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If humanity is lucky, the next flu virus with pandemic potential will unfold in a country with a strong public health service and well-stocked hospitals, able to swiftly contain the threat.

If we’re unlucky, a highly infectious, lethal flu virus will break out in a crowded, unprepared megacity.

But we don’t have to leave it to luck. There are practical things we can do—even for the world’s poorest, least-prepared cities. Support for One Health initiatives, such as monitoring animal outbreaks, is one key, says Kanta Subbarao, director of the WHO Collaborating Centre for Reference and Research on Influenza. Encouraging frontline clinics to step up diagnostics is another, according to Amesh Adalja of the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security.

Steady attention to strengthening health systems is also critical. “Rather than getting ready for the Olympics, it’s a lot like daily exercising for your health—and we haven’t really institutionalized that kind of work,” says Keiji Fukuda, director of the University of Hong Kong’s School of Public Health.

Dayna Kerecman Myers, Global Health NOW