This is a fact: a new pandemic threat is not a question of if, but when.

Armed with this knowledge, all leaders must ask themselves: Are we ready, and what more must be done to protect our people and avoid an Ebola- or COVID-sized catastrophe?

Over the last decade, outbreak and pandemic monitoring bodies and tools have been activated in the wake of crises. Many perform much-needed functions. But the approach has led to a fragmented system characterised by gaps and overlaps. Important information is available, but often it does not reach the right people at the right time, and it too seldom informs plans and investments to strengthen essential systems. (see figure 1, below) 

The result is a monitoring landscape that provides a patchwork of siloed information, rather than timely, actionable insights and a cohesive roadmap.

On 18 May, during the 79th World Health Assembly (WHA) in Geneva, senior representatives from member states, international organizations, and expert institutions came together to consider how pandemic prevention, preparedness and response (PPPR) monitoring can better inform action and investment.

Is there enough financing in the outbreak and pandemic ecosystem? Absolutely not, but political leaders and policymakers can’t pinpoint how much more we need, who needs to provide it and where it should be spent. 

Are WHO, UN agencies and key international and regional institutions well equipped to manage the next epidemic or pandemic threat? We don’t know for certain. Nationally, are we investing in communities to participate in outbreak readiness? In some places, yes. But the list of unknowns is too long.  And fundamentally, what threats should we be preparing for, which pathogens should we be targeting, and are we investing in the right capacities to address them? 

Two of the key global monitoring bodies providing important insights, The Global Preparedness Monitoring Board (GPMB) and The International Pandemic Preparedness Secretariat (IPPS), are set to close soon as their mandates come to an end. 

This will add to widening holes in our knowledge and in our collective safety. Without action, these closures risk setting back global monitoring efforts at a time when they are needed most.

The GPMB was established in 2018 following the devastating West Africa Ebola epidemic and comprises senior leaders and experts. It provides an annual assessment of the world’s preparedness. 

In 2023, it published the first proposal for a comprehensive, multisectoral framework for monitoring epidemic and pandemic risk. It recently published its last assessment. The blunt message? Our collective readiness to manage pandemic threats is not keeping pace with the risks. 

The GPMB will cease to exist later this year. Building on its eight years of experience and insights, it has made strong recommendations to establish a robust, comprehensive monitoring mechanism. Unless the UN General Assembly (UNGA) and WHA act, there is a risk nothing will replace it.

The IPPS – which tracks progress towards the 100 Days Mission for diagnostics, therapeutics and vaccines – is transitioning towards closure in early 2027, after the publication of its sixth and final major implementation report. 

While the IPPS 100 Days Mission Scorecard will be continued by Impact Global Health, the current support is only until 2028. 

Today, IPPS is providing essential real‑time insights, including its 15‑day updates on the Ebola Bundibugyo outbreak, which give countries such as the DRC and Uganda clear visibility on progress toward tests, treatments and vaccines, and maintain collective accountability for the 100 Days Mission. 

Opportunity to set up comprehensive monitoring

So how do we move from what we have towards a comprehensive monitoring ecosystem that provides a full picture?  Charting this path is essential to all our safety.

What if, for example, a multidisciplinary body of scientific experts had focussed on the geographically linked forested areas of the last two Bundibugyo Ebola outbreaks, and recommended heightened surveillance for that species? What if this recommendation had been supported with the requisite financing, technical support and system strengthening? It would have given us a far better chance of averting the current emergency.

In future, such a model could identify additional threats, and guide investments to avert a full pandemic.

This year, there is an opportunity to establish a comprehensive monitoring mechanism that will provide a clear overview of outbreak and pandemic risk and readiness, including through identifying risks from animal spillovers, to country, regional and global preparedness, response to health emergencies, and recovery.

September’s UN High-Level Meeting on Pandemic Prevention, Preparedness and Response must provide the political mandate to establish such a mechanism. Monitoring must extend beyond health ministries and embrace a whole-of-government and whole-of-society approach, reflecting the reality that pandemic threats emerge at the intersection of human, animal and environmental health, and that preparedness depends on many sectors.

Monitoring cannot be reduced to a box-ticking exercise, nor a process where those with money are scrutinizing those without. It’s about identifying collective gaps in PPR which require collective action. 

A publication by GPMB leadership in the Lancet described the principles of effective and coordinated monitoring. A recent brief by The Independent Panel highlights the need to shift to a mutually beneficial approach: one that moves from blind spots to understanding pandemic risk; from basic data collection to actionable insight; from a top-down imbalance to a federated system driven by national priorities, and from compliance to mutual trust and accountability.

Setting up a global monitoring system

What should this global monitoring system look like? For one, it needs to be independent and objective so that the information is trusted by all. Organizations, for example, cannot monitor themselves. 

Second, it needs to make information easily accessible, but based on evidence and deep dives. A risk science-based body would need to be well resourced and detailed, but its main messages must be clear to political leaders, policymakers, and the public as part of a big picture assessment.

Third, it needs to fill gaps in the system: for example, for Bundibugyo Ebola, we know what vaccines and treatments are in development, but we don’t have a clear assessment on if and how countries will eventually access them.

Fourth, it needs to be tied to funding and technical support, so that when gaps are identified, including by countries themselves, they can be prioritised and filled.

Finally, it needs legitimacy, requested by the UN, reporting to the technical body responsible for global health, the WHA and through it those who will need to act, including UNGA, relevant UN agencies, the World Bank, International Monetary Fund,, World Organisation for Animal Health, World Trade Organization, World Intellectual Property Organisation and other relevant bodies. 

It should be designed to inform the amended International Health Regulations and the implementation of the Pandemic Agreement when it comes into force. 

None of this requires a large new institution or a major additional burden on countries. Nor does it displace or duplicate existing valuable efforts; rather, it would seek to unify them in a coordinated manner and provide ready access to timely insights.

What it would need is a well-resourced secretariat with a sustained mandate, access to modern data tools, including AI, that can synthesise across fragmented sources, and connect to scientists, practitioners, civil society and policymakers in countries, regions and global capitals.

Most of all, monitoring should not be seen as a burden, but a reassurance. If done right, it can alert us to outbreak and pandemic threats, but also ease our minds. Because if we know where the risks lie, we can address them ahead of time

The Right Honourable Helen Clark is co-chair of The Independent Panel for Pandemic Preparedness and Response. She is the former Prime Minister of New Zealand.

Dr Victor Dzau is president of the US National Academy of Medicine. He is also Chancellor Emeritus and James B. Duke Distinguished Professor of Medicine at Duke University

Joy Phumaphi is co-chair of The Global Preparedness Monitoring Board. The former Minister of Health of Botswana, she also chairs the Rollback Malaria Partnership to End Malaria.

Shingai Machingaidze is co-chair of the Science and Technology Expert Group (STEG) at the International Pandemic Preparedness Secretariat, and is head of Africa Strategy and Engagement at the Coalition for Epidemic Preparedness Innovations (CEPI).

Image Credits: Alexis Huguet/MSF, Sebastien Assoignons/ Wildlife Conservation Society.