A fresh warning from The Lancet has reignited global concerns about humanity’s readiness for the next major health crisis. Dr Richard Horton, editor-in-chief of the world-renowned medical journal, has cautioned that another pandemic is “almost inevitable” as human-driven environmental destruction continues to accelerate.
Speaking to India Today, Horton said that humanity is creating the perfect conditions for future pandemics by destroying forests, expanding cities rapidly, worsening climate change and pushing animals and humans into dangerously close contact. According to him, the planet is being damaged “sufficiently to create conditions for another pandemic in the next 20 years.”
His warning follows a Lancet report published last year that projected a 48 per cent chance of a catastrophic pandemic causing more than 25 million deaths in the coming years, and a 23 per cent likelihood of a COVID-like outbreak within the next decade.
Scientists worldwide are already witnessing an alarming rise in zoonotic viruses — pathogens that jump from animals to humans. As ecosystems collapse, animals are forced closer to human settlements, increasing the chances of viruses crossing species barriers. Many of these pathogens are evolving faster, adapting to new hosts under ecological stress.
Climate change, habitat loss and biodiversity decline are no longer distant environmental concerns. Horton stressed that they are directly contributing to biological threats with serious pandemic potential.
Unsafe human-animal spaces raise alarm
Horton identified unsafe meat markets and abattoirs as critical flashpoints for viral transmission. In many countries, slaughterhouses operate in unhygienic conditions, often adjacent to open markets. Animals are killed in crowded spaces, meat is left uncovered, and flies move freely between carcasses and public areas.
“These are exactly the conditions where a mutated virus can move from animal to human,” Horton said. If such a virus spreads through respiratory transmission and remains viable for extended periods, the consequences could be devastating.
Unverified theories have long suggested that SARS-CoV-2 may have originated in a similar market in Wuhan, China. While the origins remain disputed, COVID-19 demonstrated how quickly a novel virus can engulf the world. According to the World Health Organisation, nearly 780 million cases and over 7.1 million deaths have been officially reported globally since December 2019 — though the true toll is believed to be far higher.
Questions over India’s COVID death toll
Horton also raised serious concerns about India’s official COVID-19 death figures. The Indian government initially reported around five lakh deaths to the WHO. However, multiple independent studies suggest a much higher toll.
WHO modelling in 2022 estimated India’s excess COVID-related deaths at around 47 lakh. A study by Washington University placed the figure at 41 lakh, while a Lancet analysis suggested nearly 40 lakh deaths. Data from India’s Civil Registration System showed 21 lakh excess deaths in 2021 alone, during the deadly Delta wave.
Horton dismissed the official figure as “fantastical” and “primarily not true,” emphasising that acknowledging mistakes is not about assigning blame, but about learning.
He pointed out that every country, including the UK, failed during the pandemic — citing delayed lockdowns, inadequate protection for frontline workers and fatal decisions involving care homes. “We made terrible mistakes, and we admitted them,” Horton said, arguing that such admissions are essential for future preparedness.
Failure to learn could cost millions
What worries Horton most is the lack of transparent and independent inquiries in many countries. Without an honest assessment of failures and true mortality figures, he warned, nations will remain dangerously unprepared.
“If you can’t even admit the level of mortality and failure, you can’t begin to prepare,” Horton said. With SARS-CoV-2 still circulating and mutating — and future pandemics potentially emerging from entirely different viral families — the danger is far from hypothetical.
Unless ecological destruction, unsafe food systems and institutional denial are urgently addressed, Horton cautioned, the world risks repeating the same mistakes — with potentially catastrophic consequences.