Converging infectious disease threats in the post-COVID era: surveillance fragility, pandemic risk, and global preparedness

Abstract

The COVID-19 pandemic exposed profound weaknesses in global infectious disease surveillance yet, in its aftermath, pandemic-prone threats have intensified rather than receded. This narrative review synthesizes contemporary evidence on three converging drivers of pandemic risk zoonotic emergence, antimicrobial resistance, and climate-sensitive disease expansion and examines how structural failures in surveillance and global health governance amplify their impact. Drawing on recent epidemiological analyses, policy reports, and One Health evaluations, the review maps post-COVID surges in zoonotic outbreaks, drug-resistant infections, and vector and water-borne diseases, and links these trends to fragmented laboratory networks, inequitable genomic capacity, and weak integration across human, animal, and environmental systems. It further interrogates the geopolitical and socioeconomic determinants of vulnerability, including conflict-related surveillance collapse, vaccine inequity, and the political economy of pandemic financing. Emerging digital tools from AI-enabled forecasting to wastewater and social media surveillance are assessed not only for their technical promise but also for risks related to data bias, extractives, and governance gaps. The review argues that without redistributive investment in One Health integration, regional genomic platforms, community-based surveillance, and enforceable IHR-based accountability, the world will continue to detect converging threats late and respond inequitably, leaving pandemic preparedness structurally fragile in the post-COVID era.