Rich Quelch, Global Head of Marketing, Origin09.07.22
COVID-19 has laid bare the fact that existing global health architecture is not equipped to adequately finance and support pandemic prevention, preparedness and response (PPR). Despite years of warnings that novel coronaviruses were among the pathogens most likely to cause a global health emergency, we were ill-prepared for COVID-19.
The last two years have driven home that PPR is crucial to global security, public health and economic prosperity. But it’s clear the global community is still learning from historical mistakes and taking the threat of the next pandemic seriously by building stronger health systems, increasing investment and coordination, and modernizing the supply chain.
So, what are the key lessons COVID-19 has taught us and how can the international community work closer together to ensure future pandemic preparedness?
By inviting stakeholders from business, government and public health, the event sought to simulate a coordinated policy response to a novel (and theoretical) pandemic on a global level. This was not coincidental; it was grounded in science.
Based on several recent coronavirus outbreaks—including MERS and SARS—scientists were certain another, more serious, outbreak was coming. And just two months after Event 201, their predictions became a reality when the first cases of what we now know as COVID-19 were recorded in Wuhan, China.
So why was something so certain for scientists such a shock to everyone else? And why wasn’t the world ready for it?
Until 2020, while many scientists predicted a global health pandemic, few accepted the urgency of the issue and the importance of investment up-front. Fast forward over two years and we are still learning to live with the COVID-19 virus.
In essence, it took a global pandemic to prepare the world for a global pandemic. And there’s still much more to do, particularly around financing and ensuring its equal distribution. After all, viruses don’t know borders.
But the tide is turning.
Big pharma recently lobbied for a slice of the G20 fund to prepare for the next pandemic leading to the establishment of a financial intermediary fund (FIF).1 This will finance critical investments to strengthen capacities at national, regional, and global levels, with a focus on low- and middle-income countries.
Usually focused on specific themes, FIFs are designed to mobilize significant financial resources and promote collective action for development priorities, often contributing to global public goods.
In this case, strengthening pandemic preparedness during “peacetime” was the focus, rather than starting on the back foot which we did when COVID-19 emerged, and importantly it aims to catalyze funding from private, philanthropic and bilateral sources.
So far, at the time of writing, over $1 billion in financial commitments have already been announced for the FIF, including contributions from the U.S., the EU, Indonesia, Germany, the UK, Singapore, the Gates Foundation and the Wellcome Trust.
Although, many critics have said this figure falls far short of what is needed to finish the job on COVID-19 and prevent the next pandemic. According to the G20 High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response (HLIP), we need $10 billion per year (at least) in international financing to fill preparedness gaps.
To prepare for future pandemics, other tried and tested innovative finance mechanisms must be utilized and expanded, too. This will help to take the financial sting out of the price of preparation.
A good example is the International Finance Facility for Immunization (IFFIm) which issues vaccine bonds against long-term donor government pledges in lower-income countries. Using the principle of “frontloading”, this approach makes the rate of return attractive to capital market investors and frees-up money immediately for urgent causes while allowing donor governments to spread the cost.
Furthermore, there is also untapped potential for more innovative funding mechanisms to put an early stop to outbreaks before they become pandemics. But this requires proactive, rather than reactive investment. Given the $12.5 trillion cost of COVID to the global economy, governments have come to accept if they don’t invest the billions of dollars needed to achieve global pandemic preparedness, then they will surely pay for it later.
Innovative financing can make preparing for pandemics more palatable by helping to spread the cost—not only for G20 countries but for poorer ones too.
According to WHO2 and its Blueprint for action to prevent epidemics, the priority diseases at present are: COVID-19; Crimean-Congo haemorrhagic fever; Ebola virus disease and Marburg virus disease; Lassa fever; MERS-CoV and SARS; Nipah and henipaviral diseases; Rift Valley fever; Zika; and “Disease X”—an unknown pathogen that is predicted to become a serious international epidemic in the near future.
The international R&D effort to find experimental treatments and vaccines for COVID-19 has been applaudable, given its novel nature and pressing urgency. But this has come at the expense of efforts to address other emerging infectious diseases (EIDs) as identified by WHO, including the running of clinical trials.
For example, in 20 drug companies studied by the Access to Medicine Foundation,3 there were empty R&D pipelines for ten out of 16 EIDs by the World Health Organization (WHO) as a threat to public health. This is described as alarmingly low by the researchers and it’s predicted the full impact of the COVID-19 crisis on neglected disease R&D likely won’t be felt for several years.
As much as the costs of the pandemic might raise concerns about the availability of funding, it has also been a stark demonstration of the harm caused by an uncontrolled infectious disease, and of how rapidly a global response can turn the tide.
The COVID-19 crisis has made global health more salient in the minds of policymakers and philanthropists, attracting new funders to emerging infectious disease R&D and providing evidence that tools for controlling infectious disease are both valuable and within reach.
Recent evidence for this growing support includes GSK announcement4 of £1bn investment over ten years to accelerate R&D dedicated to infectious diseases that disproportionately impact lower-income countries. Focuses include malaria, tuberculosis, HIV, neglected tropical diseases (NTDs) and anti-microbial resistance (AMR).
From advanced analytics to artificial intelligence (AI), new technologies offer a way to transform how the pharma supply chain operates and delivers during times of unprecedented demand. By meeting Pharma 4.0 standards, the sector could increase throughput, and reduce cycle times while maintaining product integrity.
For too long, pharma has relied on outdated manufacturing operations and overly complex supply chain networks. Periodical reviews of the supply chain must be carried out on a regular basis as a risk management strategy and to boost PPR. End-to-end visibility is key, and data can help give clarity impossible until now.
Modern pharma firms and healthcare systems have access to vast data banks, but many don’t have the structures or knowledge in place to maximize its value.
To be part of Pharma 4.0, leveraging data insights is key. One way of achieving this is shifting operations from enterprise resource planning software to the cloud, allowing for all organizations to connect to a shared system regardless of their own IT infrastructure; a virtual supply chain.
Pharma operations executives can leverage big data, external and internal indicators, and machine learning algorithms to better forecast demand, and automatically identify and mitigate supply risks.
In manufacturing, analytical models can accurately predict and respond to critical events in real-time to increase efficiency, reduce downtime and avoid serious shortages. This is essential during public health crises, like what we experienced during the emergency phase of the COVID-19 pandemic.
Innovative technologies promise effective therapies and sustainable new business models, but they also introduce all-new challenges.
Legacy systems and tools won’t help us overcome these challenges. To conquer EIDs, while effectively treating more common diseases, we need the willpower to undertake an honest examination of our industry, our companies, and our facilities, eliminating the systems that no longer work and making room for innovation and reinvention.
We also need to be open to learning from other industries that are leading on digital transformation and harnessing the power of big data to deliver cost-savings and greater efficiencies.
Effective communication is essential to direct the public to adopt desired behaviors during pandemics, such as social distancing and washing their hands. But what became apparent in the early stages of COVID-19, was that there were differences in cultural (and political) perspectives on vaccination and treatments, particularly vaccine hesitancy which risked undermining the united effort.
For example, in England (UK), vaccination uptake has been lower for some ethnic groups5 and lowest among the Black African community. In the U.S., vaccination uptake has varied across political affiliations, being lowest among Republican voters. This highlights the importance of targeted messaging to different groups in civil society to gain their support.
From TV adverts, signage in public spaces, radio segments and billboards, there are many mediums public health leaders have at their disposal to communicate with the public. But the public also now has a greater demand for real-time, transparent, and consistent messaging, too.
In response, social media is becoming a vital communication tool for public health authorities to disseminate information and guidance quickly among the community, as well as counter the spread of disinformation.
Facebook and Twitter are the most widely used social channels by public health authorities, but Instagram has proven its effectiveness during the COVID-19 pandemic, helping health organizations convey their messages during crisis communication, through influencer promotion, clarification posts and the use of more detailed infographics.
Some have also argued that we must prepare the next generation as a priority to cope with future and inevitable pandemics, creating more “scientifically literate citizens”6 through better education at an early age.
As part of this theory, “schools should prepare kids to contend with the realities of the world, many of which hinge deeply on the sciences. This means understanding climate change, air pollution, viruses, and beyond.” This will involve some key curriculum changes throughout the educational system, focusing on preparedness for several key issues that will greatly impact children growing up today.
The COVID-19 pandemic was a wake-up call for many and led to the implementation of relevant policies and countermeasures —some pre-existing and some innovative. But despite lessons being learned over the past two and a half years, there is much work still to be done. Greater political will, upfront investment, public health awareness and R&D are just some of the many parts of the puzzle that need to be solved.
It is not an overstatement to say that the planet is at a crossroads. As eloquently stated by Christina Figueres, former Executive Secretary of the UN Framework Convention on Climate Change, “We did not ask for the COVID-19 crisis to converge with the climate, biodiversity and inequality crises, but all converged in 2020. We have no other option but to make the solutions converge, too.”
References
Rich Quelch is global head of marketing at Origin. He is an experienced global marketer within the healthcare and pharmaceutical sector and has led the development of the Origin brand, positioning it as a supplier of innovative and ground-breaking pharmaceutical packaging devices, as well as offering a unique supply chain model. Established over 55 years ago, Origin engages in the design, manufacture and consolidated supply of pharmaceutical packaging, partnering with license holders and CMOs. For more information visit Originltd.com.
The last two years have driven home that PPR is crucial to global security, public health and economic prosperity. But it’s clear the global community is still learning from historical mistakes and taking the threat of the next pandemic seriously by building stronger health systems, increasing investment and coordination, and modernizing the supply chain.
So, what are the key lessons COVID-19 has taught us and how can the international community work closer together to ensure future pandemic preparedness?
Predicting a pandemic
In October 2019, a fictional coronavirus pandemic was modeled by the Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation in what was named ‘Event 201.’By inviting stakeholders from business, government and public health, the event sought to simulate a coordinated policy response to a novel (and theoretical) pandemic on a global level. This was not coincidental; it was grounded in science.
Based on several recent coronavirus outbreaks—including MERS and SARS—scientists were certain another, more serious, outbreak was coming. And just two months after Event 201, their predictions became a reality when the first cases of what we now know as COVID-19 were recorded in Wuhan, China.
So why was something so certain for scientists such a shock to everyone else? And why wasn’t the world ready for it?
Establishing a financing framework
Financing pandemic preparedness often falls short due to its “what if” nature. When it comes to supporting global health and communities, there are many competing priorities and it’s easy for other causes to seem more urgent and pressing when they are having real-world impacts today.Until 2020, while many scientists predicted a global health pandemic, few accepted the urgency of the issue and the importance of investment up-front. Fast forward over two years and we are still learning to live with the COVID-19 virus.
In essence, it took a global pandemic to prepare the world for a global pandemic. And there’s still much more to do, particularly around financing and ensuring its equal distribution. After all, viruses don’t know borders.
But the tide is turning.
Big pharma recently lobbied for a slice of the G20 fund to prepare for the next pandemic leading to the establishment of a financial intermediary fund (FIF).1 This will finance critical investments to strengthen capacities at national, regional, and global levels, with a focus on low- and middle-income countries.
Usually focused on specific themes, FIFs are designed to mobilize significant financial resources and promote collective action for development priorities, often contributing to global public goods.
In this case, strengthening pandemic preparedness during “peacetime” was the focus, rather than starting on the back foot which we did when COVID-19 emerged, and importantly it aims to catalyze funding from private, philanthropic and bilateral sources.
So far, at the time of writing, over $1 billion in financial commitments have already been announced for the FIF, including contributions from the U.S., the EU, Indonesia, Germany, the UK, Singapore, the Gates Foundation and the Wellcome Trust.
Although, many critics have said this figure falls far short of what is needed to finish the job on COVID-19 and prevent the next pandemic. According to the G20 High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response (HLIP), we need $10 billion per year (at least) in international financing to fill preparedness gaps.
To prepare for future pandemics, other tried and tested innovative finance mechanisms must be utilized and expanded, too. This will help to take the financial sting out of the price of preparation.
A good example is the International Finance Facility for Immunization (IFFIm) which issues vaccine bonds against long-term donor government pledges in lower-income countries. Using the principle of “frontloading”, this approach makes the rate of return attractive to capital market investors and frees-up money immediately for urgent causes while allowing donor governments to spread the cost.
Furthermore, there is also untapped potential for more innovative funding mechanisms to put an early stop to outbreaks before they become pandemics. But this requires proactive, rather than reactive investment. Given the $12.5 trillion cost of COVID to the global economy, governments have come to accept if they don’t invest the billions of dollars needed to achieve global pandemic preparedness, then they will surely pay for it later.
Innovative financing can make preparing for pandemics more palatable by helping to spread the cost—not only for G20 countries but for poorer ones too.
The R&D pipeline for treatments and vaccines
Today’s research is potentially tomorrow’s treatment. But worldwide, while the number of potential pathogens is very large, the resources for disease research and development (R&D) are limited.According to WHO2 and its Blueprint for action to prevent epidemics, the priority diseases at present are: COVID-19; Crimean-Congo haemorrhagic fever; Ebola virus disease and Marburg virus disease; Lassa fever; MERS-CoV and SARS; Nipah and henipaviral diseases; Rift Valley fever; Zika; and “Disease X”—an unknown pathogen that is predicted to become a serious international epidemic in the near future.
The international R&D effort to find experimental treatments and vaccines for COVID-19 has been applaudable, given its novel nature and pressing urgency. But this has come at the expense of efforts to address other emerging infectious diseases (EIDs) as identified by WHO, including the running of clinical trials.
For example, in 20 drug companies studied by the Access to Medicine Foundation,3 there were empty R&D pipelines for ten out of 16 EIDs by the World Health Organization (WHO) as a threat to public health. This is described as alarmingly low by the researchers and it’s predicted the full impact of the COVID-19 crisis on neglected disease R&D likely won’t be felt for several years.
As much as the costs of the pandemic might raise concerns about the availability of funding, it has also been a stark demonstration of the harm caused by an uncontrolled infectious disease, and of how rapidly a global response can turn the tide.
The COVID-19 crisis has made global health more salient in the minds of policymakers and philanthropists, attracting new funders to emerging infectious disease R&D and providing evidence that tools for controlling infectious disease are both valuable and within reach.
Recent evidence for this growing support includes GSK announcement4 of £1bn investment over ten years to accelerate R&D dedicated to infectious diseases that disproportionately impact lower-income countries. Focuses include malaria, tuberculosis, HIV, neglected tropical diseases (NTDs) and anti-microbial resistance (AMR).
The promise of Pharma 4.0
While efforts and ingenuity are ramping up in drug innovation, forecasting and inventory management, untapped opportunities remain in the outbound supply chain, from packaging to final delivery.From advanced analytics to artificial intelligence (AI), new technologies offer a way to transform how the pharma supply chain operates and delivers during times of unprecedented demand. By meeting Pharma 4.0 standards, the sector could increase throughput, and reduce cycle times while maintaining product integrity.
For too long, pharma has relied on outdated manufacturing operations and overly complex supply chain networks. Periodical reviews of the supply chain must be carried out on a regular basis as a risk management strategy and to boost PPR. End-to-end visibility is key, and data can help give clarity impossible until now.
Modern pharma firms and healthcare systems have access to vast data banks, but many don’t have the structures or knowledge in place to maximize its value.
To be part of Pharma 4.0, leveraging data insights is key. One way of achieving this is shifting operations from enterprise resource planning software to the cloud, allowing for all organizations to connect to a shared system regardless of their own IT infrastructure; a virtual supply chain.
Pharma operations executives can leverage big data, external and internal indicators, and machine learning algorithms to better forecast demand, and automatically identify and mitigate supply risks.
In manufacturing, analytical models can accurately predict and respond to critical events in real-time to increase efficiency, reduce downtime and avoid serious shortages. This is essential during public health crises, like what we experienced during the emergency phase of the COVID-19 pandemic.
Innovative technologies promise effective therapies and sustainable new business models, but they also introduce all-new challenges.
Legacy systems and tools won’t help us overcome these challenges. To conquer EIDs, while effectively treating more common diseases, we need the willpower to undertake an honest examination of our industry, our companies, and our facilities, eliminating the systems that no longer work and making room for innovation and reinvention.
We also need to be open to learning from other industries that are leading on digital transformation and harnessing the power of big data to deliver cost-savings and greater efficiencies.
Public education and outreach
As we have witnessed during the COVID-19 pandemic, public health awareness and buy-in have been critical to the success of the vaccination programs worldwide and ensuring large populations follow legal restrictions and guidance that greatly inconvenienced their everyday lives.Effective communication is essential to direct the public to adopt desired behaviors during pandemics, such as social distancing and washing their hands. But what became apparent in the early stages of COVID-19, was that there were differences in cultural (and political) perspectives on vaccination and treatments, particularly vaccine hesitancy which risked undermining the united effort.
For example, in England (UK), vaccination uptake has been lower for some ethnic groups5 and lowest among the Black African community. In the U.S., vaccination uptake has varied across political affiliations, being lowest among Republican voters. This highlights the importance of targeted messaging to different groups in civil society to gain their support.
From TV adverts, signage in public spaces, radio segments and billboards, there are many mediums public health leaders have at their disposal to communicate with the public. But the public also now has a greater demand for real-time, transparent, and consistent messaging, too.
In response, social media is becoming a vital communication tool for public health authorities to disseminate information and guidance quickly among the community, as well as counter the spread of disinformation.
Facebook and Twitter are the most widely used social channels by public health authorities, but Instagram has proven its effectiveness during the COVID-19 pandemic, helping health organizations convey their messages during crisis communication, through influencer promotion, clarification posts and the use of more detailed infographics.
Some have also argued that we must prepare the next generation as a priority to cope with future and inevitable pandemics, creating more “scientifically literate citizens”6 through better education at an early age.
As part of this theory, “schools should prepare kids to contend with the realities of the world, many of which hinge deeply on the sciences. This means understanding climate change, air pollution, viruses, and beyond.” This will involve some key curriculum changes throughout the educational system, focusing on preparedness for several key issues that will greatly impact children growing up today.
The way forward for PPR
In recent years we’ve witnessed numerous epidemics and pandemics that have each caused considerable loss of life and severe economic loss.The COVID-19 pandemic was a wake-up call for many and led to the implementation of relevant policies and countermeasures —some pre-existing and some innovative. But despite lessons being learned over the past two and a half years, there is much work still to be done. Greater political will, upfront investment, public health awareness and R&D are just some of the many parts of the puzzle that need to be solved.
It is not an overstatement to say that the planet is at a crossroads. As eloquently stated by Christina Figueres, former Executive Secretary of the UN Framework Convention on Climate Change, “We did not ask for the COVID-19 crisis to converge with the climate, biodiversity and inequality crises, but all converged in 2020. We have no other option but to make the solutions converge, too.”
References
- https://www.who.int/news/item/30-06-2022-world-bank-board-approves-new-fund-for-pandemic-prevention--preparedness-and-response-(ppr)
- https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts
- https://www.news-medical.net/news/20210127/RD-lacking-on-emerging-infectious-diseases-report-finds.aspx
- https://www.gsk.com/en-gb/media/press-releases/gsk-announces-1-billion-rd-investment-over-ten-years-to-get-ahead-of-infectious-diseases-in-lower-income-countries/
- https://hackmd.io/@scibehC19vax/vaxculture
- https://mashable.com/article/pandemic-covid-education
Rich Quelch is global head of marketing at Origin. He is an experienced global marketer within the healthcare and pharmaceutical sector and has led the development of the Origin brand, positioning it as a supplier of innovative and ground-breaking pharmaceutical packaging devices, as well as offering a unique supply chain model. Established over 55 years ago, Origin engages in the design, manufacture and consolidated supply of pharmaceutical packaging, partnering with license holders and CMOs. For more information visit Originltd.com.