Mapping the future dynamics of disease transmission: risk analysis in the United Kingdom Foresight Programme on the detection and identification of infectious diseases.

This paper reflects on the qualitative risk analysis framework developed for a Foresight study on the Detection and Identification of Infectious Diseases, which was coordinated in 2005 by the United Kingdom (UK) under what is now the Government Office for Science, Department for Innovation, Universities and Skills. The risk assessment covered human, plant and animal diseases in the UK and Africa in the years 2015 and 2030. Through engaging a diverse pool of experts, we developed a model conceptualising disease spread as the outcome of interactions among sources, pathways and drivers. We then used this model to conduct a Delphi survey of experts. The factors perceived most likely to contribute to infectious disease spread in 2015 and 2030 included geographic extension of existing pathogens (partially due to climate change), over-use of antibiotics/antivirals/pesticides leading to drug resistance, and zoonoses. Our methodology provides a framework for those who need to integrate a wide range of perspectives and factors into their planning and analyses.