Are We Ready? Global Health Security and Financing Experts, Private Sector, Academics and Civil Society Discuss Next Steps for Pandemic Preparedness

Are We Ready? Global Health Security and Financing Experts, Private Sector, Academics and Civil Society Discuss Next Steps for Pandemic Preparedness

{Photo credit: Ben Greenberg/MSH}Peter SandsPhoto credit: Ben Greenberg/MSH

On November 13, approximately 100 global health security and development experts, public health practitioners, private sector representatives, academics, researchers, NGO staff members, scientists and students gathered at Harvard Medical School for the Ready Together Conference on Epidemic Preparedness. The day-long event was co-hosted by No More Epidemics, Management Sciences for Health (MSH), Harvard Global Health Institute, and Georgetown University Center for Global Health Science and Security with support from the James M. and Cathleen D. Stone Foundation. We attempted to find answers to the following questions: 1. What are the financial, economic and other risks to the private sector associated with major disease outbreaks and what is being done to minimize risk and ensure resilience?; 2. What innovations have been developed for pandemic preparedness?; 3. How can a whole of society collaboration be enhanced to ensure global health security?; and 4. How can we overcome barriers, ensure country engagement and public private partnerships?

Here are 5 key takeaways from the discussion:

1. “We must stop ignoring the economic risks. We need Finance Ministers to recognize health threats.”- Peter Sands 

Watch Peter's keynote

The opening keynote was delivered by Peter Sands, Research Fellow at Harvard University who was recently appointed the new Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Sands noted the similarity between the expected annual economic impact of pandemic influenza ($570 billion) and climate change ($890 billion) despite the stark contrasts in terms of media and political attention. The increasing interconnectedness of the world has also increased our vulnerability to infectious disease, due to the rapid spread of fear and associated economic losses. MERS, for example has only claimed a limited number of lives, but it has had a disproportionate economic cost due to the spread of fear.

Sands proposed three key questions associated with strenghtening preparedness. 1) How do we move from self-evaluations (the current Joint External Evaluation exercises) to costed national plans on preparedness? 2) How do we ensure sustained financing for global coordination? and 3) How can we accelerate funding for R&D and take products through to market and especially fund diagnostics? He urged simulation exercises to build awareness of commercial vulnerabilities to staff, customers, supply chain, and finance.

2. “Our biggest challenge is not the CEOs, it’s going to be the day-to-day general managers who need to be convinced and invested in pandemic preparedness.” –Ben Plumley, Chevron

[Dr. Ann Marie Kimball of Chatham House (left) moderates a discussion with Graham Davidson (Rio Tinto), Ben Plumley (Chevron), Rebecca Fish, (Emergent BioSolutions), on risks to the private sector and building resilient communities]{Photo credit: Ben Greenberg/MSH}Dr. Ann Marie Kimball of Chatham House (left) moderates a discussion with Graham Davidson (Rio Tinto), Ben Plumley (Chevron), Rebecca Fish, (Emergent BioSolutions), on risks to the private sector and building resilient communitiesPhoto credit: Ben Greenberg/MSH

Watch Panel 1 video

How do companies cope during an outbreak? Graham Davidson outlined Rio Tinto’s four-pillar operational response to Ebola in Guinea, which resulted in not a single case of the disease amongst staff or family: 1. Keep staff safe. 2. Support frontline response. 3. Focus on business resilience and continuity, and 4. Support local economic recovery. He emphasized the importance of working in lower risk areas during an outbreak to raise awareness about how to avoid contracting the disease. “Private sector must partner with local health providers and not be just a financier,” said Davidson. He urged industry-wide discussions with associations and business councils to get buy-in.

Ben Plumley of Chevron noted the “business rationale” for getting involved in preparedness and warned that infectious diseases severely limit a corporation’s ability to do business. He noted that the private sector has a range of expertise that the public health authorities don’t—for example access to medicines, trained staff, and distribution chains. “There is an ambivalence to working with [the private sector], a sense that we will be seeking to make commercial benefit from whatever we do but in the context of disease preparation and rapid response, that conversation has to change.”

Rebecca Fish of Emergent BioSolutions stressed the need to create networks to build trust, to share best practices before pandemics hit and the importance of effective communication—precise, specific information. She also emphasized the importance of the private sector participating in conversations about public health, noting that it is hard for the private sector to make decisions about production when they do not have enough information about the level of demand.

3.  Data. Data. Data. “We need an outbreak analysis tool to see data for better surveillance and we need a publically accessible tool to provide insights on data gaps.” – Julie Whipple, Qlik

[Ashish Jha of Harvard Global Health Institute moderates discussion between Ryan Morhard (World Economic Forum), Julie Whipple (Qlik) and Kendall Hoyt (CEPI) on innovations for pandemic preparedness.]{Photo credit Ben Greenberg/MSH}Ashish Jha of Harvard Global Health Institute moderates discussion between Ryan Morhard (World Economic Forum), Julie Whipple (Qlik) and Kendall Hoyt (CEPI) on innovations for pandemic preparedness.Photo credit Ben Greenberg/MSH

Watch Panel 2 video

How can innovation and technology help with epidemic preparedness? Qlik is helping countries manage data to make better decisions, such as with an outbreak analysis tool for better surveillance. The Coalition for Epidemic Preparedness Innovation (CEPI) is focusing on a vaccine platform and new testing protocols, with the goal of having a vaccine in 15 weeks that is ready for testing. They are also working on diagnostics. The Epidemic Readiness Accelerator, a World Economic Forum initiative, is – amongst other areas- exploring using mobile warnings on smartphones where there is an infectious disease risk. Early warning systems established for hurricanes have significantly reduced deaths—is there a way of weaving together these services/infrastructure to help us with infectious disease outbreaks? “It’s a balance between preparedness that can be universally applied and preparedness that is pathogen-specific,” said Morhard.

4. What is most important—the message or the messenger “Craft the message first and then bring in the messengers from the community, including traditional healers, religious leaders, market women, radio programs and civil society to strengthen the message.” –Dr. Samuel Abu Pratt, FOCUS 1000

[Dr. Jonathan Quick of MSH moderates a discussion on a whole of society response to pandemics with Dr. Gagik Karapetyan of World Vision, Dr.Samuel Abu Pratt of FOCUS 1000, Sierra Leone, and Ashley Arabasadi of MSH and the GHSA-Consortium.]{Photo credit: Ben Greenberg/MSH}Dr. Jonathan Quick of MSH moderates a discussion on a whole of society response to pandemics with Dr. Gagik Karapetyan of World Vision, Dr.Samuel Abu Pratt of FOCUS 1000, Sierra Leone, and Ashley Arabasadi of MSH and the GHSA-Consortium.Photo credit: Ben Greenberg/MSH

Watch Panel 3 video

Strong community engagement is paramount for triggering community action on prevention, detection, and response. Religious leaders, traditional healers, radio programs, women’s groups, youth, and civil society groups all have a role to play in helping effectively detect and respond to epidemics and accessing new predictive models, financing mechanisms and leadership. Additionally, clear lines of communication from global leadership down to the community level are needed. “Each community has different beliefs and different customs—what we really need is that anthropological lens so we can craft effective interventions that are more efficient more quickly,” said Arabasadi.

At the global level, since the launch of the Global Health Security Agenda (GHSA) in 2014, there has been a heartening explosion of cross-sectoral initiatives for epidemic and pandemic preparedness. These include the civil society GHSA-Consortium, the Private Sector Roundtable, the JEE Alliance, and numerous others. The challenge now is maintaining the commitment and securing funding to build on these commitments.

5. “The supply chain needs to be better organized for any health security risks –including border and customs control. Without a functioning supply chain, there can’t be effective pandemic response.”- Allison Neale, Henry Schein

[Dr. Rebecca Katz of Georgetown’s Center for Global Health Science and Security moderates a panel on overcoming barriers to preparedness—public/private partnerships, country engagement and financing with Captain Nancy Knight of Centers for Disease Control and Prevention; Dr. John Paul Clarke of World Bank Group, Allison Neale of Henry Schein and Maimuna Majumder of HealthMap.]{Photo credit: Ben Greenberg/MSH}Dr. Rebecca Katz of Georgetown’s Center for Global Health Science and Security moderates a panel on overcoming barriers to preparedness—public/private partnerships, country engagement and financing with Captain Nancy Knight of Centers for Disease Control and Prevention; Dr. John Paul Clarke of World Bank Group, Allison Neale of Henry Schein and Maimuna Majumder of HealthMap.Photo credit: Ben Greenberg/MSH

Watch Panel 4 video

What has held us back when it comes to preparedness? “Insufficient support across the continuum of stakeholders; lack of timely, accurate information and sharing of data; poor assessment of risks, vulnerabilities to all sectors; partial accountability and transparency among countries; unpredictable and insufficient funding and resources,” said Knight. We also “need engagement across agricultural and environmental sectors to implement a One Health Approach”, said Clarke.

Allison Neale of Henry Schein noted the importance of moving health products and supplies, “A functioning supply chain is critical to preventing epidemics.”

Open access digital disease surveillance platforms are also valuable but there is a need for higher resolution data (types: biometric, demographic, mobility) said Majumder.

[Marian Wentworth]{Photo credit: Ben Greenberg/MSH}Marian WentworthPhoto credit: Ben Greenberg/MSH

Marian Wentworth, MSH’s President and CEO, closed the conference with these observations:

Global health security is not the purview of one sector and certainly not just healthcare or public health experts. It is a business imperative to include global health security in its enterprise risk management considerations and the economic data demonstrate that it is actually an error of stewardship otherwise. It is equally imperative for Ministers of Finance to budget for global health security issues. We saw, however, that the fact base is not there, the baseline noise is not there. We will need to do more work to bridge the divide between healthcare knowledge and public good. If we are going to be ready, we need to be Ready Together.

Kat Geddes contributed content for this piece.

Full conference proceedings will be available soon.

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