As part of a major effort to address growing biothreats, the Council on Strategic Risks (CSR) released a report on July 20 that both assesses the current state of biosurveillance in the world, and offers strong recommendations for how to build a “global pathogen early warning system” – one designed to catch the full range of biological threats before they become devastating pandemics. The report was authored by a team with deep experience in both the national security and health fields.
Though the world’s ability to detect, track, and analyze disease threats has improved considerably over the past several decades, the COVID-19 pandemic drove home a terrible reality: the systems we had in place are still deeply insufficient for halting the rapid spread of a novel pathogen fast enough to prevent a staggering level of damage.
The report identifies critical gaps in biosurveillance and recommendations for filling them.
On gaps, the analysis shows that disease reporting is highly inconsistent across geographies. According to one of the co-authors, Dr. Natasha Bajema, Director of the Converging Risks Lab at the Council on Strategic Risks, “Data collected are not always shared in a timely way, and even then are not always compatible for creating a full picture of an outbreak.”
Many of today’s systems also rely on reporting weeks or longer after diseases are diagnosed in patients. This means patients can continue spreading a disease (at times unknowingly) for longer. Novel pathogens new to human understanding, like SARS-CoV-2 was in 2019, are too often not characterized before they’ve spread to an alarming extent.
“The good news is that many countries have a strong foundation to build upon: capable laboratories, well trained personnel, often-strong coordination with neighboring nations, and rapidly-advancing technologies,” noted Christine Parthemore, CEO of the Council on Strategic Risks and co-author of the report.
Co-author and Council on Strategic Risks Fellow Bill Beaver added, “Technologies such as metagenomic sequencing have come into their own during the pandemic and are making possible a layered system to rapidly detect and characterize the next SARS-CoV-2.”
The report recommends that the world make great strides in expanding next-generation sequencing and other tools as part of creating a robust global pathogen early warning system to halt pathogen spread fast enough to prevent future pandemics. Key characteristics of such a system must include:
- A global early warning system will need to cover key high-risk nodes, such as large geographic areas with high exposure to emerging infectious diseases and significant zoonotic crossover, hospital sites with significant lab capacities, select locations like high-volume transportation hubs, and countries with labs that contain specimens of especially-dangerous pathogens (e.g., those designated as biosafety level 3 and 4).
- Given the variety of operational settings that occur within individual countries, the technologies used for early warning will have to account for diverse requirements of specific locations within countries—yet interoperability will be crucial. Given the confidence that such coordination will require, political will must be built behind data sharing, development of standards for interoperability of diverse data systems and technologies, and trust-building among nations.
- Additionally, paths created toward early warning must be mindful of covering inequities and disparities across populations.
The authors also offer additional recommendations for the international community:
- Conduct further assessments of the biosurveillance field with an aim of improving pathogen early warning. Such work should aim to characterize which ongoing efforts specifically support early warning, and those that predominantly have different functions. This will help countries, philanthropies, and others better understand how and where to target specific investments to maximize their reach.
- Set interoperability parameters as soon as possible for components of a future global early warning ecosystem. Currently, different biosurveillance systems don’t always connect, and the data within them are often not easily combined. This needs to be addressed by ensuring that all new early warning capabilities – driven by billions of dollars in current investments to combat the COVID pandemic – contribute to a common system.
- Invest in diverse tools for diverse settings. As early warning capabilities are expanded, those driving such efforts should use the descriptions offered in this report as a starting point to smartly target technology deployments that best match their use settings.
- Map how these tools will apply in specific settings. This can start with a type of template or tool to help actors map ideal technologies, information flows, and response timelines; this ideal can then be compared to existing systems to chart their early warning needs and next steps.
- Hook into enduring missions, targeting some investments to leverage activities that tie to enduring national needs, such as those focused on trade or security interests.
- Launch confidence-building measures and other diplomatic efforts to develop trust.
- Expand cooperative biological engagement programs for building out early warning system components.
The report is meant to inform concrete action in the months and years ahead. Via its Alliance to End Biological Threats and other lines of effort, CSR will continue to build on this work and collaborate across public and private sector actors to help prevent biological threats from creating mass devastation ever again.