Emerging and re-emerging infectious diseases are not episodic events, but manifestations of a continuously evolving interface between humans, pathogens, and the environment. Despite major advances in vaccines, antimicrobial therapy, and public health care, the frequency and impact of these diseases are increasing, driven by globalization, ecological disruption, climate change, and intensified human -animal interactions, alongside declining vaccine coverage and expanding antimicrobial resistance. The predominance of zoonotic origins of infectious diseases highlights the inadequacy of siloed approaches and reinforces the necessity of a One Health perspective. This review synthesizes the conceptual foundations and structural drivers of emerging and re-emerging infectious diseases, situating recent outbreaks within a broader historical and systemic context. The coronavirus disease 2019 (COVID-19) pandemic exemplified a recurring pattern: delayed recognition, rapid global dissemination, and profound societal disruption. At the same time, it demonstrated the unprecedented capacity of modern science to respond, while exposing persistent inequities and fragilities in surveillance, health systems, and global governance. Future threats cannot be mitigated through fragmented interventions. Instead, they demand a paradigm shift towards an integrated, anticipatory framework that aligns early detection, resilient health systems, rapid scientific innovation, and coordinated global action. Such a framework must transcend disciplinary and national boundaries and be grounded in equity, transparency, and sustained investment. Preparedness for emerging and re-emerging infectious diseases is no longer optional; it is an enduring imperative in an increasingly interconnected and unstable world.
Shigeki Nakamura (Sun,) studied this question.
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