Several themes emerged across the different aspects of the coronavirus disease 2019 (COVID-19) preparedness and response that were recounted by different speakers throughout the workshop sessions. Increased multidisciplinary collaborations, a greater focus on equity and access for low- and middle-income countries (LMICs), and holistic and integrated goals were all highlighted as areas that could lead to improved results if given more attention. This chapter highlights those themes and critical points to consider as the world begins to enter a new phase of the current pandemic but ideally is already shifting goals and efforts to improve planning for the next pandemic—whatever the pathogen may be.
Several speakers across fields in Chapter 2 highlighted multidisciplinary collaborations as key for a pandemic preparedness and response. Michael Kremer, Nobel Laureate and university professor at the University of Chicago, suggested partnerships, such as advanced marked commitments, which bridge the public and private sector to incentivize pre-pandemic vaccine research and development (R&D), while at the same time ensuring equitable access to vaccines in case of their need. Many participants advocated for such long-term demand of vaccines and medical research to incentivize the necessary continuous R&D investment. Integrated product development was also highlighted as a way to conduct research that leads to real-world products and applications. These diverse partnerships would lead to innovative ideas and also be easier to form compared to global collaborations. Additionally, governments could incentivize private companies to be more transparent in their supply chains, helping to prevent raw material shortages and vaccine surplus issues. Many speakers voiced support for
increased multidisciplinary collaboration within the One Health field; collaboration between private food manufacturing companies, health systems, and animal and human surveillance would lead to a lower risk of spillovers. Holistic and integrated goals were also highlighted as a way to achieve effective pandemic prevention and response, including more connection between top-down and bottom-up governance and coordination. Additionally, a greater unification between human and animal health within the One Health system was discussed. To achieve this, a few speakers proposed an international surveillance mandate and unified funding mechanisms as ways to incentivize One Health collaboration and unified objectives. Speakers agreed that data and benefits sharing should be bundled but warned against a “transactional” attitude, which would hinder global goals and vaccine R&D. Addressing vaccine nationalism would also enable more freedom of data sharing, ideally leading to more unified and efficient R&D.
Chapter 3 offered suggestions on new technology platforms for R&D, and speakers highlighted the need to be more holistic in funding and consider the entire ecosystem. They built on COVID-19 success stories but strongly emphasized the gaps in equity in terms of vaccine availability and access across the world, including the locations of manufacturing capacity and clinical trials. Charu Kaushic, chair of the Global Research Collaboration for Infectious Disease Preparedness and scientific director of the Canadian Institutes of Health Research, called specifically for a global preparedness network and more focus on One Health, as changing climate patterns and human behavior result in more exposures and opportunities for spillover. All the speakers in this discussion pointed to the need for funding and development in the interepidemic period, in order to preserve continuity and sustainability of research and allow for quickly pivoting during times of emergency. Ran Balicer of Clalit Health Services and Maria Elena Bottazzi of Baylor University both called for more high-quality data and more proactive testing of data sharing across systems during routine events, such as seasonal influenza, to ensure the capability is established in the event of a pandemic.
Speakers across many areas of expertise supported a balance between diversifying manufacturing and distribution capacities geographically and maintaining economies of scale. This was highlighted in Chapter 4. Increasing capacity, especially in LMICs, could lower vaccine hesitancy, reduce future raw material shortages, and provide more equitable access to vaccines and other medical supplies in countries that are often an afterthought in global distribution of needed countermeasures. Beyond manufacturing capacity, multiple speakers from different backgrounds noted that addressing poverty in LMICs is crucial to preventing future pandemics and is a financially sound long-term investment that would benefit wealthy countries.
Finally, Chapter 5 focused on the key elements of communicating important public health research and guidelines. A unified message that integrates holistic explanations of contexts is critical, as Tolbert Nyenswah of Johns Hopkins University and Sherine Guirguis of Common Thread emphasized. Nyenswah also emphasized that transparency when public health officials do not know something, rather than false or misleading information, is vital to gaining trust. Sarah Zhang, staff writer at The Atlantic, also advised against portraying extreme binaries in the media or oversimplifying ideas. Priya Bahri of the European Medicines Agency added that regulatory agencies should inform the public about broader methodological and risk governance topics so that people trust and understand decisions. Similarly, behavioral change interventions and the media can be more effective by seeking to understand the target population’s cultural context. Although communication should be unified across fields, various speakers made the case for needing different voices and addressing each community’s primary concerns.
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