Global genomic surveillance strategy for pathogens with pandemic and epidemic potential 2022–2032

Bull World Health Organ 2022;100:239–239A | doi: http://dx.doi.org/10.2471/BLT.22.288220 Editorials 239 The coronavirus disease 2019 (COVID-19) pandemic marked a breakpoint for genom- ic surveillance. The first severe acute re- spiratory syndrome coronavirus 2 (SARS- CoV-2) genetic sequences were shared on 10 January 2020, ten days after the World Health Organization (WHO) was notified of a cluster of pneumonia in China.1 Scien- tists across the globe immediately started developing countermeasures and the first diagnostic assay was made available on 13 January 2020.1,2 The speed of data sharing and pathogen characterization was unprecedented. Genomic surveillance was consistently used during the pandemic to monitor virus evolution and transmission, and to identify variants of concern that may impact countermeasures. During the pandemic, the Inter- national Health Regulations (2005) Emergency Committee for COVID-19 repeatedly recommended for State Par- ties to strengthen genomic surveillance strategies.3 The Independent Panel for Pandemic Preparedness and Response recently recommended regular funding for the delivery of specific global goods including genomic sequencing.4 In May 2021, through resolution 74.7, the World Health Assembly urged Member States to increase their capacity to detect new threats, including through laboratory techniques such as genomic sequencing.5 WHO began a process in July 2021 to develop a strategy to drive a unified vi- sion on global genomic surveillance for pathogens with pandemic and epidemic potential. WHO undertook a multistep con- sultative process to develop the strategy. Stakeholders consulted include global, regional and country networks, key partners such as philanthropies, donors, public health institutions, One Health partners, and WHO global and regional teams. Experts from global programmes such as polio, influenza, Ebola virus disease, antimicrobial resistance, human immunodeficiency virus and COVID-19 helped refine the strategy’s technical ori- entation considering the broader needs and the 10-year horizon. WHO presented the draft strategy to Member States at a briefing on 25 No- vember 2021 to ensure alignment with the mandate established through the resolution, followed by an online public consultation process to reach all stake- holders inclusively and transparently. A global online seminar engaging 800 stakeholders and hosted by WHO was conducted to raise awareness, present different stakeholder perspectives and encourage feedback. Nearly 100 sets of inputs from these consultations informed the final version of the strategy, launched in March 2022.6 The goal of the strategy is that ge- nomic surveillance is strengthened and scaled for quality, timely and appropriate public health actions within local to global surveillance systems. Five key objectives contribute to this goal: (i) improve access to tools for better geographical repre- sentation; (ii) strengthen the workforce to deliver at speed, scale and quality; (iii) enhance data sharing and utility for streamlined local to global public health decision-making; (iv) maximize connec- tivity for timely value-add in the broader surveillance architecture; and (v) maintain a readiness posture.5 The strategy provides the foundation for implementation plans in line with these objectives. A set of core principles will guide implementation, with countries at the centre of the strategy, ensuring investments are targeted where they are most needed. Multisectoral partnerships are criti- cal to successful strategy implementation. Catalysed by the pandemic, networks at country, regional and global level have accelerated development of sequencing and bioinformatic capacity. Investment is needed to ensure sustained integration of these technologies into national public health systems, across human, animal and environmental health. The Group of Seven (G7) and G20 have advocated and raised political awareness about the game-changing opportunities for genom- ics.7,8 The Access to COVID-19 Tools (ACT) Accelerator demonstrated how bringing partners together can increase access to and equitable distribution of tools through capacity-building and promoting affordability and availability of platforms.9 WHO is the convenor and advocate for the strategy and will work with Mem- ber States and partners to implement the strategy. Global enablers and partnerships born out of the pandemic include the ACT Accelerator and the G7 International Pathogen Surveillance Network. Through its global presence, WHO will assist coun- tries to contextualize genomics within the broader surveillance architecture, de- velop normative guidance and regulatory frameworks, provide tools and technical assistance to countries, establish research agendas and support capacity through training and simulation exercises. The strategy’s development and the global spotlight on genomics has high- lighted the importance of well-resourced and resilient end-to-end laboratory and surveillance systems. All countries should have access to sequencing, but access alone is not enough. The genomic surveillance value chain needs clear surveillance objec- tives, governance, foundational laboratory and data systems, linkages to regional and global networks, and coherence with com- plementary phenotypic, clinical and epide- miological characterization that together maximize data utility for effective public health action. Through implementation of this strategy, occurrence of pathogens with pandemic and epidemic potential can be detected earlier, thus reducing the severity of outbreaks and saving lives. ■ Global genomic surveillance strategy for pathogens with pandemic and epidemic potential 2022–2032 Lisa L Carter,a M Anne Yu,b Jilian A Sacks,b Céline Barnadas,a Dmitriy Pereyaslov,b Sébastien Cognat,a Sylvie Briand,b Michael J Ryanb & Gina Samaanb References http://www.who.int/publications/journals/ bulletin a Health Emergencies Programme, World Health Organization Lyon Office, 24 Rue Jean Baldassini, 69007 Lyon, France. b Health Emergencies Programme, World Health Organization, Geneva, Switzerland. Correspondence to Lisa Carter (email: carterl@ who .int). Editorials 239A Bull World Health Organ 2022;100:239–239A | doi: http://dx.doi.org/10.2471/BLT.22.288220 References 1. Timeline: WHO’s response to COVID-19. Geneva: World Health Organization; 2022. Available from: https:// www .who .int/ emergencies/ diseases/ novel -coronavirus -2019/ interactive -timeline [cited 2022 Mar 2]. 2. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020 Jan;25(3): doi: http:// dx .doi .org/ 10 .2807/ 1560 -7917 .ES .2020 .25 .3 .2000045 PMID: 31992387 3. Statement on the seventh meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic. Geneva: World Health Organization; 2021. Available from: https:// www .who .int/ news/ item/ 19 -04 -2021 -statement -on -the -seventh -meeting -of -the -international -health -regulations -(2005) -emergency -committee -regarding -the -coronavirus -disease -(covid -19) -pandemic [cited 2022 Mar 2]. 4. COVID-19: make it the last pandemic. Geneva: The Independent Panel for Pandemic Preparedness and Response; May 2021. Available from: https:// theindependentpanel .org/ wp -content/ uploads/ 2021/ 05/ COVID -19 -Make -it -the -Last -Pandemic _final .pdf [cited 2022 Mar 2]. 5. Resolution WHA74.7. Strengthening WHO preparedness for and response to health emergencies. In: Seventy-fourth World Health Assembly, Geneva, 31 May 2021. Geneva: World Health Organization; 2021. Available from: https:// apps .who .int/ gb/ ebwha/ pdf _files/ WHA74/ A74 _R7 -en .pdf [cited 2022 Mar 2]. 6. Consultation on the global genomic surveillance strategy for pathogens with pandemic and epidemic potential. Geneva: World Health Organization; 2021. Available from: https:// www .who .int/ news -room/ events/ detail/ 2021/ 12/ 08/ default -calendar/ who -consultation -on -the -global -genomic -surveillance -strategy -for -pathogens -with -pandemic -and -epidemic -potential [cited 2022 Mar 2]. 7. Carbis Bay G7 summit communiqué. Our shared agenda for global action to build back better. Cornwall: G7; 2021. Available from: https:// www .g7uk .org/ wp -content/ uploads/ 2021/ 06/ Carbis -Bay -G7 -Summit -Communique -PDF -430KB -25 -pages -3 -1 .pdf [cited 2022 Mar 2]. 8. Declaration of the G20 health ministers. Rome: G20; 2021. Available from: http:// www .g20 .utoronto .ca/ 2021/ 210906 -health .html [cited 2022 Mar 2]. 9. ACT-Accelerator. Geneva: World Health Organization; 2021. Available from: https:// www .who .int/ initiatives/ act -accelerator/ about [cited 2022 Mar 2].