Public Health is under pressure. Over Healthcare Systems around the world, funding is declining, exhausted professionals are leaving the field and in the US state legislatures withdraw the necessary judicial authorities. At the same time, outbreaks of diseases such as measles and dengue fever are becoming increasingly common, making the work even more urgent and responsible. In 2025, these constraints will trigger a shift in epidemiology, forcing the field to innovate to control outbreaks more efficiently and effectively.
The Covid-19 pandemic was an extraordinary challenge for public health workers as they launched a historic response to the pandemic. The prolonged crisis revealed numerous gaps in a workforce that was under enormous strain.
Unfortunately, the pandemic was neither the first nor will it be the last public health threat to overwhelm our defenses. In the past, major infectious disease threats occurred on average about every two years. Even now, Bird flu A(H5N1) has been expanding its geographic footprint and host species for years. According to some estimates The world is now closer to a flu pandemic than ever before in recent memory.
Faced with these pressures, public health has no choice but to adapt. Although new technologies such as mRNA vaccine platforms and at-home testing expand our arsenal against outbreaks, we cannot rely solely on these biomedical countermeasures.
The most significant untapped source of innovation lies in public health practice itself. The most promising development arising from these challenges is the adoption of higher reliability principles as a new operating standard. These principles come from industries with zero tolerance for accidents and errors, such as space exploration and commercial aviation.
Public health, particularly epidemiology, is beginning to shift away from tailored outbreak response approaches toward structured processes characteristic of high-reliability industries. A commitment to continuous improvement, data and metrics-based performance monitoring, and implementation of standardized operating procedures are hallmarks of high reliability. These practices enable organizations to maintain security and effectiveness even in complex and high-risk environments.
Although we are still in the early stages of this transformation, the pressures of the last five years will accelerate the adoption of high reliability in the coming year. The first successes are already visible. For example, the CDC program responsible for answering Outbreaks of foodborne illnesses has made significant progress. They have aggressively implemented whole-genome sequencing to identify the causes of outbreaks and developed a set of best model practices to assist state and local officials in their investigations. This change has led to an increase in successful investigations, meaning the causes of outbreaks are now more likely to be clearly identified. In contrast, before these changes, the causes of many outbreaks remained unclear.
Epidemiology is at a critical point. With dwindling resources, staff burnout and increasing disease outbreaks, the field is being pushed to innovate. Adopting high-reliability principles adopted from industries where failure is not an option is proving to be a promising solution. This change is already showing initial results, for example in the investigation of food-borne illnesses. By adopting structured and continuously improved processes and cutting-edge technologies, public health will improve its ability to detect and control disease outbreaks. This shift promises a more efficient and effective approach to protecting public health in the face of evolving threats.
