Applying Lessons
Learned from
COVID-19 Research and
Development to
Future Epidemics

_____

Claire Biffl, Anna Nicholson,
Tamara Hagg, and Julie Liao,
Rapporteurs

Forum on Microbial Threats

Board on Global Health

Health and Medicine Division

Proceedings of a Workshop

NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and American Society of Tropical Medicine and Hygiene, Burroughs Wellcome Fund, Centers of Disease Control and Prevention (Contract No. 75D30121D11240), EcoHealth Alliance, ExxonMobil Foundation, Infectious Diseases Society of America, Johnson & Johnson (Contract No. C2022024120), Merck & Co., Inc., National Institute of Allergy and Infectious Diseases (Contract No. HHSN263201800029I, Task No. HHSN26300011), New Venture Fund (Contract No. NVF-NGDF-NAT10-Subgrant-017387-2022-04-01), Rockefeller Foundation, Sanofi, Society of Infectious Diseases Pharmacists, U.S. Agency for International Development (Grant No. 7200AA18GR00003), Uniformed Services University of Health Sciences (Award No. HU00012210001), U.S. Food and Drug Administration (Award No. 5R13FD006897-03), U.S. Department of Veterans Affairs (Contract No. 36C25022Q1147). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-70784-8
International Standard Book Number-10: 0-309-70784-6
Digital Object Identifier: https://doi.org/10.17226/27194

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Applying lessons learned from COVID-19 research and development to future epidemics: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/27194.

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APPLYING LESSONS LEARNED FROM COVID-19 RESEARCH AND DEVELOPMENT TO FUTURE EPIDEMICS WORKSHOP PLANNING COMMITTEE¹

TIMOTHY BURGESS (Co-Chair), Professor, Department of Preventive Medicine and Biostatistics, Uniformed Services University

JON HEINRICHS (Co-Chair), Associate Vice President and the Head of Innovation and Emerging Sciences, Sanofi

DOLORES ALBARRACÍN, Professor, University of Pennsylvania

DAN BAROUCH, Director, Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center; William Bosworth Castle Professor of Medicine, Harvard Medical School

DANIEL BAUSCH, President, American Society of Tropical Medicine and Hygiene

THERESA BERNARDO, Professor, Ontario Veterinary College, University of Guelph

AMBIKA BUMB, Deputy Executive Director, Bipartisan Commission on Biodefense

ANDREW CLEMENTS, Senior Scientific Advisor, Emerging Threats Division, U.S. Agency for International Development

ELIZABETH HERMSEN, Lead, Global Antimicrobial Resistance & Antimicrobial Stewardship Medical Affairs, Pfizer

KENT KESTER, Vice President, Translational Medicine, International AIDS Vaccine Initiative

JASON NEWLAND, Professor of Pediatrics, Infectious Diseases, Washington University School of Medicine in St. Louis

JOHN PARRISH-SPROWL, Director, Global Health Communication Center Indiana University

CARLA SAENZ, Regional Bioethics Advisor, Department of Health Systems and Services, Pan American Health Organization

MATTHEW ZAHN, Deputy Health Officer, Orange County Health Care Agency

National Academies Staff

ELIZABETH ASHBY, Associate Program Officer, Forum on Microbial Threats

___________________

¹ The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

MATTHEW MASIELLO, Associate Program Officer, Forum on Medical and Public Health Preparedness for Disasters and Emergencies

CLAIRE BIFFL, Research Associate, Forum on Microbial Threats

MELVIN JOPPY, Senior Program Assistant, Forum on Drug Discovery, Development, and Translation

EMILIE RYAN-CASTILLO, Research Assistant, Board on Global Health

HOLLY HOU, National Academy of Medicine—Hong Kong University Fellow in Global Health Leadership

JULIE LIAO, Director, Forum on Microbial Threats

JULIE PAVLIN, Senior Board Director, Board on Global Health

FORUM ON MICROBIAL THREATS

PETER DASZAK (Chair), President, EcoHealth Alliance

KENT E. KESTER (Vice Chair), Vice President of Translational Medicine, International AIDS Vaccine Initiative

EMILY ABRAHAM, Director, External Affairs and Policy, Global Public Health at Johnson & Johnson

KEVIN ANDERSON, retired, formerly U.S. Department of Homeland Security

DANIEL BAUSCH, President, American Society of Tropical Medicine and Hygiene and Senior Director, Emerging Threats & Global Health Security, FIND

CHRISTOPHER BRADEN, Acting Director, National Center for Emerging Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention

CRISTINA CASSETTI, Deputy Division Director, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases

ANDREW CLEMENTS, Senior Scientific Advisor, Emerging Threats Division, U.S. Agency for International Development

MALICK DIARA, Public Health Manager, Corporate Medicine and Occupational Health Department, ExxonMobil

SCOTT F. DOWELL, Deputy Director for Surveillance and Epidemiology, Bill & Melinda Gates Foundation

MARCOS A. ESPINAL, Assistant Director, Pan American Health Organization

GREG FRANK, Director of Global Public Policy, Merck & Co., Inc.

WONDWOSSEN GEBREYES, Executive Director of Global One Health Initiative, Department of Veterinary Preventive Medicine, The Ohio State University

BRUCE GELLIN, Senior Vice President and Chief of Global Public Health Strategy, The Rockefeller Foundation

EVA HARRIS, Professor, Division of Infectious Diseases and Vaccinology; Director, Center for Global Public Health, University of California, Berkeley School of Public Health

JON H. HEINRICHS, Associate Vice President and R&D New Targets, Franchise Head in Portfolio Strategy and Execution, Sanofi

ELIZABETH D. HERMSEN, Lead, Global Antimicrobial Resistance & Antimicrobial Stewardship Medical Affairs, Pfizer

MARK G. KORTEPETER, Vice President for Research, Professor of Preventive Medicine and Medicine, Uniformed Services University of the Health Sciences

MICHAEL MAIR, Acting Assistant Commissioner for Counterterrorism Policy; Acting Director, Office of the Chief Scientist, U.S. Food and Drug Administration

JONNA A. K. MAZET, Vice Provost—Grand Challenges; Chancellor’s Leadership Professor of Epidemiology & Disease Ecology, University of California, Davis

VICTORIA MCGOVERN, Senior Program Officer, Burroughs Wellcome Fund

SALLY A. MILLER, Distinguished Professor of Food, Agricultural and Environmental Sciences in Plant Pathology, The Ohio State University

SUERIE MOON, Director of Research, Global Health Centre; Visiting Lecturer, Graduate Institute of International and Development Studies

TIMOTHY D. MURRAY, Professor, Rosalie and Harold Rea Brown Distinguished Endowed Chair, Washington State University

MELISSA NOLAN, Assistant Professor, Arnold School of Public Health, University of South Carolina

RAFAEL OBREGÓN, Country Representative, UNICEF Paraguay

BENJAMIN PINSKY, Professor of Pathology and Medicine, Stanford University School of Medicine

AMEET J. PINTO, Associate Professor and Carlton S. Wilder Junior Faculty Chair, Georgia Institute of Technology

KUMANAN RASANATHAN, Unit Head for Equity and Health, Department of Social Determinants of Health, World Health Organization

P. DAVID ROGERS, Member and Chair, Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital

GARY A. ROSELLE, Executive Director, National Infectious Disease Services Program, Veterans Health Administration, U.S. Department of Veterans Affairs

PETER A. SANDS, Executive Director, The Global Fund to Fight AIDS, Tuberculosis & Malaria

THOMAS W. SCOTT, Distinguished Professor, Department of Entomology and Nematology, University of California, Davis

MATTHEW ZAHN, Deputy Health Officer, Orange County Health Care Agency

Forum on Microbial Threats Staff

ELIZABETH ASHBY, Associate Program Officer

CLAIRE BIFFL, Research Associate

CHARLES MINICUCCI, Research Assistant (until January 2023)

JUSTIN HAMMERBERG, Senior Program Assistant (until November 2022)

NICKY KUANG, Senior Program Assistant (from February 2023)

JULIE LIAO, Director, Forum on Microbial Threats

JULIE PAVLIN, Senior Board Director, Board on Global Health

Reviewers

This Proceedings of a workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by LESLIE Z. BENET, University of California San Francisco. Leslie was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

Acknowledgments

The Forum on Microbial Threats staff and planning committee deeply appreciate the many valuable contributions from individuals who assisted with this project. Thank you to Casey Barton Behravesh, Tracey Dutcher, Mark G. Kortepeter, Maureen Lichtveld, Anne-Marie Mazza, and Liz Mumford for their insightful feedback and discussion that helped to shape the workshop charge. Our colleagues Lisa Brown, Melvin Joppy, Matthew Masiello, Emilie Ryan-Castillo, Carolyn Shore, and Scott Wollek provided invaluable assistance in the organization and logistics of the workshop. Finally, the workshop and this Proceedings of a Workshop would not be possible without the work of the planning committee members, the leadership of the committee co-chairs, and the presenters and discussants at the workshop, who gave so generously of their time and expertise.

Contents

BOXES AND FIGURES

ACRONYMS AND ABBREVIATIONS

1 INTRODUCTION

Workshop Objectives

Organization of the Proceedings of the Workshop

2 PREPAREDNESS AND RESPONSE IN THE RESEARCH COMMUNITY

The COVID-19 Pandemic: Lessons Learned

Discussion

3 EQUITABLE SCIENTIFIC COLLABORATIONS, PARTNERSHIPS, AND COORDINATION WITHIN THE UNITED STATES

Industry Perspective on the COVID-19 Response

Academic Perspective on the COVID-19 Response

Research and Partnership in COVID-19 Vaccine Development

Washington State Government COVID-19 Response

Discussion

4 EQUITABLE SCIENTIFIC COLLABORATIONS, PARTNERSHIPS, AND COORDINATION ON THE GLOBAL SCALE

Twin Pillars of Global Vaccine Partnerships: Addressing Access Equity and Hesitancy

Panel Reflections

Discussion

Expanding Global Collaboration, Capacity, and Engagement

5 COORDINATION AND PARTNERING BETWEEN SCIENTIFIC RESEARCHERS, POLICYMAKERS, AND THE GENERAL PUBLIC

Communication and Vaccine Acceptance Considerations

Coordination and Partnering between Scientific Researchers, Policymakers, and the General Public

Discussion

6 SOCIAL AND BEHAVIORAL CONSIDERATIONS FOR ACCEPTANCE AND UPTAKE OF PUBLIC HEALTH RECOMMENDATIONS

Civil Society

Individual Behavior and Identity

Communicating Biomedical Research

Full Panel Discussion

7 SUSTAINMENT: ASPECTS OF LEADERSHIP AND SUPPORT

Sustaining Leadership for Preparedness and Response

Implementing BARDA’s Pandemic Preparedness and Response Capability

Barriers to Pandemic Preparedness

Discussion

8 A VISION FOR THE FUTURE AND FINAL SYNTHESIS

Delivering Vaccines for Emerging Infectious Diseases: Harnessing the Power of Innovative Partnerships

Discussion

Final Synthesis

REFERENCES

APPENDIXES

A Workshop Statement of Task

B Public Meeting Agenda

Boxes and Figures

BOXES

2-1 Findings from a Case Study of the U.S. COVID-19 Response

2-2 Lessons Learned from the HIV Response Applicable to COVID-19

5-1 Lessons Learned from the COVID-19 Response on Public Engagement and Vaccine Acceptance

7-1 Syndemic Interaction of Mpox and HIV

FIGURES

4-1 The global unvaccinated population

5-1 Interventions to increase vaccine coverage

6-1 Knowledge used to predict hesitance to vaccinate kids

7-1 Mpox cases reported to the U.S. Centers for Disease Control and Prevention by age, gender, and race/ethnicity (December 8, 2022)

Acronyms and Abbreviations