Pandemic preparedness-political perspectives.

Pandemic preparedness is explored for the antibiotic resistance crisis and the threat of a next viral pandemic. Bacterial pathogens escaping from control by antibiotics are well defined, and resistance develops over decades while a next viral pandemic occurs suddenly with a novel virus. The death toll for resistant bacterial infections is reviewed, and the scientific and economic hurdles to the development of new antibiotics are discussed. Regulatory adaptations and financial push and pull programs to restimulate new antibiotic development are explored. The COVID-19 pandemic caused not only millions of deaths, but also economic losses in excess of 10 trillion US dollars. Coronaviruses and influenza viruses remain usual suspects for new viral pandemics, followed by paramyxoviruses. Viral infections at the animal-human interface in wet markets and in disturbed environments need active virus surveillance programs. Learning lessons from the COVID-19 for non-pharmaceutical interventions is difficult to draw since measures were frequently applied in combination against different variant viruses and against changing population immunity levels. The Randomised Evaluation of COVID-19 Therapy (RECOVERY) clinical trials demonstrated that even under emergency situations clinical trials can rapidly provide solid treatment data. Various novel vaccine approaches were the most efficient control measures for the COVID-19 pandemic. Pandemic preparedness also requires a fact-based discussion both in the public and in parliaments to settle the conflict between individual freedom and necessary restrictions during a pandemic. Mature and educated citizens are needed not only for coping with pandemics but also for creating stress-resistant democratic societies. Learned scientific societies should contribute to this discussion.