Geodemography, environment and societal characteristics drive the global diversity of emerging, zoonotic and human pathogens

Background: Understanding human disease, zoonoses, and emergence is a global priority. Multifactorial aetiologies have been proposed, but mechanistic analyses to quantify the underlying factors are limited. A deep understanding of pathogen ecology and the complex inherent relationships at the agent-environment interface are essential to inform disease control and mitigation, and to predict the next zoonotic pandemic. Methods: We present an analysis of several social and environmental factors associated with human disease, zoonoses, and disease emergence after controlling for research effort. In contrast to previous studies that used emerging infectious disease events, we used human, zoonotic and emerging pathogen diversity. Predictor-response associations were captured by generalised additive models. Research effort was controlled using gross domestic research expenditure and development at the country level. In addition, we used national level data to aid in policy development to inform control and mitigation. Findings: We show that human population density, land area, temperature, and the human development index at the country level are associated with human, emerging and zoonotic pathogen diversity. Multiple models demonstrating society-agent-environment interactions and global maps showing predicted pathogen diversity are presented. Interpretation: Social, environmental, and geographical factors predict global pathogen diversity. Further, our analyses demonstrate that climate change, such as temperature and rainfall, has the potential to influence pathogen diversity.