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Human health is facing escalating risks of circulating contagious pathogens and emerging zoonotic spillover due to global changes characterised by urbanisation and habitat fragmentation.1 The COVID-19 pandemic and 2022 mpox outbreaks have warned us of a possible harsh future, with further deterioration possible upon pathogens’ co-transmission through shared pathways—eg, influenza and SARS-CoV-2 via respiration. This co-transmission will greatly increase the risk of co-infections and pandemics that intensify the burdens of public health infrastructure and expenses for governments.2 Developing cost-effective, multi-pathogen PCR assays is therefore urgently needed. These assays allow high-throughput screening, conserve important health-care and social resources, and facilitate ongoing surveillance of pathogens’ co-transmission.3 Despite being proposed in the 1980s, multi-pathogen PCR testing has not been applied on a large scale due to high costs and analytical challenges. The ongoing COVID-19 pandemic has accelerated the development of such assays, enabling the detection of multiple pathogens from a single swab. A great example is the multiplex assay approved by the US Food and Drug Administration that simultaneously detects SARS-CoV-2 and influenza.4 Similar testing kits are currently being developed worldwide to simultaneously detect SARS-CoV-2 variants and emerging pathogens.5

ction of multiple pathogens from a single swab. A great example is the multiplex assay approved by the US Food and Drug Administration that simultaneously detects SARS-CoV-2 and influenza.4 Similar testing kits are currently being developed worldwide to simultaneously detect SARS-CoV-2 variants and emerging pathogens.5 Regulators and stakeholders should optimise policies to encourage technological advances in multi-pathogen testing and promote their applications across sectors. Rapid integration of multi-pathogen PCR testing into the existing COVID-19 surveillance network, particularly the community-based surveillance operating in 192 countries, would help prevent emerging pathogens from evolving into another pandemic. More importantly, developing similar multi-pathogen surveillance strategies as early warning systems of emerging pathogens will better prepare us for unforeseen co-transmission of zoonotic pathogens and pave the way towards One Health.6 Such efforts will be of substantial importance for the global community to achieve the Sustainable Development Goals by 2030.