Human health is facing escalating risks of circulating contagious pathogens and emerging zoonotic spillover due to global changes characterised by urbanisation and habitat fragmentation.1 The COVID-19 pandemic and 2022 mpox outbreaks have warned us of a possible harsh future, with further deterioration possible upon pathogens’ co-transmission through shared pathways—eg, influenza and SARS-CoV-2 via respiration. This co-transmission will greatly increase the risk of co-infections and pandemics that intensify the burdens of public health infrastructure and expenses for governments.2
Developing cost-effective, multi-pathogen PCR assays is therefore urgently needed. These assays allow high-throughput screening, conserve important health-care and social resources, and facilitate ongoing surveillance of pathogens’ co-transmission.3 Despite being proposed in the 1980s, multi-pathogen PCR testing has not been applied on a large scale due to high costs and analytical challenges. The ongoing COVID-19 pandemic has accelerated the development of such assays, enabling the detection of multiple pathogens from a single swab. A great example is the multiplex assay approved by the US Food and Drug Administration that simultaneously detects SARS-CoV-2 and influenza.4 Similar testing kits are currently being developed worldwide to simultaneously detect SARS-CoV-2 variants and emerging pathogens.5
Regulators and stakeholders should optimise policies to encourage technological advances in multi-pathogen testing and promote their applications across sectors. Rapid integration of multi-pathogen PCR testing into the existing COVID-19 surveillance network, particularly the community-based surveillance operating in 192 countries, would help prevent emerging pathogens from evolving into another pandemic. More importantly, developing similar multi-pathogen surveillance strategies as early warning systems of emerging pathogens will better prepare us for unforeseen co-transmission of zoonotic pathogens and pave the way towards One Health.6 Such efforts will be of substantial importance for the global community to achieve the Sustainable Development Goals by 2030.
Acknowledgments
CL and HZ contributed equally. We declare no competing interests.
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