'Abysmal' COVID-19 vaccine coverage, monkeypox and mosquitoes - what health threats will 2024 bring?
Sky News spoke to one of the World Health Organisation's foremost experts on infectious diseases to see what 2024 could have in store for the world - and if we're prepared for another pandemic.
Wednesday 27 December 2023 02:27, UK
The amount of people in high-risk groups getting the COVID-19 vaccine globally is "abysmal", the World Health Organisation (WHO) has warned, in a blunt message about global health threats in 2024.
From the emergence of the new JN.1 coronavirus strain, to concerns over monkeypox in central Africa, to the spread of mosquito-carried disease in new countries thanks to climate change, health looks set to hit the headlines once again next year.
As we close out 2023, we look at what the next 12 months could bring.
Sky News spoke to Dr Maria Van Kerkhove, an expert on infectious diseases, who leads the WHO's Department for Epidemic and Pandemic Preparedness and Prevention.
"I don't understand why it's a surprise," she tells Sky News, when asked about rising COVID-19 cases.
"Certainly we haven't really seen a seasonality with COVID yet. But for all of the other respiratory diseases we see an increase in the autumn and winter months in temperate regions. So it shouldn't be seen as a surprise."
This is why vaccination campaigns start early for things like influenza and COVID-19, targeting the most vulnerable, she says.
She adds: "But the vaccination coverage in all countries of the at-risk groups is abysmal…
"For me, this is the biggest frustration… COVID-19 actually has solutions, influenza has solutions, that can prevent severe disease and death. Why aren't we using them?"
Climate change and spread of Dengue fever
And it's not just coronavirus that could find itself in the spotlight over the coming year.
As global leaders gathered in Dubai to discuss the fight against climate change earlier this month, global warming was already having an effect on the spread of infectious disease, Dr Van Kerkhove says.
Dengue fever, a virus transmitted to humans by mosquitoes, is a good example.
"It really illustrates the challenges because you have the mosquitoes going further north and further south," she says.
"Countries like Italy are seeing dengue transmission within their borders that they've never experienced before."
It's thought that mosquitoes carrying dengue fever could be common in England by the 2040s.
Climate change, she says, is having an impact now.
"This is not a theoretical risk into the future. It's happening now and it has to be addressed now."
Monkeypox outbreak
Dr Van Kerkhove also pointed to an outbreak of the monkeypox virus in the Democratic Republic of the Congo, in central Africa.
"We have a huge outbreak which is now in sexual networks," she says. "Once this virus gets into sexual networks it can transmit quite efficiently between people."
Monkeypox is a disease caused by infection with the mpox virus. There are two types of the mpox virus: Clade I and Clade II.
Clade I has a higher mortality, with a fatality rate of around 10%. Clade II is generally milder, and it was this type that was circulating in Europe, Dr Van Kerkhove said.
"So we are worried about Clade I expanding to other countries, and there's very little attention on mpox right now," she explains.
She said these kinds of things don't need to be in the news every day, as long as governments themselves don't lose focus on infectious threats.
Infectious disease in war zones
The world goes into 2024 with two conflicts - Ukraine-Russia and Israel-Hamas - dominating the spotlight, as well as a host of other underreported wars worldwide.
For medical professionals, the desperate conditions in war zones and the destruction of people's homes raise the risk of the spread of infectious diseases.
"It makes it that much harder," Dr Van Kerkhove says. "In addition to the infectious threats that they face, people are hungry, they're malnourished, they don't have access to clean water and waste systems and they're cold.
"People who are scared and threatened will suffer more when infectious diseases are around."
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Are we prepared for another pandemic?
The pandemic felt like it came out of nowhere.
Governments were left reeling as cases soared - with their people locked down or unable to visit suffering loved ones.
So four years later, is the world better prepared?
Yes and no, Dr Van Kerkhove says.
On the one hand, she says, she looks at capacities around the world for things like surveillance, testing and sequencing of new threats, as well as advancements in areas like infection prevention and the efforts of community health workers.
"The work in those areas put us in a much better position for the next one," she says.
But there are things that make Dr Van Kerkhove less sure about how prepared we are to tackle a new pandemic.
She explains: "I look at declining trust in the world. I look at the attacks on science and on scientists, the politicisation of every aspect of COVID."
She also argued that countries may be less willing to report a new pathogen because of financial and political incentives.
"So on my less optimistic side, I'm really concerned that in some aspects we're worse off than we were even four years ago," she adds.