- A new target of 100 days for diagnostics, therapeutics and vaccines to respond to future pandemics has been set;
- Global protocols on clinical trials will need to be agreed, smart and distributed manufacturing capacity increased and health workers engaged to achieve this goal;
- "A coalition of the willing" from the public, academic, private and philanthropic sectors would be required to support WHO leadership on this mission.
The 2021 G7 Summit hosted by the UK at Carbis Bay set an ambitious target of 100 days for diagnostics, therapeutics and vaccines to respond to future pandemics. The 100 Days Mission will require a significantly different effort from what we have seen with the COVID-19 pandemic.
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There are many things that will have to change. Among them agreed global protocols for clinical trials building on the experience of the World Health Organization’s ”solidarity clinical trials”, one of the world’s largest international randomized trials for COVID-19 treatments. In parallel, we would require smart and distributed manufacturing capacity that can be ramped up in different directions depending on the nature of the pathogen. We would also need much greater coordination of investments into research and development to avoid wasting research dollars and to enable pooling of talent and resources.
Human capacity and health worker engagement will be critical to achieving the 100 Days Mission. Frontline public health officials need to be retrained for a new age of pandemics and infodemics. Collaborative development of content and training platforms would enable cohorts of such officials from different countries to come together as a learning community. This would enable them to develop an international perspective on the One Health approach, which recognizes that people’s health is closely linked to the health of animals and the shared environment, and greater appreciation of the digitalization of public health responses.
Health workers will need to be engaged from the outset to ensure that non-pharmaceutical interventions, new tests and therapeutics can be integrated smoothly and efficiently into existing workflows. This is a lesson we have learnt from the mixed results with deploying tracing apps and similar digital tools during this pandemic.
Above all, we need to get the starting line for the 100 days’ dash right. This would mean putting in place a science-based and digitally enabled global pandemic surveillance system. Such a scheme can bring data from diverse sources together in a trusted and neutral digital infrastructure to help pinpoint outbreaks that can turn into pandemics. This will buy decision-makers crucial time to ramp up preparations and get to the starting line. A “peace time” version of the scheme humming away in the background can help improve the continuum of personal and community health care.
To succeed, such a system needs to be comprehensive, coordinated and canny. Centres of excellence in a few geographies alone would not do; an equitable and distributed “hubs and spokes” network across the globe would work better. Usual public data sources would need to be combined with private sector contributions and other unusual sources. To do this in a way that builds and maintains trust, new ways of accessing sensitive data need to be deployed, including distributed and privacy preserving technologies.
Citizens and communities need to be engaged. An exciting prospect is “disease detectives” – citizen scientists that help police the One Health realm of human, animal and planetary health. The surge of new energy and ideas coming into this domain make it clear that this is not an idealist hope. The Trinity Challenge attracted 340 solutions from 61 countries aimed at helping identify, respond to and recover from pandemics while data.org’s Inclusive Growth and Recovery Challenge had more than 1,200 applicants from 108 countries focused on applying the best data science solutions to help communities recover from the economic impact of COVID-19.
The will is there; we need to channel it well. Follow-up to the G7 call could move along three tracks:
1. A political-diplomatic track which weaves the G7 work with initiatives coming from the G20, UN and the WHO to create a broader base of political support and agreement. In particular, the UK, Germany and Japan from the G7 and Italy, Indonesia and India from the G20 have a leadership opportunity to work together over the next two years to help the world get ready for the next pandemic.
2. A science and technology track that captures multi-disciplinary perspectives and shapes them into a research and development agenda for different modules of the global pandemic system. This track would also include the development of a neutral data architecture and advanced artificial intelligence (AI) models for the scheme. As the Science Academies of the G7 have underlined, the use of health data for emergencies would require action on principles based on governance mechanisms, infrastructure and technologies.
3. A public engagement track that reaches out to the general public, innovators and publicly minded private sector companies to forge a broader coalition going beyond international organizations and governments. Challenges that bring a new generation of scientists, technologists, entrepreneurs and civil society groups into pandemic surveillance and response should be part of this track. We will need a broader base of innovation than we have today if we are to beat the next pandemic to the finish line.
The Carbis Bay outcomes maintain the momentum created by the report of the WHO Independent Panel on Pandemic Preparedness and Response (IPPPR) and the G20 Rome Declaration. Initiatives for global surveillance platforms have been announced, to wit the UK’s Global Pandemic Radar and the WHO Berlin Hub. A coordinated two-year implementation roadmap with science, data and analytics as its bedrock would be a natural next step. WHO leadership is crucial to craft a common policy framework, including agreed standards and protocols for sharing data as well as legacy coupling to existing detection and surveillance systems. A coalition of the willing from the public, academic, private and philanthropic sectors can support the WHO in bringing an early harvest and a scheme for adoption to the G7 and G20 Summits in 2023 that can help us outrun the next pandemic.
The following co-authors contributed to this article: Hala Audi, CEO, The Trinity Challenge; Rupert Lewis, Chief Science Policy Officer, Royal Society; Bilal Mateen, Clinical Technology Lead, Data for Science and Health Priority Area, Wellcome Trust; Danil Mikhailov, Executive Director, data.org; and Dr Peiling Yap, Chief Scientist, I-DAIR.