Over the COVID-19 years, Dr. Van Kerkhove was among the most famous experts worldwide in this regard, appearing almost daily to clarify the pandemic's developments and ways to contain viral mutations.

After a period of relative calm, she spoke to Ahram Online about future expectations and important measures that should be taken to be prepared if another pandemic appeared.  

Ahram Online: What is the current situation regarding COVID-19 rates of infection?

Maria Van Kerkhove: Things are much better than they were during the years of the pandemic, but we must not forget that COVID-19 has claimed the lives of seven million people.

These are the numbers we received from 194 member states of the WHO, noting that estimates indicate that the number of deaths may be three times more.

Despite the accumulated experience and the availability of medicines and vaccines, the information we received from only 34 countries indicated that COVID-19 causes 4,000 deaths per month. Therefore, it is necessary not to forget what we have been through and to be more prepared for the next pandemic.

AO: When a future pandemic might happen?

MK: Any time! and that is the thing we should be prepared for.

We are in a constant state of readiness for influenza and its massive epizootic that we have seen with H5N1 virus around the world, new animal species being infected spilling over to human populations.

We have to be prepared; we have to change this narrative that we are just fighting fires. 

AO: To what extent can war zones cause epidemics?

MK: To answer your question, we must differentiate between spillover, emergence, and amplification. 

If we are talking about the emergence of pathogens, this can happen anywhere in the world. This idea that it can only happen in some far-off place is a false sense of security.

Many of the pathogens are zoonotic, so we look at where there is lots of biodiversity with animals that is why it is important to use the one health approach by linking humans, animals, and the environment.

One Health can help to address the full spectrum of disease control – from prevention to detection, preparedness, response, and management – and contribute to global health security.

We are collaborating in that regard with several agencies like the FAO, UNEP, and the World Organization for Animal Health (WOAH).

Certainly, when you have areas of displaced populations that have lower access to clean water, healthcare, poor nutrition, and bad hygiene, you could certainly have propagation and amplification of these pathogens.

That is why the polio campaign in Gaza was so critical. Every human life is precious, and we need to support them in all of the different aspects of what they face. 

Certainly, the work on pandemic preparedness, readiness, and response is getting harder because of war, displaced populations, climate change, the changing politics, and the winds of that. I think our work is getting harder.

That is why that pandemic treaty is very important. The binding agreement that they are discussing transcends politicians. It is about a collective commitment that we all share this planet and that we have to work together. 

AO: Why certain countries do not want to invest in pathogens surveillance?

MK: I think that is because of the politicization that we have seen during the covid pandemic, and the example of countries like South Africa reporting variances of SARS-COVID then immediately having travel restrictions twice.

Those are real-life consequences that have an economic impact on a country. I believe that the amendments to international health regulations will strengthen the reporting; all member states agreed to that thought it is not in effect yet.

That will put us in a better situation in terms of global health security. I do not think we should not sugar quote the challenges of surveillance and the financing for that. Transparency and collaboration are necessary for the world to be safe.

Pathogens do not respect borders. Just because a pathogen has been identified in a country does not mean that it came from it. What we want to get to a point that we have better surveillance in animals and animal human interface.

We have stronger laboratories for biosafety and biosecurity because no country wants to have a breach of these pathogens that may be harmless to animals, but if it does spill over into a human and amplifies, it creates a real threat.

AO: What are the current updates of the “pandemic treaty” negotiations?

MK: I think the member states are taking positive steps. There is much more common ground than there ever has been.

In general, the negotiations in the room are in good faith, and from what I witness, they are driven by the member states and their determination to get this done.

They want to make sure that it is long-lasting and that the COVID-19 pandemic is meant to be future-proof. I am quite hopeful that they will reach a consensus on the treaty by May 2025.

AO: Some voices have criticized the agreement as unapplicable or does not ensure equitable access to vaccines. What is your comment?

MK: That is specifically why member states are taking time and are revising the pathogen access and benefit sharing system (PABS) for sharing data and biological samples on pathogens in exchange for  benefits like new treatments, diagnostics, and vaccines.

That is what they are discussing now. Certainly, there are differences between member states. I really do feel — whether we are talking north or south, developing or high-income countries — the understanding that there will be some certainty in this information being shared so that risk assessment could be done regularly. This is a global good as well.

Member states are making sure that the wording in it is realistic, actionable, and implementable in legal aspects as well as in technical and public health and multilaterals.

No one wants to have a treaty that is useless. I believe that the treaty is a massive step forward, and we cannot be in a situation like we were during the COVID-19 pandemic.  

AO: This year we witnessed 77 elections around the world, to what extent it will impact global health policy or lead to a failure in reaching an agreement? 

MK: Of course they will have an impact, but as a technical person in the WHO and a public health professional I see no room for failure.

We cannot continue with the same approach and mechanisms of work as we did during the COVID-19 pandemic. We have to cross that bridge if we come to it. I have full expectation that the member states will reach an agreement on the pandemic treaty. 

AO: What other mechanisms does the WHO have in place to control pathogens emergence?  

MK: We do have the pandemic influenza preparedness (PIP) framework, which the member states agreed upon to utilize during flu pandemic.  

We are also using the access and allocation mechanism (AAM) through the interim medical countermeasures network that the member states ask the WHO to establish with partners each time.

We used this mechanism for mpox medical countermeasures including vaccines, treatments, and diagnostic tests for people at highest risk to ensure that the limited supplies are used effectively and equitably. 

We cannot set it up each time, that is why we need to boost for the pandemic treaty agreement.  

AO: What is the objective of establishing the Pandemic Hub? 

MK: The Berlin Pandemic Hub is part of the WHO health emergencies programme. It is also part of the innovation programme coming from COVID-19 setting up technology transfer.

The hub is looking mainly at different aspects of surveillance and data systems, sustaining some of the work that we have done with supporting member states in the fields of training programmes. 

AO: How do you appraise the role of the media during the COVID-19 pandemic?

MK: The media is a massive ally. During my experience in the last five years with COVID-19 and now with monkeypox and avian influenza, the media has been incredibly helpful in sharing accurate information specially in the context of disinformation and misinformation that is circulating on social media.