It became apparent very quickly that the world was not ready to respond to the novel COVID-19 virus.
Despite regular warnings from the scientific community that a deadly global pandemic appearing was a question of when, not if, opportunities to prepare were missed by those with the power to act.
As a result, the rapid spread of COVID-19 caused widespread disruption and panic, taking most of humanity by surprise. And we’re still learning to live alongside it, almost three years later.
While many extraordinary feats have taken place in response to the pandemic to minimise its impact on public health and get us back to normality faster, inefficiencies in global health architecture have been exposed for all to see. And with the threat of more global pandemics
in the future a certainty, not a question, these inefficiencies must be addressed.
The crucial role of pandemic preparedness and response (PPR) in protecting global security, public health and economic prosperity has been demonstrated, not through modelling but through lived experience.
Now is the time for us to start building stronger health systems, increase investment and coordination, and modernise the pharma 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?
The challenge of financing pandemic preparedness
Financing pandemic preparedness often falls short due to its ‘what if’ nature. But as we have seen with COVID-19, the risks are very real.
Until 2020, while many scientists predicted a global health pandemic, few accepted the urgency of the issue and the importance of investment upfront. Fast-forward over two years and we are still learning to live with the COVID-19 virus.
It took a global pandemic to prepare the world for a global pandemic, but we are learning from our historical mistakes.
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). This will finance critical investments to strengthen capacities at national, regional and global levels, with a focus on low- and middle-income countries.
It aims to strengthen pandemic preparedness during ‘peacetime’, rather than ad hoc, by raising funding from private, philanthropic and bilateral sources in advance.
While over $1bn in financial commitments have already been announced from public and private sources, many critics have said this figure falls far short of what is needed.
According to the G20 High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response (HLIP), we need $10bn per year (at least) to fill preparedness gaps.
To prepare for future pandemics, other tried and tested innovative finance mechanisms also need to be utilised and expanded. This will help to take the financial sting out of the price of preparation.
The principle of ‘front-loading’ is a good example, which makes the rate of return attractive to capital market investors and makes money immediately available for urgent causes while allowing donor governments to spread the cost.
There is also untapped potential for more innovative funding mechanisms to put an early stop to outbreaks before they become pandemics. Innovative financing can make preparing for pandemics more palatable for both rich and poorer nations by helping to spread the cost.
Given the $12.5tn cost of COVID-19 to the global economy, governments have come to accept that if they don’t invest the billions of dollars needed to achieve global pandemic preparedness, they will surely pay for it later.
Strengthening the R&D pipeline
Today’s research is tomorrow’s treatment. But worldwide, while the number of potential pathogens is very large, the resources for disease R&D are limited.
The international R&D effort to find experimental treatments and vaccines for COVID-19 has been laudable, given its novel nature and urgency. But this has come at the expense of efforts to address other emerging infectious diseases (EIDs), including the running of clinical trials.
For example, in 20 drug companies studied by the Access to Medicine Foundation, there were empty R&D pipelines for ten out of 16 EIDs. This is described as alarmingly low by the researchers and it’s predicted that the full impact of the COVID-19 crisis on R&D for neglected disease likely won’t be felt for several years.
As much as the costs of the pandemic might raise concerns about the availability of funding, the impact of the pandemic 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 funding and demonstrating that tools for controlling infectious disease are both valuable and within reach.
Recent evidence for this growing support includes GSK’s announcement of a £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 antimicrobial resistance (AMR).
Pharma 4.0 and supply chain transformation
While efforts and ingenuity are ramping up in drug innovation, forecasting and inventory management, untapped opportunities remain across the supply chain, from packaging to final delivery.
From advanced analytics to artificial intelligence (AI), new technologies offer opportunities to transform the way the pharma supply chain operates during times of unprecedented demand. By meeting Pharma 4.0 standards, the sector could increase throughput and reduce cycle times while still maintaining quality.
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 that was impossible to achieve 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 maximise its value.
To be part of Pharma 4.0, leveraging data insights is key. One way of achieving this is by shifting operations from enterprise resource planning software to the Cloud, allowing all organisations to connect to a shared system regardless of company IT infrastructure – thereby creating 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, such as the one the world experienced during the emergency phase of the COVID-19 pandemic.
Innovative technologies promise effective therapies and sustainable new business models, but they also introduce a lot of new challenges.
Legacy systems and tools won’t help us overcome these challenges. To conquer EIDs, while effectively treating more common diseases, we need 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.
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.”
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