Bolstering global pandemic preparedness must be an intentional, collaborative exercise in building the right ecosystems at local, regional, and global levels, a group of public health experts told audience members at Devex World in Washington, D.C. on Tuesday.
And there is urgency to lay this groundwork now, ahead of future pandemics. “You don't want to be exchanging business cards at the site of a disaster,” said Richard Hatchett, chief executive officer at the Coalition for Epidemic Preparedness Innovations.
During the COVID-19 pandemic, new vaccines were deployed at record speed — from the time between when the virus was sequenced to when the new vaccines were approved by regulatory authorities. This was only possible due to previous investments in learning how to “crack the code” in developing vaccines for coronaviruses, including for SARS and MERS, as well as research on messenger RNA technology, Hatchett said.
But this previous work has its limitations.
“We are not prepared for many of the other viral families that represent threats, and we have to have a global [research and development] concerted investment to make sure that our preparedness for future threats is broad. Then, once a threat emerges, we need to be able to deliver vaccines much more rapidly than we did in 2020,” he said. “The delivery mechanisms were not as practiced, and they had to be kind of assembled on the fly.”
But this needs strengthening moving forward. “These aren't things that we can put on the shelf, and dust off when we need them. They have to be embedded capabilities at the country level, at the local level. And if we don't succeed in doing that, when the next crisis comes along, we will stumble in the same places,” Hatchett said.
Chikwe Ihekweazu, director general of the World Health Organization’s Hub for Pandemic and Epidemic Intelligence, noted the importance of front-line workers in tracking and preventing potential pandemics. Health responders on a daily basis investigate signals such as clusters of new fevers or deaths — signals, he pointed out, that can evolve into an epidemic and even pandemic.
“The better we get that bottom of the pyramid activity happening and happening well and effectively, the safer we all are,” he said. WHO detects about 5,000 signals every month that could end up being an epidemic, he said, adding that “most of them are never heard about because they are well-managed.”
“Any chance that we have of defeating future pandemic threats will depend on the types of on-the-ground capabilities. ... It will depend on early detection; early, effective, rapid public health response to contain; and early delivery of definitive countermeasures — diagnostics, therapeutics, and vaccines,” Hatchett said. “If we can do those three things, which require success at all levels of the pyramid, then we actually have the potential to prevent future pandemics. And they are coming.”
Now, WHO is trying to be more intentional about increasing ecosystems of trust so countries and communities feel comfortable sharing information with each other. Countries thus far have sometimes found themselves penalized for outbreaks, either by a loss of tourism and trade or by measures such as travel bans.
“Building trust takes time. It's hard. It takes working together in peacetime, but you can't do it in the middle of a pandemic,” Ihekweazu said.
It’s really important to build up regional and subregional capabilities, such as with the Africa Centres for Disease Control and Prevention, in areas such as surveillance, supply chains, and research, said Jumana Qamruddin, a senior health specialist at the World Bank Group.
The World Bank — which Qamruddin said took on significant risk during the pandemic — is “really thinking about how to finance differently,” Qamruddin said. The new financial intermediary fund, which is the first of its kind and was overwhelmingly approved by the World Bank’s board, is one example.
The bank has also intensified its investments with regional institutions. “We see this really as a critical avenue to ensure that investments in preparedness are both sustainable, equitable, and … impactful at the end of the day.”
The pandemic sparked a “flurry of activities” in innovations in areas such as contact tracing, surveillance, infrastructure upgrades, and improvements to supply chains — but because these efforts were organic, they weren’t always coordinated, Ihekweazu said. To increase coordination, WHO has set up a new pandemic hub in Berlin.
“We have to really socialize, internalize that we're interdependent on each other,” he said. “We're putting forward a new concept of collaborative intelligence, collaborating across regions, across disciplines, across professions. Really, we're in this together.”