When the Global Preparedness Monitoring Board (GPMB) published its first report in 2019, it was in the wake of the West African Ebola epidemic that claimed 11,000 lives. Then came Covid: a monumental upheaval which had a death toll of over seven million and effectively shuttered the world economy. 

In the seven years that have passed since, the GPMB's independent annual report, which is co-convened by the World Health Organization (WHO) and the World Bank, has become an eminent voice in understanding how ready the world is to respond to the next existential threat. And one might expect that lessons had been learnt. 

Yet the GPBM's eighth instalment has revealed this is far from the case: in their 2026 report titled A World on the Edge, experts have revealed we are at greater risk of a pandemic than we were a decade ago. As the world grapples with soaring Ebola deaths in central Africa and a recent hantavirus scare, the question remains: what's gone wrong?

Intertwined factors

Described as "sobering", the report's take-home message is that the knowledge and technical advances made in the post-pandemic years are being systematically undercut. 

While improved vaccines, streamlined diagnostics and the enormous potential of artificial intelligence may paint a positive picture, the starker reality of reduced financing, distrust in health authorities and geopolitical fragmentation has worked to exacerbate pandemic risk factors. Throw in issues of climate change, increased mobility and armed conflict, and you're left with a world on a pandemic precipice. 

Unsurprisingly, these factors are all largely intertwined. The targeting of public health budgets, which have all but collapsed over recent years, have left the world "moving in the wrong direction", say the report's authors. 

Development assistance for health dropped by over $10 billion in 2025, and international aid freezes have led to the rationing of medical countermeasures across more than 50 countries, including antiretroviral HIV drugs, tuberculosis treatments and reproductive health supplies. 

As public health declines, inequalities both within and between countries become entrenched, as vicious cycles of poverty, financial instability and public health insecurity impound the ability to bounce back both economically and socially. 

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A further worrying casualty of these trends includes the erosion of trust and equity "between governments and citizens, among countries, and across multilateral institutions and industry." 

Attributing the decline to today's fluctuating geopolitical stability as well as lingering impacts of Covid-19 responses, the report emphasises trust as the "absolute bedrock" of pandemic prevention, preparedness and response (PPR), and that where such ties break down, the cooperation needed to correct inequities becomes much harder to sustain.

'More frequent and more consequential' 

The disconcerting reality of this convergence of factors is underscored in the report's revelation that "infectious disease outbreaks are becoming more frequent and more consequential", with the world facing a "cycle of accelerating health crises, where each new shock further erodes resilience and widens existing fractures." 

In 2024, the WHO detected almost twice as many health emergency events as in 2015, and despite faster detection likely reducing the proportion of outbreaks that evolve into large epidemics, those that broke still became high-impact events. 

Such concerns are illustrated by the Ebola crisis that is currently gripping the Democratic Republic of Congo. With this outbreak originating in the Ituri province, where more than 100,000 people have been displaced in recent months because of armed conflict, detection and prevention measures have been complicated by compromised health facilities and a lack of medical workers. 

On top of this, access issues, including frequently canceled flights, have hampered efforts to get tests and other supplies to the affected province.

As the DRC still bears the economic and social scars from the epidemic 10 years ago, this latest outbreak will only contribute to the entrenchment of inequalities across the region.  With cases since reported in Uganda, the WHO has called for neighboring countries to implement effective cross-border prevention measures, including track-and-trace initiatives, to both identify and close existing chains of transmission.

Hantavirus measures display localized differences 

Hantavirus, the severe, zoonotic disease that took the lives of three passengers onboard the Dutch MV Hondius in April, is a further example of uneven international cooperation when it comes to disease management. 

Despite a successful repatriation operation of the remaining passengers and crew, starkly different quarantine measures across the recipient countries underscores how prevention quickly becomes localized to national governments. 

To compare, all returning British passengers have undergone testing and other clinical assessments within 72 hours of arriving back home; they are now isolating for 42 days, in line with WHO recommendations, in specialized units.  

The US on the other hand has gone for a more relaxed approach: after a medical evaluation at a specialized quarantine unit, the passengers are free to go home without self-isolating, providing they report to their state's health authorities daily.

The report's authors provide three critical recommendations for an effective shift in global PPR approaches: mechanisms to track pandemic risk; equitable access to medical necessities; and financing for immediate 'Day Zero' action. 

Yet the reality of their analysis remains clear: that while we may be living in a post-Covid world, we are far from post-pandemic.