Russia’s silence over the death of a lab worker underlines that pandemic preparedness amounts to nothing if information on threats is withheld

In pandemic preparedness work, scientists like to focus on the technical challenges: identifying pathogens, diagnosing infections, understanding their effects and developing vaccines and treatments. Each step promises progress through human innovation, investment and planning. The World Health Organization (WHO), for example, brings experts together to identify and prioritise emerging disease threats and collect the evidence needed to prepare for them. But preparedness depends on more than scientific innovation.

As the past week has shown, politics is the elephant in the room in all of this. No one could have predicted we would be talking about pneumonic plague, and that the death of a single lab worker in Russia would cause global headlines. It might feel like an overreaction: the WHO deals with thousands of potential disease signals worldwide every month. But the circumstances of this case are unusual given the lack of transparency from Russian authorities on what happened – and ongoing concern about biological weapons research.

Some change in our lifestyles and environments over a generation has caused this increased risk. What, exactly, is a mystery

• Prof Devi Sridhar is chair of global public health at the University of Edinburgh

In the field of global health, we often talk about each generation living longer and healthier lives than their parents. We’ve seen this in the gains in life expectancy, the sharp decrease in child mortality and in the near elimination of many vaccine-preventable diseases. But since the turn of the century this progress has stalled, and in some cases several health metrics have gone backwards.

Take cancer, which was long thought to be a disease linked to old age. While most cancers do indeed still occur in elderly people, a new report highlights that a number of cancers are increasing in people who are under 50, often referred to as “early onset cancer”. The report, undertaken by the World Cancer Research Fund, looked at data from 12 different cancer types in England, the US and the Netherlands over the past 20 years. What they found isn’t pretty.

Prof Devi Sridhar is chair of global public health at the University of Edinburgh