Seeing threats before they arrive: RIVM’s Global Risk Assessment of Public Health
HBM Hilderink, I Özdemir, J Miedema, E Van der WilkAbstract
Most public health foresight operates at the national level, optimising for domestic policy relevance. But the most consequential threats of the coming decades — pandemic risk, antimicrobial resistance, climate-driven disease emergence — are global in origin and require anticipatory governance that extends beyond borders. This presentation describes RIVM’s Global Risk Assessment of Public Health, a horizon scanning and scenario-based foresight study designed to identify and prioritise emerging international health threats before they reach the Netherlands and Europe. The study combines systematic horizon scanning — drawing on global disease surveillance networks, scientific literature and expert networks — with a structured risk characterisation process that assesses each identified threat on dimensions of probability, potential health impact, speed of onset and current preparedness adequacy. The output is not a static ranked list but a living assessment updated iteratively as signals strengthen or fade, designed for direct use by the Ministry of Health, Welfare and Sport in preparedness planning and international engagement. Three methodological features distinguish this study from conventional epidemiological risk assessment. First, deep uncertainty is treated explicitly: rather than forcing probability estimates where genuine uncertainty is irreducible, the study uses qualitative likelihood categories and scenario families that acknowledge the limits of quantification without abandoning rigour. Second, non-health drivers are integrated as first-order determinants: geopolitical instability, trade disruption, climate tipping points and ecosystem degradation are not treated as background context but as direct drivers of emerging health risk. Third, the governance interface is deliberately designed: the presentation describes how findings are communicated to non-specialist policy audiences and how they connect to European preparedness frameworks.