The Lancet Commission on lessons for the future from the COVID-19 pandemic, 14th September 2022… Viral origins The proximal origin of SARS-CoV-2 remains unknown. There are two leading hypotheses: that the virus emerged as a zoonotic spillover from wildlife or a farm animal, possibly through a wet market, in a location that is still undetermined; or that the virus emerged from a research-related incident, during the field collection of viruses, or through a laboratory-associated escape. No independent, transparent, and science-based investigation has been carried out regarding the bioengineering of SARS-like viruses that was underway before the outbreak of COVID-19. The laboratory notebooks, databases, email records, and samples of institutions involved in such research have not been made available to independent researchers. Independent researchers have not yet investigated the US laboratories engaged in the laboratory manipulation of SARS-CoV-like viruses, nor have they investigated the details of the laboratory research that had been underway in Wuhan. US National Institutes of Health (NIH) has resisted disclosing details of the research on SARS-CoV-related viruses that it had been supporting, providing extensively redacted information only as required by Freedom of Information Act lawsuits. In brief, there are many potential proximal origins of SARS-CoV-2, but there is still a shortfall of independent, scientific, and collaborative work on the issue. The search for the origins of the virus requires unbiased, independent, transparent, and rigorous work by international teams in the fields of virology, epidemiology, bioinformatics, and other related fields, and supported by all governments. In the absence of an unbiased, independent, and rigorous search for a natural origin by a multidisciplinary team of experts alongside an unbiased, independent, and rigorous investigation of the research-related hypotheses, the public’s trust in science will be imperilled, with potentially grave long-term repercussions. It is therefore crucial to investigate all hypotheses fully, not only to ascertain the source of the pandemic and to protect against future emerging infectious diseases, but also to ensure the integrity of science itself. The perceived lack of transparency to date by leading scientific agencies and laboratories is troubling and needs to be addressed. Strategies to prevent research-related releases should include stronger international and national oversight of biosafety, biosecurity, and biorisk management, including the strict regulation of gain of function research of concern. When investigating the origins of any novel pathogen, potential hypotheses should not be prematurely rejected to ensure that time-sensitive data— such as early case information and laboratory records—are collected.SHOW LESS