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Influenza Pandémica, 1918-1919 , Gripe Humana , Neumonía Viral , Humanos , Masculino , Adulto Joven , Dolor en el Pecho/diagnóstico , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Disnea/diagnóstico , Disnea/etiología , Pulmón/diagnóstico por imagen , Pulmón/patología , Radiografía Torácica , Fiebre/diagnóstico , Fiebre/etiología , Tos/diagnóstico , Tos/etiología , Gripe Humana/complicaciones , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Influenza Pandémica, 1918-1919/historia , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Historia del Siglo XX , Historia del Siglo XXI , Monitoreo Epidemiológico , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Preparación para una Pandemia , Vacunas contra la Influenza/administración & dosificaciónRESUMEN
Pandemics are regularly occurring events, and there are foundational principles of pandemic preparation upon which communities, regions, states, and nations may draw upon for elevated preparedness against an inevitable future infectious disease threat. Many disciplines within the social sciences can provide crucial insight and transdisciplinary thinking for the development of preparedness measures. In 2023, the National Science Foundation funded a conference of circumpolar researchers and Indigenous partners to reflect on COVID-19-related research. In this article, we synthesise our diverse social science perspectives to: (1) identify potential areas of future pandemic-related research in Alaska, and (2) pose new research questions that elevate the needs of Alaska and its people, pursuant of a specific body of pandemic knowledge that takes into account the ecological and sociocultural contexts of the region. In doing so, we highlight important domains of research in the social sciences from transdisciplinary perspectives, including the centering of Indigenous knowledges and needs, the contexts of risk perception and resilience, food and housing security, and more. We highlight the contributions of social sciences to pandemic knowledge and provide a foundation for future pandemic-related research in Alaska.
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COVID-19 , Pandemias , Humanos , Alaska/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , SARS-CoV-2 , Ciencias Sociales , Regiones Árticas/epidemiología , Comunicación Interdisciplinaria , Nativos Alasqueños , Preparación para una PandemiaRESUMEN
A public health emergency provides an opportunity and need to utilize the power of evidence, science, research and innovation, and practicality to provide rapid solutions. The COVID-19 pandemic did exactly that. It challenged the scientific and public health community from identification to tracking the virus, from characterizing the disease to developing strategies to treat and contain the pathogen. The Pan American Health Organization (PAHO), as an international public health agency working in the region of the Americas, responded to these challenges with extreme vitality, transparency and accountability, and many achievements were made. The PAHO clinical management team put into practice a rapid response program to support evidence-informed decision making (EIDM) in the Region, and in Member States.
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Urgencias Médicas , Preparación para una Pandemia , COVID-19 , Toma de Decisiones , Uso de la Información Científica en la Toma de Decisiones en Salud , Ciencia Traslacional Biomédica , AméricasRESUMEN
Whilst many lessons were learned from the COVID-19 pandemic, ongoing reflection is needed to develop and maintain preparedness for future outbreaks. Within the field of infectious disease and public health there remain silos and hierarchies in interdisciplinary work, with the risk that humanities and social sciences remain on the epistemological peripheries. However, these disciplines offer insights, expertise and tools that contribute to understanding responses to disease and uptake of interventions for prevention and treatment. In this Perspective, using examples from our own cross-disciplinary research and engagement programme on vaccine hesitancy in South Africa and the United Kingdom (UK), we propose closer integration of expertise, research and methods from humanities and social sciences into pandemic preparedness.
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COVID-19 , Humanidades , Pandemias , Ciencias Sociales , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Reino Unido , Sudáfrica , SARS-CoV-2 , Vacilación a la Vacunación/psicología , Salud Pública , Preparación para una PandemiaAsunto(s)
COVID-19 , Enfermedades Transmisibles Emergentes , Pandemias , Humanos , Pandemias/prevención & control , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Enfermedades Transmisibles Emergentes/virología , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/virología , SARS-CoV-2/genética , Animales , Virus/genética , Virosis/epidemiología , Virosis/prevención & control , Virosis/virología , Preparación para una PandemiaRESUMEN
INTRODUCTION: The COVID-19 pandemic catalyzed unprecedented vaccine innovation, revealing critical shortcomings in achieving equitable vaccine access and underscoring the need for a focused review of the lessons learned to inform future pandemic preparedness, with emphasis on vaccine delivery, equity, and challenges in LMICs. AREAS COVERED: We critically analyzed the pandemic vaccine development and distribution journey and the operational mechanisms that facilitated these achievements. For this purpose, we primarily searched pandemic vaccine stakeholder websites, reports, and publications. The analysis extends beyond the scientific narrative to address the 'how' of the process while anchoring the discussion on equity and global health security as fundamental to preparing for future pandemics. EXPERT OPINION: Drawing on the insights gained from the COVID-19 pandemic, we identify several key challenges requiring immediate attention to fortify preparedness for future pandemics. These are cultivating leadership in the field of vaccinology, guaranteeing equitable global access to diagnostics, therapeutic agents, and vaccines, securing adequate funding for ongoing research and development, ensuring the fair distribution of vaccines, and strategically allocating biomedical manufacturing facilities to ensure a balanced global production capacity. Addressing these challenges is imperative to establish a robust pandemic response framework and mitigate the impact of future global health crises.
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Vacunas contra la COVID-19 , COVID-19 , Salud Global , Pandemias , Desarrollo de Vacunas , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Pandemias/prevención & control , Países en Desarrollo , SARS-CoV-2/inmunología , Preparación para una PandemiaAsunto(s)
Salud Global , Reglamento Sanitario Internacional , Preparación para una Pandemia , Pandemias , Humanos , Salud Global/normas , Cooperación Internacional , Reglamento Sanitario Internacional/normas , Pandemias/prevención & control , Preparación para una Pandemia/métodos , Preparación para una Pandemia/normasRESUMEN
The German Biosecurity Programme was launched in 2013 with the aim to support partner countries overcome biological threats including natural outbreaks or the intentional misuse of highly pathogenic agents. As part of this programme, this paper describes the development and implementation of a multilateral biosafety and biosecurity training initiative, called 'Global Partnership Initiated Biosecurity Academia for Controlling Health Threats' (GIBACHT). To achieve its objectives, GIBACHT implemented a blended-learning approach with self-directed, distance-based learning phases and three training-of-trainer workshops. The programme follows Kirkpatrick's model of learning to guarantee sustainable effects of improved knowledge and skills. One hundred nine fellows from 26 countries have been trained in seven cohorts. Many GIBACHT alumni have established additional biosafety/biosecurity trainings in their home countries. The knowledge exchange is strengthened by the implementation of a Moodle-based alumni network. GIBACHT has the potential to contribute to strengthening the capacities of partner countries in Africa, the Middle East, and South and Central Asia to respond and build resilience to biological threats.
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Becas , Preparación para una Pandemia , Humanos , Creación de Capacidad , Becas/organización & administración , Alemania , Cooperación Internacional , Pandemias/prevención & control , Medidas de SeguridadRESUMEN
Planning for public health emergencies should ensure that capabilities developed during previous emergencies are maintained, incorporated, and put into practice when a new event of public health concern arises. Investments in pandemic preparedness lead to more rapid detection and a stronger response to public health threats, thereby shielding communities from the debilitating social and economic effects of epidemics and pandemics. The Pan American Health Organization (PAHO) recognizes the efforts of countries in the Region of the Americas to develop and/or strengthen their respiratory pathogen pandemic plans. PAHO supports planning activities with tools and expertise, aligning these efforts with the Preparedness and Resilience for Emerging Threats (PRET) initiative. The PRET initiative is an innovative approach to improving disease pandemic preparedness. It recognizes that the same systems, capacities, knowledge, and tools can be leveraged and applied for groups of pathogens based on their mode of transmission (respiratory, vector-borne, foodborne etc.). The PRET initiative incorporates the latest tools and approaches for shared learning and collective action established during the COVID-19 pandemic and other recent public health emergencies. It places the principles of equity, inclusivity, and coherence at the forefront. This document outlines four steps for respiratory pathogen pandemic planning (PRET Module1). Step 1: Prepare, analyze the situation and engage stakeholders, Step 2: Draft the plan, Step 3: Evaluate, finalize and disseminate the plan and Step 4: Implement, monitor and continuously evaluate the plan. The scope of this document is guide the process of updating and developing preparedness and response plans for pandemics caused by respiratory pathogens, in order to strengthen their basic capacities and encourage the countries of the Region of the Americas to have operational, proven plans, and with a regular monitoring and updating plan to address epidemics and pandemics in the face of this type of threat.
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Urgencias Médicas , Pandemias , Transmisión de Enfermedad Infecciosa , Transmisión de Enfermedad Infecciosa , Preparación para una Pandemia , Preparación para una Pandemia , Planificación en DesastresRESUMEN
During the COVID-19 pandemic, intellectual property licensing through bilateral agreements and the Medicines Patent Pool were used to facilitate access to new COVID-19 therapeutics in low- and middle-income countries (LMICs). The lessons learnt from the application of the model to COVID-19 could be relevant for preparedness and response to future pandemics and other health emergencies.The speed at which affordable versions of a new product are available in LMICs is key to the realization of the potential global impact of the product. When initiated early in the research and development life cycle, licensing could facilitate rapid development of generic versions of innovative products in LMICs during a pandemic. The pre-selection of qualified manufacturers, for instance building on the existing network of generic manufacturers engaged during the COVID-19 pandemic, the sharing of know-how and the quick provision of critical inputs such as reference listed drugs (RLDs) could also result in significant time saved. It is important to find a good balance between speed and quality. Necessary quality assurance terms need to be included in licensing agreements, and the potentials of the new World Health Organization Listed Authority mechanism could be explored to promote expedited regulatory reviews and timely access to safe and quality-assured products.The number, capacity, and geographical distribution of licensed companies and the transparency of licensing agreements have implications for the sufficiency of supply, affordability, and supply security. To foster competition and support supply security, licenses should be non-exclusive. There is also a need to put modalities in place to de-risk the development of critical pandemic therapeutics, particularly where generic product development is initiated before the innovator product is proven to be effective and approved. IP licensing and technology transfer can be effective tools to improve the diversification of manufacturing and need to be explored for regional manufacturing for accelerated access at scale in in LMICs and supply security in future pandemics.
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COVID-19 , Países en Desarrollo , Propiedad Intelectual , Concesión de Licencias , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Pandemias , Tratamiento Farmacológico de COVID-19 , Antivirales/uso terapéutico , Industria Farmacéutica/legislación & jurisprudencia , Industria Farmacéutica/organización & administración , Preparación para una PandemiaAsunto(s)
COVID-19 , Preparación para una Pandemia , Pandemias , Humanos , COVID-19/epidemiología , COVID-19/inmunología , COVID-19/prevención & control , Predicción , Pandemias/prevención & control , SARS-CoV-2 , Estados Unidos/epidemiología , Preparación para una Pandemia/organización & administración , Preparación para una Pandemia/normas , Vacunación/normas , Ensayos Clínicos como Asunto/normasRESUMEN
Problem: While the COVID-19 pandemic threatened the entire world, the extremely remote Pitcairn Islands faced unique vulnerabilities. With only a physician and a nurse to care for an ageing population of fewer than 40 residents, and with very limited referral pathways, Pitcairn encountered distinct challenges in preparing for and responding to the COVID-19 pandemic. Context: The Pitcairn Islands is an overseas territory of United Kingdom of Great Britain and Northern Ireland consisting of four islands in the South Pacific: Pitcairn, Henderson, Ducie and Oeno. Pitcairn is the only inhabited island with a local resident population of approximately 31 people, around half of whom were over 60 years old in 2023. The islands are only accessible by sea and are located more than 2000 km from the nearest referral hospital in French Polynesia. Actions: Pitcairn's Island Council took aggressive action to delay the importation of SARS-CoV-2, vaccinate its small population and prepare for the potential arrival of the virus. Outcomes: As of May 2024, Pitcairn was one of the only jurisdictions in the world not to have had a single COVID-19 hospitalization or death. Nevertheless, the pandemic presented the islands' population with many economic, social and health challenges. Discussion: Pitcairn's population avoided COVID-19-related hospitalizations and deaths despite its elderly population's vulnerability to COVID-19, a significant level of comorbidities, and limited clinical management capabilities and options for emergency referrals. The pandemic highlighted some of the population's health vulnerabilities while also underscoring some of their innate strengths.
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COVID-19 , Pandemias , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Reino Unido/epidemiología , Preparación para una PandemiaRESUMEN
BACKGROUND: Covid-19 has reinforced health and economic cases for investing in pandemic preparedness and response (PPR). The World Bank and World Health Organization (WHO) propose that low- and middle-income governments and donor countries should invest $31.1 billion each year for PPR. We analyse, based on the projected economic growth of countries between 2022 and 2027, how likely it is that low- and middle-income country governments and donors can mobilize the estimated funding. METHODS: We modelled trends in economic growth to project domestic health spending by low- and middle-income governments and official development assistance (ODA) by donors for years 2022 to 2027. We modelled two scenarios for countries and donors - a constant and an optimistic scenario. Under the constant scenario we assume that countries and donors continue to dedicate the same proportion of their health spending and ODA as a share of gross domestic product (GDP) and gross national income (GNI), respectively, as they did during baseline (the latest year for which data are available). In the optimistic scenario, we assume a yearly increase of 2.5% in health spending as a share of GDP for countries and ODA as a share of GNI for donors. FINDINGS: Our analysis shows that low-income countries would need to invest on average 37%, lower-middle income countries 9%, and upper-middle income countries 1%, of their total health spending on PPR each year under the constant scenario to meet the World Bank WHO targets. Donors would need to allocate on average 8% of their total ODA across all sectors to PPR each year to meet their target. CONCLUSIONS: The World Bank WHO targets for PPR will not be met unless low- and middle-income governments and donors spend a much higher share of their funding on PPR. Even under optimistic growth scenarios, low-income and lower-middle income countries will require increased support from global health donors. The donor target cannot be met using the yearly increase in ODA under any scenario. If the country and donor targets are not met, the highest-impact health security measures need to be prioritized for funding. Alternative sources of PPR financing could include global taxation (e.g., on financial transactions, carbon, or airline flights), cancelling debt, and addressing illicit financial flows. There is also a need for continued work on estimating current PPR costs and funding requirements in order to arrive at more enduring and reliable estimates.
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COVID-19 , Países en Desarrollo , Desarrollo Económico , Modelos Económicos , Pandemias , Humanos , COVID-19/economía , COVID-19/epidemiología , COVID-19/prevención & control , Pandemias/economía , Salud Global , Producto Interno Bruto , Gastos en Salud/tendencias , Gastos en Salud/estadística & datos numéricos , Preparación para una PandemiaRESUMEN
Objective: To assess national pandemic preparedness and response plans from a health system perspective to determine the extent to which implementation strategies that support health system performance have been included. Methods: We systematically mapped pandemic preparedness and response implementation strategies that improve resilience to pandemics onto the Health System Performance Assessment Framework for Universal Health Coverage. Using this framework, we conducted a document analysis of 14 publicly available national influenza pandemic preparedness plans, submitted to the European Centre for Disease Prevention and Control, to assess how well health system functions are accounted for in each plan. Findings: Implementation strategies found in national influenza pandemic preparedness plans do not systematically consider all health system functions. Instead, they mostly focus on specific aspects of governance. In contrast, little to no mention is made of implementation strategies that aim to strengthen health financing. There was also a lack of implementation strategies to strengthen the health workforce, ensure availability of medical equipment and infrastructure, govern the generation of resources and ensure delivery of public health services. Conclusion: While national influenza pandemic preparedness plans often include provisions to support health system governance, implementation strategies that support other health system functions, namely, resource generation, service delivery, and in particular, financing, are given less attention. These oversights in key planning documents may undermine health system resilience when public health emergencies occur.
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Gripe Humana , Pandemias , Humanos , Pandemias/prevención & control , Europa (Continente)/epidemiología , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Planificación en Desastres/organización & administración , Atención a la Salud/organización & administración , Preparación para una PandemiaRESUMEN
BACKGROUND: The COVID-19 pandemic has highlighted the importance of evidence-informed priority setting and situational analysis in pandemic preparedness and response. Health Technology Assessment (HTA) has been identified as an essential tool for evidence-informed decision-making in healthcare. However, the potential role of HTA in pandemic preparedness and response in Africa has yet to be explored. The objective of this scoping review is to ascertain the current understanding of the possible role of HTA in Africa to support future pandemic preparedness and response. METHODS: We will conduct a scoping review of literature published between 2010 and 2024. Electronic databases like Embase, PubMed, Scopus, Web of Science, and Google Scholar will be utilized to perform the search. We will also search grey literature sources such as websites of relevant organizations and government agencies. The search will only include studies that were conducted in the English language. Two reviewers will evaluate the titles and abstracts of the publications independently to determine their eligibility using Covidence. Full-text articles will be reviewed for eligibility and data extraction. The data will be extracted using a standardized form. The extracted data will include information on the study design, objectives, methods, findings, and conclusions. The thematic analysis approach will guide the data analysis. Themes and sub-themes will be identified and reported. The review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. DISCUSSION: This scoping review will identify the existing knowledge on the potential role of HTA in Africa to support future pandemic preparedness and response. The findings will aid in identifying deficiencies in knowledge and provide valuable insights for future study. Additionally, they will inform policy-makers and other stakeholders about the potential contribution of the Health Technology Assessment (HTA) in enhancing Africa's readiness and response to pandemics.
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Prioridades en Salud , Preparación para una Pandemia , Evaluación de la Tecnología Biomédica , Humanos , África/epidemiologíaRESUMEN
INTRODUCTION: The surge of public health emergencies over the past decade has disproportionately affected sub-Saharan Africa. These include outbreaks of infectious diseases such as Ebola, Monkeypox and COVID-19. Experience has shown that community participation is key to the successful implementation of infection control activities. Despite the pivotal role community engagement plays in epidemic and pandemic preparedness and response activities, strategies to engage communities have been underexplored to date, particularly in sub-Sahara Africa. Furthermore, reviews conducted have not included evidence from the latest pandemic, COVID-19. This scoping review aims to address these gaps by documenting through available literature, the strategies for community engagement for epidemic and pandemic preparedness and response in sub-Sahara Africa. METHODS AND ANALYSIS: We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the methodological framework for scoping reviews from Arksey and O'Malley to guide the review. Two reviewers will develop a systematic search strategy to identify articles published from January 2014 to date. We will retrieve peer-reviewed research published in the English language from databases including Embase, EBSCO-host, PubMed, Global Health, CINAHL, Google Scholar and Web of Science. Additionally, we will search for relevant grey literature from the websites of specific international organisations, public health institutes and Government Ministries of Health in African countries. After the removal of duplicates, the two reviewers will independently screen all titles, abstracts and full articles to establish the relevance of each study for inclusion in the review. We will extract data from the included articles using a data extraction tool and present the findings in tabular form with an accompanying narrative to aid comprehension. ETHICS AND DISSEMINATION: Ethical approval is not required for the conduct of scoping reviews. We plan to disseminate the findings from this review through publications in a peer-reviewed journal, presentations at conferences and meetings with policy-makers.