{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:32:08Z","timestamp":1792873928077,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Infectious disease burden is dynamic and devastating across the globe. We need to better understand and predict these threats to mitigate harm from new, re-emergent and endemic pathogens. 3,752 globally diverse participants took part in this two-step, mixed-methods adapted Delphi study. Firstly, an online survey asked health workers and researchers to identify the infectious diseases they considered to be at greatest risk of escalation in their setting, along with the factors driving this. Secondly, structured thematic workshops were hosted in Africa, Asia and Latin America, to allow in-depth exploration of the factors driving the prioritisation of these diseases. Participants considered the primary threat to be the escalation of high burden, endemic diseases, rather than emerging or re-emerging pathogen outbreaks. This was driven by the high prioritisation of vector-borne diseases (primarily malaria and dengue), tuberculosis, and HIV\/AIDS. Whilst the main finding from survey responses (n\u2009=\u20093,700) identified growing concern over tuberculosis, participants in the subsequent workshops (n\u2009=\u2009169) emphasised the increasing threat of vector-borne diseases. Participants considered the impact of climate change, socioeconomic factors and increasing drug resistance patterns to be driving the escalation of these diseases. This study provides striking new insight into priority infection threats due to the large scale of participation, breadth of stakeholder experience, and wide global representation. These factors allowed us to accurately determine the consensus of a substantial component of the global infectious disease research community and share unprecedented insights from the lived experience of researchers and health workers in low resource settings. We consider these perspectives particularly valuable given the absence of biological data that concurrently assesses all infectious diseases across global regions at a single point in time. Our findings represent an important new evidence-based alarm call; the next pandemic may not be a sudden event, but a slow, \u2018creeping catastrophe\u2019, impacting the most impoverished regions and communities. We need to respond now, having heard these important, consistent opinions from these previously unheard and collective voices.<\/jats:p>","DOI":"10.1038\/s41598-025-22573-3","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T19:03:57Z","timestamp":1762283037000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Global perspectives on infectious diseases at risk of escalation and their drivers"],"prefix":"10.1038","volume":"15","author":[{"given":"Ryan James","family":"Walker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Tunde","family":"Kingpriest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Naisanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mir Nabila","family":"Ashraf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Roberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trudie","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"22573_CR1","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1038\/s41579-021-00639-z","volume":"20","author":"RE Baker","year":"2022","unstructured":"Baker, R. E. et al. Infectious disease in an era of global change. Nat. Rev. Microbiol. 20, 193\u2013205. https:\/\/doi.org\/10.1038\/s41579-021-00639-z (2022).","journal-title":"Nat. Rev. Microbiol."},{"issue":"5","key":"22573_CR2","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/S1473-3099(20)30265-6","volume":"20","author":"T Ducomble","year":"2020","unstructured":"Ducomble, T. & Gignoux, E. Learning from a massive epidemic: measles in DRC. Lancet. Infect. Dis 20(5), 542 (2020).","journal-title":"Lancet. Infect. Dis"},{"issue":"11","key":"22573_CR3","doi-asserted-by":"publisher","first-page":"2400106","DOI":"10.2807\/1560-7917.ES.2024.29.11.2400106","volume":"29","author":"LM Masirika","year":"2024","unstructured":"Masirika, L. M. et al. Ongoing Mpox outbreak in Kamituga, South Kivu province, associated with monkeypox virus of a novel Clade I sub-lineage, Democratic Republic of the Congo, 2024. Euro Surveill. 29(11), 2400106. https:\/\/doi.org\/10.2807\/1560-7917.ES.2024.29.11.2400106 (2024) (PMID:38487886;PMCID:PMC10941309).","journal-title":"Euro Surveill."},{"key":"22573_CR4","unstructured":"Pan American Health Organization \/ World Health Organization. Epidemiological Alert: Dengue in the Region of the Americas. Washington, D.C.: PAHO \/ WHO 16 February (2024)."},{"issue":"26","key":"22573_CR5","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.1016\/j.nmni.2018.09.004.PMID:30402238;PMCID:PMC6205565","volume":"21","author":"F Fenollar","year":"2018","unstructured":"Fenollar, F. & Mediannikov, O. Emerging infectious diseases in Africa in the 21st century. New Microbes New Infect. 21(26), S10\u2013S18. https:\/\/doi.org\/10.1016\/j.nmni.2018.09.004.PMID:30402238;PMCID:PMC6205565 (2018).","journal-title":"New Microbes New Infect."},{"key":"22573_CR6","unstructured":"Pandemic Pact [Internet]. Available from: https:\/\/www.pandemicpact.org. Accessed 12th June (2025)."},{"issue":"26","key":"22573_CR7","doi-asserted-by":"publisher","first-page":"e2321978121","DOI":"10.1073\/pnas.2321978121","volume":"121","author":"D Tortorice","year":"2024","unstructured":"Tortorice, D., Rappuoli, R. & Bloom, D. E. The economic case for scaling up health research and development: Lessons from the COVID-19 pandemic. Proc. Natl. Acad. Sci. U.S.A. 121(26), e2321978121. https:\/\/doi.org\/10.1073\/pnas.2321978121 (2024).","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"22573_CR8","unstructured":"World Health Organization. Global Observatory on Health\u202fR&D: Bridging the gap in global health research and development [Internet]. Geneva: WHO; https:\/\/www.who.int\/news\/item\/21-11-2023-global-observatory-on-health-r-d--bridging-the-gap-in-global-health-research-and-development (2023)."},{"key":"22573_CR9","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1590\/S0104-12902014000200003","volume":"23","author":"J Biehl","year":"2014","unstructured":"Biehl, J. & Petryna, A. Peopling Global Health. Sa\u00fade e Sociedade 23, 376\u2013389. https:\/\/doi.org\/10.1590\/S0104-12902014000200003 (2014).","journal-title":"Sa\u00fade e Sociedade"},{"key":"22573_CR10","unstructured":"The Global Health Network [Internet]. https:\/\/tghn.org\/. Accessed 12th June (2025)."},{"key":"22573_CR11","unstructured":"Wellcome Trust and the Global Health Network [internet]. Microbial Reservoirs and Transmission Dynamics of Escalating Infectious Diseases. https:\/\/media.tghn.org\/medialibrary\/2024\/03\/Microbial_Reservoirs_Report_Final_1st_March_2024.pdf (2024)."},{"key":"22573_CR12","unstructured":"de la Horra A,\u00a0de Colombi NF,\u00a0Baker B,\u00a0et al. Developing an evidence-led essential research skills training curriculum.\u00a0World Health Organization.\u00a0https:\/\/iris.who.int\/handle\/10665\/363325.\u00a0License: CC BY-NC-SA 3.0 IGO. (2022)."},{"key":"22573_CR13","doi-asserted-by":"publisher","first-page":"e003306","DOI":"10.1136\/bmjgh-2020-003306","volume":"5","author":"A Norton","year":"2020","unstructured":"Norton, A. et al. The remaining unknowns: a mixed methods study of the current and global health research priorities for COVID-19. BMJ Glob. Health 5, e003306 (2020).","journal-title":"BMJ Glob. Health"},{"key":"22573_CR14","volume-title":"Can Building a Community of Practice Improve Pharmacovigilance in Low-Resource Settings?","author":"RJ Walker","year":"2022","unstructured":"Walker, R. J. Can Building a Community of Practice Improve Pharmacovigilance in Low-Resource Settings? (University of Oxford, 2022)."},{"key":"22573_CR15","unstructured":"Organisation for Economic Co-operation and Development [Internet]. ODA recipients: countries, territories, and international organisations. https:\/\/www.oecd.org\/en.html. Accessed 12th June (2025)."},{"issue":"2","key":"22573_CR16","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun, V. & Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 3(2), 77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa (2006).","journal-title":"Qual. Res. Psychol."},{"issue":"10440","key":"22573_CR17","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","volume":"403","author":"M Naghavi","year":"2021","unstructured":"Naghavi, M. et al. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study. Lancet 403(10440), 2100\u20132132 (2021).","journal-title":"Lancet"},{"key":"22573_CR18","unstructured":"Institute for Health Metrics and Evaluation (IHME). Tuberculosis - Level 3 cause [Global Health Metrics Factsheet]. Seattle (WA): IHME. https:\/\/www.healthdata.org\/research-analysis\/diseases-injuries-risks\/factsheets\/2021-tuberculosis-level-3-disease"},{"key":"22573_CR19","unstructured":"Institute for Health Metrics and Evaluation (IHME). Malaria - Level 3 cause [Global Health Metrics Factsheet]. Seattle (WA): IHME. https:\/\/www.healthdata.org\/research-analysis\/diseases-injuries-risks\/factsheets\/2021-malaria-level-3-disease"},{"key":"22573_CR20","unstructured":"Institute for Health Metrics and Evaluation (IHME). HIV\/AIDS - Level 3 cause [Global Health Metrics Factsheet]. Seattle (WA): IHME. https:\/\/www.healthdata.org\/research-analysis\/diseases-injuries-risks\/factsheets\/2021-hivaids-level-3-disease"},{"key":"22573_CR21","unstructured":"World Health Organisation. Pathogens prioritization: a scientific framework for epidemic and pandemic research preparedness. https:\/\/www.who.int\/publications\/m\/item\/pathogens-prioritization-a-scientific-framework-for-epidemic-and-pandemic-research-preparedness (2024)."},{"issue":"10316","key":"22573_CR22","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.1016\/S0140-6736(21)01897-3","volume":"398","author":"S Singh","year":"2021","unstructured":"Singh, S. et al. How an outbreak became a pandemic: a chronological analysis of crucial junctures and international obligations in the early months of the COVID-19 pandemic. Lancet 398(10316), 2109\u20132124. https:\/\/doi.org\/10.1016\/S0140-6736(21)01897-3 (2021) (Epub 2021 Nov 8. PMID: 34762857; PMCID: PMC8575464).","journal-title":"Lancet"},{"key":"22573_CR23","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s13063-018-2440-y","volume":"19","author":"A Rosala-Hallas","year":"2018","unstructured":"Rosala-Hallas, A. et al. Global health trials methodological research agenda: results from a priority setting exercise. Trials 19, 48. https:\/\/doi.org\/10.1186\/s13063-018-2440-y (2018).","journal-title":"Trials"},{"key":"22573_CR24","unstructured":"World Health Organisation. A coordinated global research roadmap: 2019 novel coronavirus. https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/coordinated-global-research-roadmap.pdf (2020)."},{"issue":"2","key":"22573_CR25","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1177\/17474930221096935","volume":"18","author":"S Leitch","year":"2023","unstructured":"Leitch, S., Logan, M., Beishon, L. & Quinn, T. J. International research priority setting exercises in stroke: A systematic review. Int J Stroke. 18(2), 133\u2013143. https:\/\/doi.org\/10.1177\/17474930221096935 (2023) (Epub 2022 May 12 PMID: 35422174).","journal-title":"Int J Stroke."},{"key":"22573_CR26","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s12916-025-03973-8","volume":"23","author":"E Antonio","year":"2025","unstructured":"Antonio, E. et al. Research prioritisation in preparedness for and response to outbreaks of high-consequence pathogens: a scoping review. BMC Med. 23, 147. https:\/\/doi.org\/10.1186\/s12916-025-03973-8 (2025).","journal-title":"BMC Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22573-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22573-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22573-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T19:03:59Z","timestamp":1762283039000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-22573-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["22573"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-22573-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"assertion":[{"value":"28 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"38630"}}