As someone who has spent many years studying and responding to viral threats, I’m deeply concerned that we face an unprepared future again. Significant cutbacks in medical science funding, especially in global health, research, and surveillance, leave us vulnerable as new threats emerge.
HIV taught the world that a single virus can reshape the trajectory of global health. When I was at the National Cancer Institute and first proposed in 1982 that a retrovirus might be the cause of AIDS, many in the scientific community doubted that humans could even carry such pathogens. This skepticism existed even though we had discovered the first human retroviruses, HTLV-1 and HTLV-2, within the previous two years.
At the time, the prevailing belief in the U.S. and other high-income countries was that infectious diseases were a problem of the past. This false sense of security led to the closure of infectious disease departments, a decline in specialized training, and a loss of institutional expertise just as a new global health crisis was beginning to unfold.
But the data guided my National Cancer Institute colleagues and me forward, and there was a rapid resurgence of funding and interest in virology, immunology, and public health as the AIDS pandemic spread. Our co-discovery of HIV as the cause of AIDS, our development of the HIV blood test, and the rapid deployment of treatments that have since saved millions of lives were not the result of serendipity, but of relentless research, infrastructure, and global scientific collaboration. As philanthropist and health advocate Mary Lasker famously said, “If you think research is expensive, try disease.”
That quote captures the truth. I was once asked, “How much funding does it take for greater progress?” I responded: “If you invest more, progress comes sooner. If you invest less, it comes later. Some financial loss is the cost of progress; nothing would move forward without it.” In other words, progress is a matter of sustained, wise investment. There is no shortcut.
Now, H5N1 avian influenza may be the next major risk, and we are seeing a troubling trend: declining investment in global health surveillance, research, and scientific innovation, precisely when the need for vigilance has never been greater, as new challenges such as urbanization and global travel accelerate the emergence and spread of infectious diseases beyond any single threat. A recent paper by Global Virus Network experts in The Lancet Regional Health—Americas underscores the urgent need for renewed investment in pandemic preparedness and scientific research.
H5N1, once primarily a threat to birds, now infects mammals, including cows and humans. Since 2022, according to the Lancet paper, more than 168 million poultry have been culled in the U.S. alone. The virus has reached all 50 states, affected over 1,000 dairy herds, and caused more than 70 human infections, including the first confirmed death.
The threat is looming, but it is only a threat since it has not yet mutated to a form that can transmit from human to human. We need stronger surveillance, especially at the human-animal interface. Genomic monitoring and sharing of those results are essential. For example, data from Nature Communications showed that globally, only about 0.5% of Covid-19 cases were sequenced, a figure significantly less than the recommended levels needed for real-time variant detection.
I commend recent U.S. efforts, including $1 billion in biosecurity, relief, and vaccine development. But this must be just the start. The mRNA vaccines that were mobilized quickly during Covid-19 show the power of modern medicine. Yet we now see such science met with challenges, not dissimilar to the skepticism my colleagues and I faced in the 1980s. It is incumbent upon scientists and public health officials to communicate clearly, engage transparently, and uphold the highest standards of rigor. We must do better together.
We need to bring the same urgency and innovation to H5N1 and strengthen global virology expertise more broadly because we cannot afford to overlook the distinct nature of each virus. Viruses can differ significantly in their behavior and transmission, whether it’s HIV, SARS-CoV-2, or influenza. And we must remain vigilant about where these threats may emerge or re-emerge.
It’s also time to strengthen our health systems. The early stumbles in Covid-19 cost the global economy $16 trillion and led to a considerable dose of skepticism in science. We can’t afford to repeat that. Public-private partnerships, cross-border collaboration, science-driven solutions, and ongoing investment in research are our best tools for meeting the next threat.
Finally, we need to recognize that innovation doesn’t appear overnight. It comes from years of basic science, sometimes decades before a breakthrough reaches the clinic or the pharmacy. It comes from believing the data, even when the implications are uncomfortable or not yet widely accepted.
Science has given us the tools to detect, understand, and mitigate HIV and has produced record-breaking vaccines for Covid-19. But science can’t do it alone. It needs support, investment, and trust.
The lessons are clear. We must act now, not after the next outbreak is already in progress.
Robert C. Gallo is a co-founder of the Global Virus Network and a professor at the University of South Florida. He is best known for his pioneering discovery of human retroviruses, co-discovery of HIV, and development of the HIV blood test.