To assess the global pandemic preparedness crisis through spillover prevention capacity — examining the epidemiological acceleration of zoonotic spillover events, the surveillance capacity gaps that allow pathogens to reach pandemic scale before detection, and the chronic underinvestment in spillover prevention despite overwhelming cost-benefit evidence.

Synthesis of epidemiological surveillance data from PREDICT network and WHO systems; analysis of spillover event acceleration trends 1970-2024; assessment of global surveillance capacity using WHO IHR Core Capacity indicators; cost-benefit analysis comparing spillover prevention investment against pandemic response costs.

Zoonotic spillover events estimated at 30,000-850,000 annually with <1% detected. Spillover frequency has increased 4-fold per decade since 1970. Average detection lag is 30-60 days from initial spillover to international notification. 60% of countries fail WHO minimum surveillance standards.

Sub-Saharan Africa, Southeast Asia, and South Asia — regions with highest spillover risk — have lowest surveillance capacity. The PREDICT project (highest-capacity spillover surveillance network) was closed post-COVID despite being the most effective early warning system. 01% of pandemic response costs (COVID-19 response exceeded $10 trillion).

A $5B annual spillover prevention program would cost less than pandemic response for a single 1918-level event.