AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE:THE ROLE FOR INTERNATIONAL LAW IN PREVENTING PANDEMICS.

• Author: Maunder, Britta

I INTRODUCTION

The impacts of a pandemic pervade all segments of society, devastating the global economy, weakening already fragile health systems and ultimately leading to mass mortality. As of November 2021, SARS-CoV-2, the virus that causes the novel coronavirus disease ('COV1D-19') has spread to more than 200 countries and directly led to more than 5,000,000 deaths. (1) The COVID-19 pandemic has demonstrated the inexorable human and economic toll that results from a collective failure to prevent the outbreak and spread of emerging infectious diseases of animal origin.

The outbreak of zoonotic diseases, diseases that originate in animals, is among the greatest threats to global health. (2) Approximately 80% of emerging infectious diseases are zoonotic in origin. (3) Current research overwhelmingly indicates that COVID-19 is a zoonotic disease. (4) Although biodiversity loss, the trade in wild fauna and intensive livestock production constitute the major drivers of zoonoses, international instruments fail to comprehensively and uniformly address these factors in pandemic prevention strategies. (5) The international approach to pandemic prevention is critically fragmented and ineffective. There is no international instrument that has been adopted with the specific object of preventing pandemics of animal origin. (6) Instead, international legal responses are grounded in the language of containment and health system strengthening, to the detriment of upstream or 'first mile' (7) strategies that seek to address the conditions cultivating zoonotic disease. (8)

Although not a panacea, the adoption of an international legal instrument within the public health framework may play a critical role in driving concerted and coordinated action to prevent the next pandemic. This instrument must reflect a multidisciplinary understanding of the drivers of zoonotic disease. This article will outline the rationale for the creation of such an international legal instrument, the current role of international law in prevention strategies and the possible methods of implementation for a novel legal instrument.

Part II of this article will commence by broadly outlining the interconnected roles of the trade in wildlife, intensive animal agriculture and biodiversity disruption in driving zoonotic diseases. Part III will then consider the current role of international law in addressing these underlying drivers of disease. In response to the key shortfalls in the international approach identified in part III, part IV will consider the rationale for a novel international legal approach to pandemic prevention. Furthermore, part IV will cursorily consider two major policy challenges that may underly a new international approach to pandemic prevention, relating to the de-intensification of animal agriculture practices and prohibitions on the wildlife trade.

II BRIDGING THE DIVIDE: A'ONE HEALTH'APPROACH TO UNDERSTANDING PANDEMICS

Since the 1970s, there has been significant growth in the emergence of new human infectious diseases, with an average of one new disease identified every eight months. (9) The common thread shared between most of these novel diseases, that include Severe Acute Respiratory Syndrome ('SARS'), Middle Eastern Respiratory Syndrome ('MERS') and the Ebola virus, is their zoonotic character. (10) As with COVID-19, all these diseases originated in wild animals and eventually spilled over into human populations. A coalescence of anthropogenic factors, including habitat destruction, intensive agricultural practices and the trade in wildlife, are considered the foremost drivers of emerging infectious disease. (11)

The complex interplay between the human, animal and environmental factors driving the emergence and re-emergence of infectious diseases can be understood from a 'One Health perspective. (12) Re-emerging diseases describe those diseases once considered to be major health burdens that subsequently experienced a dramatic decline and eventually, a notable resurgence in specific populations, such as the rubeola virus (measles) and yellow fever. (13) Generally considered to be discrete disciplines, the One Health approach unites epidemiology, conservation sciences and animal health under one umbrella. (14) This approach acknowledges and explores the increasing interplay between the multitude of factors driving human health, animal health and environmental outcomes. (15) In particular, One Health science highlights the manner and degree in which animal health and environmental factors play a pivotal role in effecting global health outcomes. With unnerving prescience, One Health experts have in recent years warned of the increased risks of pandemics associated with the intensification of factors driving disease. The trade in wild animals, intensive animal agriculture and the destruction of habitat are considered the dominant drivers of zoonoses.

1. Wildlife Trade

   The emergence of COVID-19 exemplifies the ways in which zoonotic diseases transcend the fragile biological boundaries separating animals and humans. Although there remains some uncertainty as to the precise evolution of the disease, it is widely accepted that COVID-19 originated in a species of bat, and was likely transmitted to humans through an intermediary host animal. (16) With approximately 70% of zoonotic diseases originating in wild animals, they are considered to be the primary reservoir of zoonotic agents. (17) The first major cluster of COVID-19 cases is linked to a wet market in Wuhan that sold numerous wild and domesticated animal species. (18)

   Wet markets are a major risk factor for emerging infectious disease and are considered 'unique epicenters for transmission of potential viral pathogens.' (19) Both exotic wild animals and domesticated animals sold in wet markets are generally held in confined and unhygienic spaces in close proximity to other species, increasing the risk of inter-species disease transmission through exposure to oral and faecal matter. (20) The acute stress suffered by animals in these conditions is likely to weaken animals' immune systems, thereby increasing their propensity to both harbour and spread disease. (21) Wet markets have also been identified as the genesis for other major disease outbreaks of significant public health concern, including SARS and Influenza A Virus H5N1 (avian influenza). (22) In the case of both the SARS epidemic and avian influenza, the relevant pathogens are believed to have originated in wild animals before being transmitted to humans via an intermediary host animal in a wet market setting. (23)

   Beyond the sphere of wet markets, the broader trade in 'bushmeat' is also considered a major source of zoonotic disease. 'Bushmeat' is a catch-all term describing the trade in wild animals that have been hunted for human consumption. (24) The outbreak of the Ebola virus in humans, which can be traced to the consumption of primates, highlights the risks associated with the bushmeat traded. (25) In spite of the disease risks associated with both wet markets and the bushmeat trade, there remains a degree of hesitance among experts in calling for a global ban. The burden of such a ban may fall disproportionately on communities that rely on bushmeat for food security. (26) Nonetheless, the trade in wild animals is more generally characterised as a lucrative and organised global industry fuelled by wealthy consumers. (27)

   The globalised nature of the illegal trade in wildlife poses significant biosecurity risks. As an example, the demand for bushmeat in Europe has resulted in large quantities being imported on commercial passenger flights to countries such as France and Switzerland. An inspection of bushmeat found on Air France routes found 39% of carcasses to be species listed in the Convention on the International Trade in Endangered Species ('CITES'), in both Appendix 1 (trade banned) and Appendix 2 (trade restricted). (28) The global trade in wild animals is emblematic of the way in which the risks associated with zoonotic diseases readily transcend political borders.

2. Animal Agriculture

   A prodigious appetite for wildlife products is greatly surpassed by human consumption and use of domesticated farm animals. Animal agriculture plays a central role in the emergence of zoonotic diseases, with intensive animal farming systems described as cultivating a 'ready-made disease pool'. (29) The risks associated with the industrialisation of animal agriculture are two-pronged, as modern large-scale farming practices both incubate disease and lead to a critical overreliance on antimicrobial drugs. (30) These intensive conditions, particularly in the case of poultry and pork, can be characterised as highly systematised, concentrated and confined production processes that amplify the risk of disease. (31)

   The density and scale of modern factory farming operations renders it difficult to prevent, isolate and control the outbreaks of disease among farmed animals. Not dissimilar from live animal markets, the severe stress experienced by factory farmed animals in unhygienic and confined conditions serves to compromise the immune system and leads to an increased likelihood of disease emergence. (32) Despite the biosecurity risks inherent in intensive animal agriculture operations, regulatory guidance for disease prevention chiefly frames these risks as external to production processes, rather than embedded within it. Advice is largely directed towards preventing the importation of disease from outside food products, water, animals and machinery into farming operations. (33)

   Outbreaks of disease, including diseases that have not spilled over into human populations, can result in devastating and widespread economic impacts. (34) In 1998-9, the Nipah Virus ('NiV') outbreak in Malaysia lead to the deaths of 105 people and the near nation-wide collapse of the billion-dollar pig farming industry. (35) Similarly, the...