The Pandemic Preparedness We Need: A Q&A with Friends President and CEO Chris Collins

In this Q&A, Friends President & CEO Chris Collins spoke with our team about the path forward in pandemic preparedness.

Two years into the COVID-19 pandemic, people seem ready to move on. Can you explain why it’s so important to make preparation for future pandemics a top priority?

We rush to move on from COVID-19 at our own peril. The stark disparities in access to COVID-19 vaccines, diagnostics, therapies and other lifesaving tools between wealthy countries and the rest of the world is unconscionable on a moral level. It’s also unacceptable if we want to bring the pandemic under control and minimize chances of a dangerous new viral variant emerging.

We need to rapidly scale up access to COVID-19 tools globally. And while policy makers work on that, they also need to be strengthening pandemic preparedness, because more pandemics are inevitable. If we don’t seize this moment to both address COVID-19 and invest against future pandemics, it’s very likely we will lose the window for action. These two priorities are not separate; they should reinforce each other. We must move beyond a siloed approach to global health and make investments now that protect people’s health immediately. We can do this while also laying a foundation for stronger health systems able to identify and respond to future threats.

Can you explain what exactly pandemic preparedness entails if done right?

Pandemic preparedness really should be a global advocacy movement because genuine pandemic preparedness means advancing health equity. The world certainly needs to improve research and development capacity to create vaccines and other essential tools more rapidly, but stronger health systems are at the core of effective pandemic preparedness. You see that with COVID-19 vaccine access today – the challenge is not only access to vaccines, but also fragile health systems that struggle to deliver vaccines.

Health systems need to be able to invest in priorities that advance health today and prepare us for the future, including laboratory, surveillance, community health workers and community systems for health, health workforce training and antimicrobial resistance. It is clear in the COVID-19 era that countries everywhere are only as safe as the weakest health system anywhere. At the local level, communities affected by a pandemic are only as safe as the most marginalized individuals among them. 

We need pandemic preparedness that invests in health systems that can deliver equitably and reach everyone. We need an approach that includes communities in decision making and that monitors quality and equity in delivery. We should put a premium on building health systems that can engender trust, particularly as the latest research on COVID-19 outcomes shows that trust is a critical factor in success. Some of the ways you build trust are by including people in decision making and in program design and service delivery. In addition, we have to ensure that human rights principles are built into health service delivery.

How can we make sure that preparing for future pandemics includes the opinions and voices of those in low-and middle-income countries? Why is that important?

First, we need broad recognition that community engagement is essential to health delivery and to pandemic responses. This means establishing decision making bodies on the local, national, regional and global levels that include multiple stakeholders, including affected populations, not just governments. The Global Fund’s Country Coordinating Mechanisms (CCMs) are one model to build from. Donors and governments need to commit to community participation in decision making and invest in community-based services and community monitoring of health care. 

What are your recommendations for moving forward? What should Congress be doing now to take action on this?

We urgently need a plan of action to eliminate disparities in access to COVID-19 tools, and the global investment to make that possible. At the same time, the global community needs to develop a global health architecture that strengthens pandemic preparedness through stronger, more equitable and more accountable health systems.

The easiest and most logical way to do this is to build out from programs that are working well now. We’ve seen in COVID-19 that investments in disease specific programs, including HIV, TB and malaria, made critically important contributions to national COVID-19 responses. Let’s learn that lesson: build on what works. This includes the Global Fund, the biggest supporter of health systems in the world, which has a track record of success and that has demonstrated agility and effectiveness in the COVID-19 response. The Global Fund is poised to build upon its current activities to do more in pandemic preparedness if additional funds are dedicated to this activity, and doing so should actually strengthen programming for HIV, TB and malaria.