Evaluating Global Health Priorities: Endemic Pathogens Versus Emerging Outbreaks in LMICs

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Data Quality: STRONG
Summary of  Scientific Reports https://doi.org/10.1038/s41598-025-22573-3 
Dr. Ryan James Walker  et al.

Points

The study utilized a mixed-methods Delphi approach to gather insights from over three thousand health experts across one hundred fifty-one countries regarding infectious disease priorities.
Participants identified the expansion of existing endemic conditions like malaria and tuberculosis as a more pressing global threat than the emergence of novel viral outbreaks.
Rising global temperatures and shifting precipitation patterns were cited as primary drivers facilitating the geographic spread of mosquito populations and other disease vectors.
The research highlights how socioeconomic inequality and antimicrobial resistance compound climate factors to create a slow-moving humanitarian crisis in low- and middle-income nations.
Authors advocate for immediate investment in diagnostic infrastructure and surveillance systems to mitigate the escalating burden of these known pathogens on fragile health economies.

Summary

This two-step, mixed-methods adapted Delphi study assessed global perceptions regarding the escalation of infectious diseases, utilizing data from 3,752 health professionals across 151 countries. Notably, 86.9% of participants were based in low- and middle-income countries (LMICs), ensuring representation from regions with the highest disease burdens. The methodology comprised an initial online survey of 3,700 respondents followed by structured thematic workshops with 169 participants in Africa, Asia, and Latin America to explore the drivers of disease prioritization and health system strain.

The analysis revealed a consensus that the primary threat to global health is the escalation of existing endemic diseases rather than outbreaks of novel pathogens. While survey respondents initially highlighted tuberculosis as a major concern, workshop participants emphasized the rapid expansion of vector-borne diseases, particularly malaria and dengue, alongside HIV/AIDS. This prioritization reflects a “creeping catastrophe” model where established pathogens expand into new geographies due to changing environmental conditions, rather than presenting as sudden, acute pandemic events.

Three synergistic drivers were identified as central to this escalation: climate change, socioeconomic inequality, and antimicrobial resistance. Rising temperatures and altered precipitation patterns are expanding vector ranges and breeding sites, while drug resistance undermines treatment efficacy for established infections. The authors conclude that without targeted investment in diagnostics and surveillance for these known infectious diseases, particularly in resource-limited settings, health systems face a compounding humanitarian crisis driven by environmental and social determinants.

Link to the article: https://www.nature.com/articles/s41598-025-22573-3

References

Walker, R. J., Kingpriest, P. T., Gong, J., Naisanga, M., Ashraf, M. N., Roberti, J., & Lang, T. (2025). Global perspectives on infectious diseases at risk of escalation and their drivers. Scientific Reports, 15(1), 38630. https://doi.org/10.1038/s41598-025-22573-3