Zoonotic diseases in low and middle-income countries (LMICs): Economic burden, challenges, strategies, and future directions

More than 200 zoonotic diseases are known to affect humans, representing a significant share of both emerging and existing infectious diseases worldwide. These diseases pose a major global public health challenge, particularly in low- and middle-income countries (LMICs), where limited surveillance systems, inadequate containment measures, and structural inequities allow rapid transmission. Key contributing factors include poverty, fragile healthcare infrastructure, political instability, fragmented policies, and low public awareness. Addressing these challenges demands integrated and context-sensitive strategies that strengthen community-based surveillance, promote the development of affordable diagnostic and preventive tools, and empower local institutions. Collaborative efforts among national and international partners, grounded in the One Health framework, are essential for achieving sustainable disease control and prevention. In addition, the strategic application of emerging technologies such as genomics, artificial intelligence, and precision medicine can improve diagnostic capacity, facilitate real-time data sharing, enable predictive modelling, and support evidence-based policy decisions. Together, these approaches can enhance equity, efficiency, and sustainability in the management of endemic, emerging, and novel zoonotic diseases, while strengthening preparedness for future zoonotic threats. • Zoonotic diseases constitute a major share of emerging infections, placing a significant burden on LMICs public health. • Weak surveillance and limited healthcare access impede zoonotic disease prevention in LMICs. • The One Health framework fosters multisectoral collaborationfor disease prevention and outbreak response. • Integrating genomicsartificial intelligence, and ecosystem methods enhances early prediction of zoonotic threats.