Sir John Edmunds, British epidemiologist: ‘The dangerous events are the ones that we don’t really know about, like Donald Rumsfeld’s unknown unknowns’

Sir John Edmunds says pandemic planning must cover more than influenza, which he considers the most likely familiar threat. The British epidemiologist warns that diseases with different ways of spreading, as well as unexpected events, could trigger major outbreaks, making broader preparedness important.

Edmunds recently visited Bunia in the Democratic Republic of the Congo, where an Ebola outbreak is unfolding amid conflict and a severe humanitarian crisis. He says African institutions now lead much of the response, reflecting improvements in scientific capacity and organisation, while conditions remain more challenging than during the 2014–16 West African outbreak. He also points to mpox, which spread internationally in 2022, and HIV, whose pandemic has continued for four decades; the supplied article ends as he begins discussing the costs of neglecting preparedness.