Crafting The Mosaic A Framework For Resilient Surveillance For Respiratory Viruses Of Epidemic And Pandemic Potential

Vaccines are powerful weapons in the fight against pandemic viruses as shown by responses to both the 2009 H1N1 influenza and the COVID-19 pandemics. However, planning for accessing, allocating and deploying vaccines in a pandemic situation is a complex endeavour, beset with multiple challenges at all levels – local, regional and global. The World Health Organization (WHO) and its partners have prepared this revised guidance document to assist countries update their national deployment and vaccination plans (NDVPs) by leveraging global learnings from past pandemic responses, including the recent COVID-19 vaccination effort. The development and testing of a NDVP would not only advance pandemic preparedness efforts but would also have benefits in terms of increasing national capabilities to manage other health emergencies which require emergency vaccination campaigns.

The complex challenges highlighted by the COVID-19 pandemic and other major health emergencies emphasize the need to rethink our approach to surveillance, while building upon the momentum of substantive investments in public health capacity in recent years. At the 75th World Health Assembly in May 2022, WHO set out a harmonizing framework to strengthen the global architecture for health emergency preparedness, response, and resilience (HEPR). Under the proposed global architecture, the ability to effectively prevent, prepare for, detect, respond to, and recover from health emergencies at subnational, national, regional and global levels depend on the operational readiness and capacities in five interconnected systems: collaborative surveillance, community protection, safe and scalable clinical care, access to countermeasures, and emergency coordination. This document defines the collaborative surveillance concept—proposing a conceptual model, dimensions across which collaboration should occur to enable multi-source and multisectoral surveillance, key objectives and concrete capabilities for how countries, with the support of WHO and partners, can further advance surveillance capabilities, and address fragmented and insufficient capacity. The collaborative surveillance concept was developed to support all stakeholders working on surveillance.

The Strategic Framework for enhancing control and achieving elimination of human-to[1]human transmission of mpox (2024-2027) is a guide to Member States on the next phase of the global mpox response and to enhance preparedness for future outbreaks. During the public health emergency of international concern (PHEIC) for the global mpox outbreak (July 2022-May 2023), the WHO supported Member States in taking action to stop the outbreak of mpox. In the transition from emergency to long-term response, WHO now recommends that all countries develop and implement plans for mpox control and the elimination of person-to-person transmission of this infectious disease, while continuing to ensure mitigation of zoonotic transmission. This strategic framework supports the development of these strategies.

The updated WHO pandemic influenza severity assessment (PISA) framework set out in this document provides a systematic approach for interpreting data collected through existing surveillance systems and improving their usefulness for risk communication and decision-making. The approach enables the severity of current influenza and syndromic respiratory illness activity to be assessed relative to previous years by using historical data to set thresholds that then allow for the qualitative categorization of such activity. PISA is designed to be implemented continuously based on stable/ routine reporting systems, enabling activity during epidemic and pandemic periods to be compared. Information to assess severity especially early and throughout the course of a pandemic will also be provided through investigations, studies and modelling.