In September 2023 WHO shared Considerations for developing a national genomic surveillance strategy or action plan for pathogens with pandemic and epidemic potential to support countries in the development of genomic surveillance strategies. This publication seeks to answer some questions that arise in the wake of surveillance gains from the pandemic, which highlighted the importance of genomics in public health toolkits. The guide establishes key considerations and an approach for developing a national strategy, and WHO recommends that all stakeholders can use it.
Developing an effective health toolkit
The introduction reflects that genomic surveillance has become a “priority” in public health systems, with genomic sequencing being used to characterise pathogens and monitor important public health priorities.
“The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance.”
During the COVID-19 pandemic, sequencing was emphasised as a useful tool in infectious disease surveillance, facilitating “earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution, and tailored development and evaluation of interventions”. Despite the importance of genomic sequencing, WHO identifies a need to “coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data with clinical and epidemiological data”.
In the spring of 2022 WHO launched a 10-year global genomic surveillance strategy for pathogens with pandemic and epidemic potential. The goal is to “strengthen and scale up” genomic surveillance to promote “quality, timely, and appropriate” actions. Furthermore, WHO developed 13 “foundational principles” to encourage global data sharing:
- Capacity development
- Collaboration and cooperation
- High-quality, reproducible data
- Global and regional representativeness
- Acknowledgment and intellectual credit
- Equitable access to health technologies as a benefit
- As open as possible, and as closed as necessary
- Interoperability and relevance for national, regional, and global decision-makers
- Trustworthiness and ease of use
- Consistency with applicable law and ethical regulations
- Compliance and enforcement
Challenges and opportunities
The report recognises “considerable” challenges and opportunities in terms of infrastructure, capacity and capability requirements, and “harmonisation across systems”. However, these vary depending on the national context. Thus, an “adequately resourced” strategy will enable countries to set goals, objectives, and priority strategic actions.
The tool outlines key considerations and a stepwise approach, recommending that a national strategy should reflect the stages of the genomic surveillance value chain:
The guide suggests 5 “considerations” to inform strategy development:
- Ensure strong national leadership, financial commitment, and governance framework
- Focus on public health decision-making
- Target all relevant pathogens with priority pathogen use cases
- Strengthen data management
- Promote data sharing and collaboration
Alongside the key considerations, the guide offers seven key steps with proposed actions for direct implementation. The duration and chronology, it suggests, can be adapted to national contexts.
How do you think this guide can be used in your region?
We look forward to hearing more on surveillance in the context of pandemic preparedness and prevention at the Congress in Barcelona next month. Are you joining us there?
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