The world is unprepared for another pandemic like Covid-19 in the next one decade, Dr Francis Collins, the longest serving director of the National Institutes of Health (NIH), the main government agency for public health research in the United States, has said.

“I don’t have a better crystal ball than anyone else about what the next major threat to public health will be. People say, statistically, another pandemic is likely to occur within the next couple of decades. I hope it doesn’t arrive soon, because at the moment, we are not well prepared to respond to it,” Dr Collins said.

The physician-geneticist, noted for his landmark discoveries of disease genes and leadership of the International Human Genome Project, was responding to queries at a recent virtual interaction with reporters and incoming Fellows of the Health Coverage Fellowship at Harvard T H Chan School of Public Health. The interaction was moderated by Larry Tye who directs the Center for Health Communication’s Health Coverage fellowship at Harvard T H Chan School of Public Health.

On a query by The Indian Express as to which global health issue worries him the most, Dr Collins categorically said: HIV.

“We have highly effective treatments, but no cure. These treatments only work if people can actually access them. With recent disruptions to programmes like PEPFAR and USAID, that access is being threatened, meaning people may once again die from a disease we know how to manage,” he said.

Six years since Covid-19 pandemic began, Collins said he was worried by the fact that mRNA vaccine research, aimed at pandemic preparedness, had been scaled back in the United States.

“I think it leaves us in a very vulnerable position,” he said, explaining that one of the key advantages of the mRNA technology was the speed with which it could be developed.

“It (mRNA technology) allows for rapid vaccine design, as we saw during the response to SARS-CoV2. In that case, the Moderna vaccine design was completed at the NIH Vaccine Research Centre within about 48 hours after the viral sequence was released by a Chinese scientist on January 10, 2020,” he said.

He said traditional vaccine development methods are slower and, in a fast-moving pandemic, time is critical. “The pandemic tends not to sneak up on you. It hits you hard,” Dr Collins said.

He also expressed deep concern about the way in which widespread polarisation, distrust, misinformation and disinformation shaped public perception and response during Covid-19.

“That experience may leave populations more sceptical in the future. In case there is a severe influenza pandemic similar to the one that spread in 1918, one with high mortality even among young people and without an immediately available vaccine or effective treatment, again we would have to rely on traditional public health measures such as isolation, quarantine and masking,” he said.

“The question is whether the public would be in the mood to do that or is everybody so jaded at this point that it will be very hard to implement these standard approaches. I am really worried about this,” he said.

“So, both in terms of our vaccine and public health response, I think we are worse off than we were in the early days of 2020, in terms of being ready to handle what comes along,” he said.