The world is now on the brink of the abyss. These are the conclusions of the WHO report entitled “A world on the brink of the abyss”. Behind this strong image is the fracture of public trust and the breakdown of collective action to address inequalities, factors that will leave countries around the world more exposed to the severe and inevitable health, social and economic impacts observed during the latest pandemic.
But why so much pessimism? The report photographs some alarming situations, such as the fact that global preparedness is failing to keep pace with the risk of a new pandemic and that political attention is directed elsewhere and is not thinking about collective health.
COVID-19 was not an isolated event: the pandemic risk
The World Health Organization opens the report by recalling that COVID-19 was not an isolated event, but the result of converging global trends that increase the risk of pandemics.
Among these he cites climate change, increased mobility and armed conflicts.
We are not totally clueless, we have the technologies to respond to a pandemic or to diagnose other health emergencies in time, but, they write:
Their enormous transformative potential risks being compromised by disinformation (…) in parallel, growing geopolitical fragmentation, nationalism and commercial interest are weakening collective action.
It is these elements that together have weakened trust in international organizations such as the WHO or, more generally, in approaches to medicine and therapies, including vaccination ones.
And it is this lack of trust that could be at the root of a new epidemic.
The world is not safe
Faced with health emergencies, the world is not safe. The report shows that:
- infectious disease epidemics are becoming more frequent and more severe in terms of the number of cases and deaths due to the changing risk landscape (agricultural practices, livestock practices, climate change and urbanisation);
- the short and long-term economic impacts of health emergencies are increasing and are leading to important structural changes in economies;
- timeliness and access to medical countermeasures have decreased;
- investments in emergency preparedness have decreased;
- many societies have emerged from serious health emergencies poorer, more unequal and more divided.
All of these elements suggest that “preparation efforts are being overtaken by new and more complex stressors.” The consequences could be more frequent, disruptive and difficult to manage health emergencies in a world that is more vulnerable, more uncertain and characterized by declining trust, as well as growing inequalities.
10 years of health emergencies
If we think about the last decade, only one major health emergency comes to mind, that of the COVID-19 pandemic. Yet, if you start mentioning the other cases that have occurred, concerns about Ebola, the Zika virus and many others come to mind.
There have been six public health emergencies of international concern from 2014 to 2025, namely:
- the Ebola epidemic in West Africa, where 11,000 people died due to weak health systems and delayed international intervention (8 August 2014 to 29 March 2016);
- the Zika virus epidemic, which resulted in thousands of children born with disabilities such as microcephaly, brain and eye abnormalities, and developmental delays (February 1 to November 18, 2016);
- the Ebola epidemic that caused 2,300 deaths (from July 17, 2019 to June 16, 2020);
- the COVID-19 pandemic (from January 30, 2020 to May 5, 2023);
- monkeypox in multiple countries (July 23, 2022 to May 11, 2023);
- monkeypox (from 14 August 2024 to 5 September 2025).
The effects of epidemics
The impact of health emergencies can be very large and difficult to analyse. This is why the WHO has divided it into health and economy, society and politics. From a health point of view, today the world is better prepared than in the past to face health emergencies, but the improvements are still limited.
The economic impact, however, is worsening and follows the trend of the worsening of epidemic events, which are becoming more serious and lasting over time. We don’t talk so much about economic shock, because countries have the potential to recover quickly; no, the most worrying thing is long-term structural changes, such as changes to trade models, fiscal deficits and widening inequality.
From a social point of view, for example, in Italy we are still paying for the decrease in jobs due to COVID-19, which has had a greater impact on young people and female employment.
Finally, the COVID-19 pandemic has also had a serious impact on press freedom, reducing it globally. These are all elements that tell of the structural deficiencies that have not been remedied even following the most serious pandemic event we have experienced in recent history, namely the COVID-19 pandemic.
What worries the WHO, which raises the alarm, is how health emergencies can erode the work done so far and the democracies themselves, because these have direct consequences on the preparation for the next pandemic, including weakened institutional trust, reduction of space for civil society and contraction of investments for more effective preparation.
