World leaders haven't done nearly enough to prepare for pandemic threats, leaving some eight billion people vulnerable, a report co-chaired by Helen Clark says.
The Independent Panel for Pandemic Preparedness and Response report says say lack of action on diseases such as H5N1 avian influenza leaves the world's population, particularly children, highly vulnerable.
"If there were a pandemic threat today - such as if H5N1 began to spread from person to person - the world would likely again be overwhelmed," Clark said.
Now that the world is through the the worst of Covid-19, leaders have turned to other issues like the cost of living, housing and the spillover from conflicts, Clark told Morning Report.
Pandemics, preparing for them and how to respond to them have "slipped down the list".
"Unfortunately these threats don't go away."
Alongside the threat of H5N1, the mpox infectious disease is leading to the deaths of children, and has caused 1000 deaths in the Democratic Republic of the Congo where there is little access to testing and vaccines, she said.
"Any of these threats can suddenly come up and bowl you over materialise as a major global threat".
While the memory of Covid-19 was still relatively fresh, leaders needed to step up to support getting a better response system in place.
New international health regulations, which former director-general of health Ashley Bloomfield played a part in negotiating, had to flow through to a pandemic agreement, better financing and better access to vaccines, she said.
In its report, No Time to Gamble: Leaders Must Unite to Prevent Pandemics, the panel said there had been signs of progress.
The 77th World Health Assembly agreement to amend the International Health Regulations (IHR) can result in faster information-sharing from countries and from the World Health Organization, more transparent processes in deciding a public health emergency of international concern, and a definition of a pandemic emergency which was not codified before.
However an international trend for those with links to vaccine scepticism and disinformation being elected to positions of power makes it urgent to achieve better pandemic preparedness.
"This is a moment in time to try to get some important gains on better international law and provision, and if we miss this moment we will be badly equipped for the next major threat that comes."
The International Panel is co-chaired by Clark and former president of Liberia Ellen Johnson Sirleaf.
President Sirleaf noted with alarm the number of child deaths occurring as a result of a more dangerous strain of mpox, a dearth of diagnostic testing, and the fact that while vaccines exist, they are not yet available where children are dying.
Clark said funds now available paled in comparison to the needs, and high-income countries were holding on too tightly to traditional charity-based approaches to equity.