COVID-19 caught the world off guard; the speed at which it spread and the extent of its impact on people’s lives came as a great shock. Many experts had long been warning about the risks of a new pathogen and its global spread but weren’t taken seriously and hence the disaster unleashed.
History informs that more than six distinct influenza pandemics and epidemics have struck in just over a century. Ebola viruses have spilled over from animals about 25 times in the past five decades. At least seven coronaviruses, including SARS-CoV-2, have brought illness and death. Despite all the advances in science and medicine, the risk of pandemics is actually increasing. It’s not a question of if there will be the next pandemic but “when”?
Averting the next pandemic requires a strategic reset of our preparedness system. Fine-tuning & investing in strengthening the surveillance system, vaccine and supply chain, communication, health governance, global collaboration, innovation and adequate financing is likely to pay off.
A need for an effective surveillance system
The world’s largest Ebola epidemic was spreading for more than a month before anyone diagnosed it. Similarly, scientists opine that China had probably been infected by SARS-CoV-2 for several weeks before officials reported mysterious pneumonia in Wuhan. This was partly due to limited laboratory facilities in the region, but also because of the absence of an efficient disease surveillance network.
Early detection of an outbreak can bring it under control and end it quicker, but to do so resilient national response systems need to be in place once the alarm bell has been sounded. As COVID-19 has shown, when an outbreak escalates into a pandemic, the increased pressure it can place on health systems can cause them to quickly buckle, even in the wealthiest countries. A sensitive, efficient and responsive surveillance system is the key.
Data-driven decision making
Better data would have helped epidemiologists to determine more quickly and confidently the SARS-CoV-2 spreads through the air and that it could be transmitted without symptoms. Resultantly scientists in the early phase could have advocated for measures such as widespread testing and face masks.
Many criticized China for being less than forthcoming at the beginning of the pandemic, but it hasn’t been alone. In India, local journalists exposed the fact that officials were not sharing the case numbers in a timely manner. Arvind Subramanian, an economist at Brown University, estimated that India had under-reported deaths by 3 million or more from the start of the pandemic to June 2021.
Sharing epidemiological and genomic data in an outbreak might have political dimensions that must be negotiated at high forums, similarly to the 2011 influenza framework and other multilateral treaties. Disease modeling had predicted well before an impending pandemic and could guide the course in the future adequately.
Vaccine & supply chain
With COVID-19, the speed and the response from the scientific community have been incredible. From the moment the genome of the SARS-CoV-2 virus was published, it took just 327 days for the first vaccine to be developed, tested and authorized for emergency use. Today there are 19 vaccines authorized, 110 in clinical trials and further 184 vaccine candidates in pre-clinical development.
The irony is that despite that the World has made little progress when it comes to the distribution of COVID vaccines as less than 5 % of people in low-income countries have been vaccinated so far.
We’re still hampered by vaccine nationalism and export restrictions that plagued us during the 2009 swine flu pandemic.
To avoid a repeat of this we need to develop a system that can ensure vaccine delivery within just 100 days after a pandemic has been declared.
The best course is to build on our existing global supply chains, such as that of routine immunization programs.
Read more: Covid-19 response in India and Pakistan
Fighting the infodemics
We witnessed confusion at the start of this pandemic and at times it seemed as if the mandated agency for safeguarding world health itself was the least informed and ready, to say the least?
In Pakistan health ministers in televised interviews didn’t recommend face masks by the public until mid-2020. In Brazil, President JairBolsonaro trivialized COVID-19, calling it “little flu”.
In May 2020, the WHO passed a resolution in which countries agreed to combat misinformation at home. A committee of experts listed some key approaches. i.e. working with data scientists and social-media companies to amplify the reach of credible messages from mandated credible sources. Social Media handles are bound to remove disinformation from their platform. A Crisis communication cell at the central level could better harmonize the flow & content of information.
Strengthening public-health system
Investing in strengthening Primary health care and making universal health coverage a cornerstone of national health policy is the simplest recipe for success.
Granting public-health departments more power during health crises, along with more stable budgets would pay dividends. Similarly building and retaining surge technical capacity at all levels of the health spectrum is a sine qua non for an effective response. Improved health governance, meritocracy and a multi-purpose coordination platform like NCOC would serve the purpose.
International Collaboration, leadership & innovation
World leaders now recognize the devastation that health crises create and are motivated to act. A report from a G20 panel calls for $75 billion in international financing for pandemic prevention and preparedness — twice as much as current spending levels. A stronger alliance between low- and lower-middle-income countries would yield much.
Galvanizing global entities for vaccine equity, debt wavering, global standards and solidarity demand champions that can fuel the momentum.
While fundraising during a crisis is less than ideal, there is clearly a need for a more coordinated approach to funding pandemic preparedness in advance.
Innovations like mRNA vaccines, the establishment of COVAX, CEPI are great leaps forwards and global pandemic response funds with equity implanted as the main pillar would serve the world better.
Despite the complexity, we should pin hopes on the global conscious awakened by the huge cost of the pandemic.
Dr. Nadeem Jan (Tamgha I Imtiaz) is an internationally recognized health & development expert, who has an illustrious career with UN, USAID, World Bank, Gates Foundation, and Governments of Pakistan, Somalia, Kenya, Ethiopia, South Sudan, Afghanistan, and the Philippines. He can be reached at Nadeemjan77@hotmail.com. The views expressed in the article are the author’s own and do not necessarily reflect the editorial policy of Global Village Space.