United States
United States
United States
The COVID-19 pandemic has proven that infectious diseases cannot be stopped by geopolitical borders. An increasingly interconnected world heightens the risk of lightning-fast spread of pathogens regardless of oceans or national travel bans.1 The silver lining, though, is that those interconnections can also link people, nations, and governments in ways that boost collective power to tackle global crises.
While international campaigns to advance health are hardly new—the Spanish government launched a smallpox vaccination effort in its American and Asian territories in the early 19th century—COVID-19 has sparked an unprecedented joint commitment among nations to build common resilience against future pandemics.2
Robust international partnerships to build pandemic preparedness are coalescing and becoming stronger; more governments are working with the United Nations, the World Bank, the World Health Organization (WHO), and other organizations on the issue.4
Collaborative efforts are underway to:
Every emerging disease differs in terms of its communicability, severity, and genetic makeup. Public health officials need rapid, credible information to understand these characteristics before they can tailor an effective response. The rapid spread of COVID-19 illustrates the importance of a global early warning system with broad international participation to rapidly identify potential outbreaks, forecast risk levels, and guide prevention and containment strategies. The current system, to the extent it exists at all, has a distressing number of weaknesses. Some nations are investing in sophisticated surveillance mechanisms for emerging diseases, but many others are far behind.5
Collaboration among nations and international organizations can close some of these gaps, particularly in data-sharing.6 WHO’s Epidemic Intelligence from Open Sources (EIOS) initiative, formalized in 2017, is building a global community of public health stakeholders from nations and international organizations to share ideas, expertise, and promising practices for facilitating early threat detection.7 Building on the EIOS initiative, in September 2021 the WHO launched its Hub for Pandemic and Epidemic Intelligence, which will facilitate international collaboration and knowledge-sharing through networks augmented by artificial intelligence–based solutions.8
Such systems are giving public health leaders a faster and deeper understanding of new viruses. Recently founded collaborative genome sequencing networks—one operated by Brazil, Russia, India, and China and another by the US Centers for Disease Control and Prevention and the United Kingdom’s Health Security Agency—will help researchers detect dangerous variants and foresee outbreaks.9
Another international priority for governments is the containment of zoonotic diseases—diseases that can be transmitted from animals to humans. Zoonotic diseases account for more than half of all emerging infectious diseases.10 Also, the growing interdependencies between planetary health and human health pose a concern. How humans treat the planet for their own benefit holds long-term implications for human health and well-being.
Governments and international organizations are shifting toward a “one health” approach that highlights the interconnectedness between human, animal, and environmental health. As a result, global leaders are actively discussing the establishment of comprehensive surveillance and monitoring systems to screen for disease-causing viruses in animals. In early 2021, multiple international organizations including the WHO and the Food and Agriculture Organization (FAO) came together to launch a One Health High-Level Expert Panel for providing guidance to partners and supporting evidence-based decision-making on matters related to One Health.11
The arrival of COVID-19 spurred unprecedented innovation worldwide to develop novel technologies, treatments, and vaccines. Nations rushed to share genome sequencing data and information to rapidly put in place countermeasures, including diagnostic tests and vaccines. Governments took steps to speed up the mass production of vaccines, making significant research and development (R&D) investments and absorbing some risks associated with the process.12
The crisis and the response to it have illustrated the importance of moving from the traditional step-by-step model for R&D to an agile approach that can both shorten time to market and expand the scale of production.Global initiatives are building upon the remarkable speed of innovation in response to COVID-19 by accelerating rapid response solutions for future health threats.
In March 2021, for instance, the global Coalition for Epidemic Preparedness Innovations (CEPI) laid out a five-year, US$3.5 billion plan for the entire life cycle of pandemic preparedness, including the “moonshot” objective of developing and authorizing vaccines in 100 days.13
A United Kingdom–led pandemic preparedness partnership, affirmed by the G7 Carbis Bay Declaration in June 2021, also has called for vaccine development within 100 days, as well as accelerated development and deployment of diagnostics and therapeutics.14
Clinical trials represent another area in which international partnerships can expedite critical and life-saving treatments. WHO’s Solidarity Clinical Trial is an international collaboration among 600 hospitals in more than 50 countries to rapidly identify treatments for COVID-19; its goal is to simplify and accelerate trial procedures and minimize paperwork for patient enrollment, while also encouraging local researchers to contribute their expertise.15 In a similar vein, regional collaboratives for clinical trials, such as the European Research and Preparedness Network for Pandemics and Emerging Infectious Diseases, are building adaptive platforms that allow researchers to study multiple therapies simultaneously—and quickly eliminate unsafe or unpromising interventions.16
While the pandemic has facilitated novel and innovative international partnerships, it has also exposed inequities.17 The distribution of COVID-19 vaccines and therapeutics was starkly unequal. High-income and developed countries managed to procure a significant chunk of supplies early on, while low-income nations and regions continue to struggle with insufficient support from scientific and manufacturing companies. This highlights the need to close widening disparities in global health resources.18
With increasing recognition that “no country is safe unless all countries are safe,” governments and multinational organizations are starting to mobilize their resources to build pandemic response capacity in low-resource settings.19 For example, apart from the UN-backed Access to COVID-19 Tools Accelerator (see the sidebar, “The ACT Accelerator: A coalition for global vaccine equity”), the Quad Vaccine Partnership between the United States, Japan, Australia, and India aims to expand COVID-19 vaccine manufacturing capabilities in the Indo-Pacific region, drive community engagement, and counter vaccine misinformation.20
African nations’ relative lack of scientific and manufacturing infrastructure has hindered their efforts to supply and distribute COVID-19 vaccines. However, some countries have looked to ramp up capacity. One large, multipartner initiative aims to reduce Senegal’s dependence on vaccine imports by boosting local manufacturing capabilities. The European Commission and public entities from Germany, France, and the United States are working with Senegal’s biomedical research center, Institut Pasteur de Dakar, to create a new production facility.21 Also WHO has joined a South African consortium and other partners to establish a technology transfer hub for mRNA vaccines in South Africa. Such initiatives could help countries become self-reliant, but much will depend on the willingness of mRNA manufacturers to share their technology and expertise.22
In addition to strengthening infrastructure, global collaboratives are also working to bolster clinical trial capacity in lower and middle income countries. The nonprofit, International AIDS Vaccine Initiative, drawing on funding from a wide range of European and African countries and CEPI, is moving toward the next stage of clinical trials for a vaccine for Lassa fever, which is endemic in West Africa.23
Building on the unprecedented collaborative momentum in response to the COVID-19 pandemic, agencies can leverage the following five tactics to foster durable global partnerships.
