Integrating Prevention and Response at the Crossroads of Henipavirus Preparedness, Hendra@30 Conference, 2024

H enipaviruses, exemplified by Hendra virus (HeV) and Nipah virus (NiV), represent critical threats to global health security, given their broad host geographic range, repeated spillover into humans and domestic animals, high case-fatality rates (CFR; 57% CFR for HeV (1) and 80% CFR for NiV [2]), and limited medical countermeasures, creating substantial challenges for outbreak preparedness.Since its emergence in 1994, HeV has caused devastating outbreaks in Australia with infection primarily in horses and humans; there were >105 equine cases in which the animals died or were euthanized and 7 human cases, including 4 deaths (3).NiV was identified in 1998 after it caused a large outbreak in Malaysia and Singapore that affected pigs and humans, resulting in 110 human deaths (1).Since then, NiV outbreaks have been reported in Bangladesh and India, with near-annual human outbreaks in Bangladesh since 2001.An outbreak consistent with NiV infection also occurred in the Philippines, although full viral sequence and isolates were not obtained (1).The scientific community has recently mobilized efforts to address those challenges through policy frameworks, research roadmaps, investments in vaccines and therapeutics, and collaborative scientific exchange.The World Health Organization (WHO) prioritized Henipavirus nipahense as a prototype pathogen within the Paramyxoviridae family (4).In parallel, 15 subject matter experts published an update to the 2019 WHO research and development (R&D) roadmap for accelerating the development of medical countermeasures to enable effective and timely responses to NiV outbreaks (5).The WHO South-East Asia Regional Office (SEARO) synthesized