Digital Health, Drug Resistant Pathogens & Pandemic Preparedness: Keynote Topics At World Health Summit
Left to right: Miriam K. Were; Amandeep Singh Gill; Alicia Ely Yamin; Dame Sally Davies; Soumya Swaminathan; and Aishath Samiya at the World Health Summit Achieving Health for all through Digital Collaboration session.

At a time when the COVID-19 pandemic has exposed the fragility of health systems – digital health technologies are playing a fast-expanding role – showing their revolutionary potential to address old and new needs and gaps, said participants on a Digital Health panel at the World Health Summit on Monday. 

“COVID-19 is the first pandemic of the digital age. We’re seeing first-hand how these new tools can support our efforts. Digital health technologies are helping to screen populations, track infection rates, and monitor resources,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO. “They’re also helping us monitor the social and environmental determinants of health, which are fundamental elements in the fight against COVID-19.” 

Data sharing with biological specimens and whole genome sequences have enabled an unprecedented level of vaccine development within 10 months of the discovery of the novel virus, WHO Chief Scientist Soumya Swaminathan, another panel participant pointed out. 

Digital solutions also are making health care services more accessible and allowing people to better monitor and manage their own health – and their potential in that respect has only begun to be tapped, said Stella Kyriakides, Commissioner for Health and Food Safety in the European Commission.  

Stella Kyriakides at the World Health Summit Achieving Health for all through Digital Collaboration session.

“COVID-19 has accelerated the use of digital tools in health and helped make telemedicine more effective and accessible. However, it is also a stark reminder that we must ensure the growth in mutual support, inclusive resilience, and sustainable economies and societies. Every person must be able to benefit,” said Kyriakides. 

She and others called for more global collaboration on prioritizing and investing in digital health technologies, while ensuring high ethical standards to protect patient privacy and confidentiality. 

But despite the opportunities digital technologies offer, 47 percent of the world’s population is not connected to broadband internet and many low-income countries don’t have the capacity to invest in digital health. 

In this context, three values are critical to reaping the benefits of digital health technologies: inclusivity, collaboration, and innovation, said Dame Sally Davies, Special Envoy on Antimicrobial Resistance in the UK Government.

Digital Technologies Need to Spread Globally 

“These are global issues, so any digital technology cannot be confined – if it’s successful – to a national space. We need to collaborate to govern these technologies, but we also need to collaborate to maximize the use for addressing concrete challenges,” said Amandeep Singh Gill. Gill is Project Director of the International Digital Health and AI Research Collaborative (I-DAIR), which aims to do just that. It was recently launched by the Geneva Graduate Institute and Fondation Botnar and Geneva Science & Diplomacy Anticipator Foundation. 

“The promise of the SDGs, leaving no one behind, will not be met if we don’t change the rules of the game that continue to drive income to be redistributed upwards from poor to rich within countries…Part of unlocking the resources that are necessary to fully use digital technologies needs to include some assessment of those rules,” including rules around technology and intellectual property, warned Alicia Ely Yamin, Senior Advisor on Human Rights at Partners in Health. 

A draft WHO global strategy on digital health will be brought before the World Health Assembly for approval when it reconvenes in November. Member states will review a WHO roadmap to promote expanded, worldwide use of digital technologies over the next five years. 

The end goals for digital technologies are improved health outcomes, a people-centered approach, empowered community health workers and the public, and trust, said Swaminathan. 

The innovations from digital technologies that emerged during the COVID-19 pandemic could also help address other existential threats, such as climate change and antimicrobial resistance (AMR) – all of which were key themes at this year’s World Health Summit. 

In other sessions of the Summit, participants have debated how to improve pandemic preparedness going forward in the age of COVID-19 as well as examining risks and solutions to drug-resistant bacteria, viruses and other pathogens – which could in the future trigger another major outbreak of diseases for which few treatments exist. Here are snapshots of key messages conveyed: 

Antimicrobial Resistance  – The Importance of Innovation
Scientists test a variety of bacteria for antimicrobial resistance.

If not addressed, the evolution of new strains of drug resistant bacteria and viruses could eventually pose an even bigger health emergency than the COVID-19 pandemic, potentially causing 10 million deaths annually by 2050, according to one recent UN report. At a session on Perspectives from the Covid19 Pandemic, the Importance of Innovation, Panelists at another World Health Summit session zeroed in on the future threat posed by antimicrobial resistance (AMR), the process by which some bacteria, viruses and other common pathogens become resistant to commonly used drugs, threatening effective prevention and treatment of a wide range of infectious diseases.

“The main threat of AMR is that it undermines modern medicine as we have it today. Antimicrobials are fundamental tools and how modern medicine is practiced. As resistance emerges against the tools that we have refined, the ability to deliver other types of medical interventions becomes more difficult and the threat of infectious diseases more generally, becomes a much bigger problem,” said Tim Jinks, Head of the Drug Resistant Infections Priority Program at Wellcome Trust.

It is perhaps no accident that in July 2020, at the height of the COVID-19 pandemic, the AMR Action Fund, was launched. The fund, developed in a partnership between the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), WHO, Wellcome Trust, the Biopharmaceutical CEO Roundtable, and the European Investment Bank, aims to address the current dearth of funding in R&D for new antimicrobial agents, and bring 2-4 new antibiotics to market this decade.  Some two dozen leading pharma companies, including Pfizer, Roche, Johnson & Johnson, Merck and others, have invested in the fund.  

Panelists noted that other innovative R&D frameworks created in response to the COVID-19 pandemic could be used in the future to develop better treatments to address AMR. One example is  the Access to COVID-19 Tools (ACT) Accelerator, a global collaboration to speed up the development, manufacture, and distribution of tests, vaccines, and treatments for COVID-19. 

Along with innovation, much more needs to be done to strengthen global collaboration on AMR surveillance and regulation, to ensure that existing antibiotics and other antimicrobial drugs are better rationalized in human and animal populations to prolong their usefulness, while ensuring access to legitimate, full-formulas in developing country markets where weakened or counterfeit formulations may also contribute to growing drug resistance.

“Through data-driven practices, we can ensure that our antimicrobials, particularly the last line of drugs are there for patients who really depend on them, sharing data and collaborating to deliver…health care,” and encouraging investment in the antibiotic pipeline, said Davies.

Pandemic Preparedness in the Age of COVID-19
Tom Frieden at the World Health Summit’s Pandemic Preparedness in the Age of COVID-19 session.

The global experience with COVID-19 has cast a spotlight on the emergency preparedness of health systems, revealing that “the world remains woefully underprepared for epidemics,” warned Tom Frieden, President of Resolve to Save Lives, at the Pandemic Preparedness in the Age of COVID-19 session of the World Health Summit. 

“We have to recognize that COVID it is a long term threat to public health and the pandemic is nowhere near over...It’s very clear that this is the most destructive infectious disease threat the world has faced in a century,” said Frieden. “The disruption that COVID causes could kill many millions. The risk of explosive spread is not going to end when we have a vaccine.”

The lessons learned from combatting SARS, MERS, Ebola, and SARS-CoV2, thus far, are essential to better prepare for the continued threat of COVID-19 and future pandemics that will follow, he said. 

On a brighter note, the unprecedented speed of progress made in developing tests, treatments and vaccines since the beginning of the pandemic has created models for new modes of global collaboration, and strengthened public-private partnerships. 

The industry, the IFPMA manufacturers, have committed to sharing their know-how, their experience, to work together, to collaborate with each other, but also with society at large… And one of the reasons [this happened] is that there was this deep sense of responsibility that the industry has the unique skill set to help us,” said Thomas Cueni, Director-General of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA). “As a result, eight months later we have almost 1000 clinical trials [looking at], more than 300 treatments. We have 200 vaccine candidates, 12 of them in late stage clinical development.”

Thomas Cueni speaking at the World Health Summit session on Pandemic Preparedness in the Age of COVID-19.

Industry mobilization, as well as some of the technologies being developed, both can help improve future pandemic preparedness. he cited examples such as: “ever-warm” vaccine technologies, which could be stored at a higher range of temperatures than existing vaccines, and drug treatments using monoclonal antibodies, which require a complex manufacturing process, but could provide a basis for treating other pathogens that could emerge as future pandemic threats. 

Image Credits: World Health Summit, World Health Summit , Flickr – UK Department for International Development.

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