Translated title: Epidemic Failure: Why States and International Organizations Repeatedly Fail to Combat Epidemics


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          Warum haben Staaten und internationale Organisationen wiederholt bei der Epidemiebekämpfung versagt? Wir analysieren das Vorgehen währen der Ebolaepidemie und der SARS-CoV‑2-Pandemie. In beiden Fällen erfolgte die Reaktion im Rahmen eines Zyklus epidemischen Versagens (ZEV) mit folgenden Phasen: Vernachlässigung, Arroganz/Leugnung, Panik und Analyse/Selbstkritik. Zentrale Ursachen für den ZEV sind die Ökologie (v.a. die Vernachlässigung von Zoonosen), die Politik (v.a. negative Anreize bei der Epidemiebekämpfung), sozioökonomische Kontexte, die menschliche Psychologie (v.a. kognitive Verzerrungen) sowie erkenntnistheoretische Probleme (v.a. der Rückgriff auf die Erfahrungen früherer Epidemien).

          Translated abstract

          Why have states and international organizations repeatedly failed to successfully respond to epidemics? We analyze the response during the Ebola epidemic and the SARS Cov‑2 pandemic. In both cases, the response occurred within an Epidemic Failure Cycle (EFC) with the following phases: Negligence, Arrogance/Denial, Panic, and Analysis/Self-Criticism. Central causes of ZEV include ecology (especially neglect of zoonotic diseases), politics (especially negative incentives in epidemic control), socioeconomic contexts, human psychology (especially cognitive biases), and epistemological problems (especially recourse to the experience of previous epidemics).

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          Most cited references53

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          Prediction and prevention of the next pandemic zoonosis

          Summary Most pandemics—eg, HIV/AIDS, severe acute respiratory syndrome, pandemic influenza—originate in animals, are caused by viruses, and are driven to emerge by ecological, behavioural, or socioeconomic changes. Despite their substantial effects on global public health and growing understanding of the process by which they emerge, no pandemic has been predicted before infecting human beings. We review what is known about the pathogens that emerge, the hosts that they originate in, and the factors that drive their emergence. We discuss challenges to their control and new efforts to predict pandemics, target surveillance to the most crucial interfaces, and identify prevention strategies. New mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease. We lay out a series of research and surveillance opportunities and goals that could help to overcome these challenges and move the global pandemic strategy from response to pre-emption.
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            Infectious Disease Threats in the Twenty-First Century: Strengthening the Global Response

            The world has developed an elaborate global health system as a bulwark against known and unknown infectious disease threats. The system consists of various formal and informal networks of organizations that serve different stakeholders; have varying goals, modalities, resources, and accountability; operate at different regional levels (i.e., local, national, regional, or global); and cut across the public, private-for-profit, and private-not-for-profit sectors. The evolving global health system has done much to protect and promote human health. However, the world continues to be confronted by longstanding, emerging, and reemerging infectious disease threats. These threats differ widely in terms of severity and probability. They also have varying consequences for morbidity and mortality, as well as for a complex set of social and economic outcomes. To various degrees, they are also amenable to alternative responses, ranging from clean water provision to regulation to biomedical countermeasures. Whether the global health system as currently constituted can provide effective protection against a dynamic array of infectious disease threats has been called into question by recent outbreaks of Ebola, Zika, dengue, Middle East respiratory syndrome, severe acute respiratory syndrome, and influenza and by the looming threat of rising antimicrobial resistance. The concern is magnified by rapid population growth in areas with weak health systems, urbanization, globalization, climate change, civil conflict, and the changing nature of pathogen transmission between human and animal populations. There is also potential for human-originated outbreaks emanating from laboratory accidents or intentional biological attacks. This paper discusses these issues, along with the need for a (possibly self-standing) multi-disciplinary Global Technical Council on Infectious Disease Threats to address emerging global challenges with regard to infectious disease and associated social and economic risks. This Council would strengthen the global health system by improving collaboration and coordination across organizations (e.g., the WHO, Gavi, CEPI, national centers for disease control, pharmaceutical manufacturers, etc.); filling in knowledge gaps with respect to (for example) infectious disease surveillance, research and development needs, financing models, supply chain logistics, and the social and economic impacts of potential threats; and making high-level, evidence-based recommendations for managing global risks associated with infectious disease.
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              Bat Coronaviruses in China

              During the past two decades, three zoonotic coronaviruses have been identified as the cause of large-scale disease outbreaks–Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Swine Acute Diarrhea Syndrome (SADS). SARS and MERS emerged in 2003 and 2012, respectively, and caused a worldwide pandemic that claimed thousands of human lives, while SADS struck the swine industry in 2017. They have common characteristics, such as they are all highly pathogenic to humans or livestock, their agents originated from bats, and two of them originated in China. Thus, it is highly likely that future SARS- or MERS-like coronavirus outbreaks will originate from bats, and there is an increased probability that this will occur in China. Therefore, the investigation of bat coronaviruses becomes an urgent issue for the detection of early warning signs, which in turn minimizes the impact of such future outbreaks in China. The purpose of the review is to summarize the current knowledge on viral diversity, reservoir hosts, and the geographical distributions of bat coronaviruses in China, and eventually we aim to predict virus hotspots and their cross-species transmission potential.

                Author and article information

                Z Außen Sicherheitspolit
                Zeitschrift für Außen- und Sicherheitspolitik
                Springer Fachmedien Wiesbaden (Wiesbaden )
                24 November 2021
                24 November 2021
                : 1-15
                [1 ]GRID grid.424060.4, ISNI 0000 0001 0688 6779, Departement Gesundheit, , Berner Fachhochschule, ; Murtenstrasse 10, 3008 Bern, Schweiz
                [2 ]GRID grid.412559.e, ISNI 0000 0001 0694 3235, Zentrum Psychiatrische Rehabilitation, , Universitäre Psychiatrische Dienste Bern, ; Bern, Schweiz
                © The Author(s) 2021

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                : 17 September 2021
                : 11 October 2021
                Funded by: Bern University of Applied Sciences

                epidemie, pandemie, ebola, coronavirus, epidemic, pandemic


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