Opinion: A pathogen surveillance network will strengthen global health

The COVID-19 pandemic clearly demonstrated the value that pathogen sequencing played in developing diagnostics within weeks, vaccines within months, and therapeutics in less than two years. To ensure we don’t backtrack on one of the few positive developments to come out of the pandemic, a pathogen surveillance network launched just last week. Pathogen genomic surveillance, or PGS, is the ongoing collection, sequencing, and analysis of the genetic code of viruses, bacteria, and other disease-causing pathogens. It is a critical tool for the management of threats to public health. Without the rapid sequencing, analysis, and sharing of the genomic data of COVID-19, we would not have been able to develop vaccines as quickly as we did; neither would we have been able to develop therapeutics that were adapted to successive variants as they emerged. During the COVID-19 pandemic, countries invested substantial resources in scaling up PGS capacity. At the height of the pandemic, more than 67,000 genomes were being deposited in public viral genome data repositories each day.. COVID-19 is just one of many risks that PGS seeks to address. Globalization, climate change, and antimicrobial resistance will create opportunities for the emergence of new diseases, and new geographies for existing ones. A robust and flexible PGS system is essential to manage these risks. Amid lockdowns, political division, and overwhelmed emergency systems, the international scale-up and cooperation in PGS stand as one of the pandemic’s few success stories. --— These challenges cannot be addressed in isolation, and the fragility of investments made during the pandemic threatens progress. There are now many technical and financial groups working in genomic surveillance, but currently, no global platform to support them. Creating a more connected and sustainable international system requires a network of country, regional, and global partners designed to facilitate coordination and collaboration between policy, technical, and financing groups. The International Pathogen Surveillance Network A new initiative that aims to fill this need was launched last week in Geneva, on the sidelines of the 76th World Health Assembly. The International Pathogen Surveillance Network, or IPSN, is a global network of public health officials, academia, philanthropy, regional, and international organizations, and the private sector. It will be supported by a World Health Organization secretariat, housed in the WHO Hub for Pandemic and Epidemic Intelligence in Berlin. It is financed by a number of bilateral and philanthropic partners, including the German government. The IPSN will bring together disease surveillance groups around the world that will solve common challenges collectively, including working on standards and protocols for data and data sharing, determining how to increase PGS capacity in countries, testing new innovations, and contributing to the global knowledge base. It will be a global voice that advocates for quality disease surveillance, supported by sustainable financing. PGS serves clinical, research, and public health needs. It provides data to determine optimal treatment regimens, such as for patients with tuberculosis and HIV; it can detect and monitor AMR; identify the source of outbreaks; and support the creation of vaccines for seasonal viruses such as flu. In addition to its purpose in the health sector, PGS also provides important insights for the food, agriculture, and environment sectors. Investing in the future of health systems Investing in PGS is an investment in the future of health systems. Robust PGS ensures that we can respond to outbreaks with vaccines, diagnostics, and therapeutics that are as effective as possible; that treatments are tailored to the requirements of patients; and that public health decision making is supported by the best possible evidence, especially for new and emerging threats. Although the COVID-19 pandemic has led to rapid growth in PGS capacity, we are in danger of losing the opportunity to build on these investments and instead backtracking on our gains. We need to recognize that not all the resources required are available in one country, region or organization, and networks are necessary to harness the full potential of pathogen genomics. At present, though, PGS faces many challenges. Sharing of data and benefits is hampered by unresolved issues of transparency, accountability, and credit. Countries differ widely in their ability to fund and sustain PGS capacity, and resources are not always allocated according to need. The result is a disjointed disease surveillance system that is not as effective as it should be. Moreover, we cannot continue to reinforce the inequalities that shut some countries out of the knowledge and benefits PGS provides. A more collaborative sequencing ecosystem will respond more quickly to new disease threats and will help to better manage current threats. The IPSN is designed to support stronger country and regional systems, with more capacity that is more equitably distributed. Amid lockdowns, political division, and overwhelmed emergency systems, the international scale-up and cooperation in PGS stand as one of the pandemic’s few success stories. The IPSN will build upon this success and help strengthen quality disease surveillance efforts around the world.