Based on consideration by the Scientific Academies of the G20 countries of how the experience of the response to COVID-19 might inform pandemic preparedness in the future, the governments of G20 are urged to undertake the following actions:
1. Promote the creation of a global network of surveillance, with agreed criteria to:
• Detect emerging unusual clusters of morbidity and mortality that may be the harbingers of a potential new pandemic by:
- building on existing infrastructures including the global alert and response system for disease outbreaks;
- promoting enhanced support for systems such as the Epidemic Intelligence from Open Sources initiative (EIOS);
- developing robust policies and platforms for collating and sharing detailed data - for example on pathogen genomics.
• Provide molecular epidemiological surveillance for directly transmitted respiratory infections (the most dangerous in terms of rapid spread) and bacterial infections in the context of the spread of antibiotic resistance genes.
• Strengthen the system for worldwide antimicrobial resistance surveillance.
• Advertise, educate and promote support for these, and build capacity and skills for their use.
The network should be underpinned by the governance, infrastructure and skills to interpret, analyse and connect across countries, and to learn from international data.
2. Promote the distributed manufacture and delivery of diagnostics, drugs, vaccines, medical supplies and equipment for:
• Increased technology and manufacturing capability worldwide, but especially in low and middle-income countries.
• Streamlined regulatory processes for novel diagnostics, drugs and vaccines.
• International regulatory agencies to look at the lessons learned from swift development of vaccines in the COVID-19 pandemic and ensure new regulatory processes can be implemented in a timely fashion.
• Provide an international structure to compile and advise on the sensitivity and specificity of different diagnostic tools.
• Enhance access to new technologies, accounting for intellectual property, patenting and pricing mechanisms.
3. Launch an Intergovernmental Convention that should:
• Pave the way to the formulation of an International Agreement on Pandemic Preparedness and Management, as recently proposed by more than 20 world leaders.
• Provide a unique forum to assess the experience of COVID-19 for successes and failures in global cooperation.
• Discuss the need for incentives and mechanisms to reinforce the International Health Regulations (2005) that must become a sharper instrument for action and more timely reporting of potential outbreaks.
