While the public responses to prescient threats like COVID-19, Zika, and monkeypox capture immediate attention and resources, endemic diseases with substantial global health impact often do not incite a similar emotional urgency. Specific, acute crises may evoke stronger responses than statistical, chronic threats. Notwithstanding their long histories and high mortality rates, infectious diseases such as TB, HIV and malaria often lack the attention given to diseases like COVID-19, reducing their visibility and the urgency of interventions. At the same time, a transforming climate may impact the spread and distribution of both novel and endemic diseases, producing new circumstances of response. This interdisciplinary roundtable, part of History Week and run by History Council NSW, will explore how we can think about lessons learned from historically important diseases to create more effective and adaptive strategies for present and future health crises.

Facilitated by Philippa Nicole Barr, the panel of experts discussed what can be learned from past pandemics for the future of global health.

This post will cover the highlights and takeaways from the session. For the full recording, please see our podcast channels (click here), or our YouTube channel (click here).

Our facilitator, Philippa, reached out to an impressive range of experts for this panel, who are active experts in their fields across multiple health challenges and research disciplines. The panel comprised of:

• Edward Holmes, Professor of Virology, University of Sydney, and NHMRC Leadership Fellow
• Claire Hooker, Associate Professor in Health and Medical Humanities, University of Sydney, and President of the Arts Health Network NSW/ACT
• Julie Leask, Professor of Public Health, University of Sydney, and Visiting Professorial Fellow, National Centre for Immunisation Research and Surveillance
• Brent Mackie, Director Policy, Strategy and Research at ACON
• Bernadette Saunders, Associate Professor in Life Sciences (Cellular Immonology) and Tuberculosis & Respiratory Diseases Group Head, University of Technology Sydney
• Susana Vaz Nery, Professor at Kirby Institute UNSW, and Neglected Tropical Diseases research group lead
• Jane Williams, Research Fellow (public health ethics), University of Wollongong

At this important discussion, five years since the onset of COVID-19, we explored the enduring legacies of historically important diseases. Progenitors of TB date back 3 million years, yet even with millenia to know, research and prevent this disease, in 2021, TB was the 10th leading cause of death globally. In the same year we are probably more familiar with Covid-19, which was the 2nd leading cause of death and a public health emergency. During emergencies scientists often face intense pressure to deliver results swiftly, compelling them to operate under “fast science” conditions that put pressure on standard protocols and ethical norms. This roundtable considered the the profound ethical dilemmas and personal pressures encountered by scientists and social scientists working on pathogenic disease during crises and in the inter-crisis periods. It addressed ongoing global issues such as climate change and treatment resistance in endemic diseases, as well as global health inequalities that could escalate into future emergencies if not proactively managed. Educating the public about the value of science and how science works not only empowers individuals but also ensures that science continues to receive the necessary support from society, including from policymakers and benefactors. Likewise empowering communities to contribute to scientific understanding and shape practices is profoundly valuable. This engagement is vital for nurturing a culture of curiosity and engagement prepares us to address enduring and emerging global health challenges effectively. For the podcast featuring the full conversation, see our podcasts page.

1. The Crucial Role of Public Trust in Pandemic Responses

Trust emerged as a core theme, which the panelists described as the “bedrock” of effective pandemic management. Transparent communication consistently fosters trust, enabling communities to respond more effectively during health crises. Professor Julie Leask and her colleagues stressed the importance of transparency during COVID-19, particularly around policy decisions and health recommendations. Leask explained that when leaders clearly outline the values underpinning their choices, they reduce fear and resistance, allowing communities to adapt more readily.

Historically, pandemics such as the 1918 influenza (“Spanish flu”) reveal similar patterns of distrust, often fuelled by misinformation and stigmatisation. During events like the bubonic plague or recent polio outbreaks, the absence of trust led to isolation and the marginalisation of those affected. In contrast, community-based approaches consistently achieved faster recoveries and minimised social disruption.

2. Lessons from the AIDS Epidemic: Community-Led Health Responses

Drawing comparisons between COVID-19 and the HIV/AIDS epidemic of the 1980s, panellist Brent Mackie highlighted the power of community involvement in shaping health strategies. During the AIDS crisis, the LGBTQ+ community took charge of outreach and education, creating targeted and compassionate messaging that avoided sensationalist fear tactics.

In contrast, COVID-19 responses often lacked this community-centred focus, particularly in marginalised groups. The panel agreed that engaging communities, especially those vulnerable to stigma or distrust of authorities, is crucial for successful public health campaigns. Mackie urged future responses to prioritise inclusivity and sensitivity, which would not only increase compliance but also mitigate the damaging effects of public stigmatisation.

3. The Global Nature of Pandemic Preparedness

The panel emphasised the importance of a global perspective in addressing health crises. Diseases ignore borders, and an interconnected world means that local outbreaks can escalate into international emergencies. However, “vaccine nationalism” during COVID-19, where wealthier nations stockpiled vaccines and delayed distribution to low-income countries, highlighted a major failure in global solidarity. Panellist Susana Vaz Nery detailed the consequences of these delays in low-resource regions, where diseases like tuberculosis and neglected tropical diseases already strain public health systems. She argued that addressing global health inequities before the next pandemic would save lives and curb the spread of zoonotic diseases, which are increasingly driven by environmental disruptions and human-animal interactions.

4. Historical Patterns of Stigmatization and Xenophobia

Claire Hooker, a humanities scholar, traced the historical tendency to scapegoat marginalised groups during pandemics. She cited examples where immigrants, ethnic minorities, and other vulnerable populations were unfairly blamed for the spread of disease, a pattern evident throughout history. Even the term “Spanish flu” reflects a misnomer that inaccurately blamed Spain.

Hooker noted that COVID-19 followed this trend, with early references to the “China virus” in media coverage echoing past xenophobic responses and reinforcing divisive narratives. The panel stressed the need for future pandemic responses to actively counter stigmatising tendencies, promoting inclusivity to prevent long-term social divisions.

5. The Persistent Threat of “Invisible” Diseases

The pandemic highlighted the ongoing challenges of managing “invisible” diseases, such as tuberculosis (TB), which has persisted for millennia despite the availability of effective treatments. Panellist Bernadette Saunders noted how COVID-19 redirected resources away from diseases like TB, setting back global health progress by years. The discussion underscored the need for sustained attention to endemic diseases, even during acute health crises. The panel advocated for a more holistic approach to global health, where investment in emerging disease responses does not come at the expense of long-term strategies for diseases like TB, particularly in light of the rising threat of antimicrobial resistance.

6. Moving Forward: Global Cooperation and Surveillance

The panel called for stronger global cooperation in pandemic preparedness. Virologist Edward Holmes proposed creating a “global pandemic radar,” a collaborative system for disease surveillance and rapid vaccine development. While promising ideas emerged at the start of the COVID-19 pandemic, Holmes warned that political will to fund and maintain these initiatives has since waned.

Holmes urged greater investment in pandemic research, emphasising that consistent funding could prevent future global catastrophes. Although technological advancements make rapid vaccine development possible, inconsistent political collaboration continues to slow the speed at which science can address emerging threats.

Learning from the Past, Preparing for the Future

The panel’s discussions highlighted a crucial point: history offers invaluable lessons for managing pandemics. Trust, community involvement, and global cooperation have consistently proven effective in pandemic responses. Reflecting on COVID-19, the need for transparent, inclusive, and globally coordinated approaches has never been more apparent. The pandemic exposed vulnerabilities in public health systems and the social fabric of communities. Addressing these requires recognising historical patterns of inequity and stigmatisation while fostering global citizenship as a cornerstone of health policy. The insights shared by the panel point to a future where proactive, inclusive strategies can strengthen resilience and prepare the world for the challenges ahead.

In summing up the insights from the evening, Philippa noted that the contested end of a pandemic does not guarantee that diseases won’t persist, resurface, or evolve. This reality underscores the vital importance of public engagement and continuously bridging the gaps between scientific advancement and public knowledge.

Philippa noted that the panelists had emphasised that knowledge is not static, but rather relational – it is the knowledge we share and learn from others. She stated that moments like this panel discussion, between crises, are essential for building knowledge, trust, and enhancing community involvement in public health decision-making. Strategies for addressing health challenges must be dynamic and flexible, just as the pathogens we face. The global nature of infectious diseases, which do not respect national borders, mean we need to think about international solutions and what is happening beyond our own borders. If a disease is prevalent in one region, it needs to be addressed by the whole global community, not just left for that community to suffer. This global perspective, Philippa noted, highlights the imperative for continual international cooperation and innovation to respond to both existing and emergent health concerns.

In concluding, Philippa thanked the panel, audience, and the organizers from the History Council of New South Wales and SMSA for presenting this important event. HCNSW Programs Officer Amanda Wells offered additional thanks to Philippa, who did so much work to bring this event together.

Images from the event at Henry Carmichael Theatre, SMSA

The History Council of New South Wales would like to thank our panel for their generosity and expertise for this event. A special thank you also goes to Philippa Nicole Barr for her excellent chairing, and for organising this impressive panel of experts. Thank you to our partner orgnasations, the Australia New Zealand Society for the History of Medicine (NSW) and the Australian Health and Medical Humanities Network. Our event venue partner is the Sydney Mechanics’ School of Arts (SMSA) were fantastic to work with, and provided an excellent venue for this valuable panel.