Antoine Flahault advocates vaccine use as epidemics face gaps

Global pandemic preparedness faces persistent gaps between acute health crises, marked by opaque state reporting in Siberia and funding shortfalls at the World Health Organization. Public health analysts note that while governments generally respond effectively to immediate emergencies, routine prevention and intercrisis investments remain neglected.

Fatal laboratory case in Siberia highlights state opacity

Local authorities in Siberia initially announced a suspected case of plague following the death of a 28-year-old laboratory technician. The Russian federal government subsequently denied the diagnosis entirely. The episode underscores the ongoing opacity of states regarding public health threats and points to a lack of independent international inspection mechanisms comparable to the International Atomic Energy Agency in the nuclear sector.

Democratic Republic of Congo battles Ebola outbreak in Ituri

The Democratic Republic of Congo is managing its 17ᵉ Ebola epidemic, driven by the Bundibugyo strain. Officials have not yet confirmed any specific treatments or vaccines for this strain. Armed conflicts in Ituri, resistance to safe burial practices, and attacks on medical teams continue to hamper the public health response.

Antoine Flahault advocates for the immediate compassionate use of the Ervebo vaccine, which was originally developed for the Zaire strain. This deployment would follow a ring vaccination strategy targeting direct contacts and secondary contacts, an approach now supported by the World Health Organization and Africa CDC.

Global health governance confronts funding and structural strains

The withdrawal of the United States has cost the World Health Organization 20 % of its budget and stripped the agency of historical scientific and methodological leadership, embodied by the CDC. The Gates Foundation has consequently emerged as the organization’s primary financial contributor. Meanwhile, the ratification of the global pandemic agreement adopted in May 2025 remains on hold pending the negotiation of its annexes.

Geneva-based institutions continue to anchor international health cooperation. UNAIDS relies on an inclusive governance model involving civil society and affected populations, submitting its strategy every five years to the United Nations General Assembly. The broader Geneva ecosystem, encompassing more than 350 organizations including the World Health Organization, the Global Fund, GAVI, MSF, and the Red Cross, has helped double global life expectancy over the past 80 years.

Historical cooperation demonstrates path forward

Past diplomatic tensions have not entirely blocked health breakthroughs. In 1958, the USSR of Khrushchev proposed a global smallpox eradication program at the World Health Assembly. Despite initial skepticism, the initiative succeeded twenty-two years later, aided by American epidemiologists who deployed ring vaccination campaigns in India.

Definitions of disease control and prevention

Public health strategies divide disease management into three distinct categories based on viral circulation and public health goals:

• Eradication represents the permanent global disappearance of a pathogen, achieved for smallpox in 1980 and approached by polio, which persists in foyers at the Afghan-Pakistani border due to regional conflicts.
• Elimination defines the halt of pathogen transmission within a specific territory, such as polio in Europe or measles in the Americas prior to the rise of vaccine hesitancy.
• Control aims to protect vulnerable populations and prevent hospital overcrowding, as seen with seasonal influenza and Covid-19.