WHO played an instrumental role in the development, implementation and scaling-up of research agendas, predictive models, innovative tools, products and interventions throughout the biennium.

As a technical organization with global convening power, WHO activated, coordinated and leveraged the expertise of global networks and WHO collaborating centres throughout 2020 and 2021. This not only drove research, innovation and the development of new countermeasures but also fostered information-sharing and translation of science into policy. The WHO R&D Blueprint for Epidemics facilitated and accelerated the research and development response to COVID-19, contributing to the development and emergency use approval by WHO of nine COVID-19 vaccines, the first of these on the last day of 2020. WHO played a key role in providing evidence-based guidance, aiding informed decision-making and promoting the uptake of sound practices, such as use of public health and social measures, clinical care pathways and minimum standards for infection prevention and control. WHO will build on the successes of the Access to COVID-19 Tools Accelerator (ACT-A).

Despite well-documented disruptions to routine immunization and the diversion of resources away from preventive measures such as vector control and water, sanitation and hygiene, WHO continued to support countries in implementing and scaling up proven prevention strategies for priority pandemic- and epidemic-prone diseases. The support included strategies for yellow fever (see infographic below), meningitis, cholera, measles and rubella, with a focus on high-risk countries and fragile, conflict-affected and vulnerable settings. New global strategies, partnerships and platforms are being defined for diseases such as those due to Marburg virus and Ebola virus, Lassa fever, Crimean-Congo haemorrhagic fever, Rift Valley fever and Nipah virus. WHO continues to coordinate equitable management, stockpiling and distribution of scarce resources (vaccines, therapeutics and diagnostics), including through the International Coordinating Group on Vaccine Provision, by sustaining the necessary operational capacity at all levels and by forecasting and price negotiation. WHO worked with Member States to accelerate catch-up vaccination, leverage the capacities and systems built for COVID-19 and mitigate any further negative effects such as “spillover vaccine hesitancy”.

Many of the successes of the COVID-19 response would have been much harder to achieve without the investments and gains made under the Pandemic Influenza Preparedness (PIP) Framework during the past 10 years (see box below). For example, WHO worked with partners to leverage existing influenza sentinel surveillance systems and to scale-up surveillance of COVID-19 variants through genomic sequencing.

Many lessons learnt from COVID-19 have informed WHO’s work with countries and partners to mitigate the risks of emergence and reemergence of high-threat pathogens. Member States and WHO worked to strengthen infection prevention and control and clinical management tools and capacity, implement multisectoral OneHealth strategies, scale up capacity in use of techniques such as genomic surveillance and sequencing, and prioritize pandemic preparedness. WHO developed and used innovative means for communicating risk and managing infodemics to tackle the threat of misinformation and disinformation. In response to the global need for a rapid, safe, transparent mechanism for voluntary sharing of biological materials with epidemic or pandemic potential, WHO has jointly started to pilot-test a system, which will enable rapid risk assessments that can be shared with all countries and will accelerate research and innovation, including for medical countermeasures that can be shared equitably. In 2021, WHO became the leader of the UN bio-risk working group, an interagency group charged with improving UN-wide coordination in mitigation of bio-risks.

Preventing the next human influenza pandemic: celebrating 10 years of the Pandemic Influenza Preparedness Framework

Ten years ago, WHO Member States adopted the PIP Framework as a pioneering approach for sharing influenza viruses and thus achieving more equitable access for Member States to vaccines and medicines for use in a pandemic. WHO has systematically implemented the PIP Framework in partnership with the Global Influenza Surveillance and Response System (GISRS), industry and other partners. WHO received more than US$ 252 million in partnership contributions, which has been used to strengthen pandemic influenza preparedness around the world and which contributed to some of the earliest and continuing successes of the global COVID-19 response.

Today, thanks in part to the PIP Framework and partners:

• 10% of future pandemic influenza vaccine production, 10 million antiviral treatments, 250 000 diagnostic kits and 25 million syringes have been secured for use by WHO in the event of a pandemic through legally binding PIP SMTA2 advance supply contracts with 14 manufacturers.
• 12 influenza laboratories were recognized as National Influenza Centres, including two in 2020–2021. There are now 148 Centres in 124 countries, increasing the geographical representativeness of GISRS for sharing influenza viruses, monitoring influenza activity and informing risk assessments. 137 countries participate in GISRS by sharing data or viruses, which required them to improve their laboratory and surveillance systems.
• 48 countries published estimates of their burden of disease, 16 countries either for the first time or updating previous estimates. These data are critical for evidence-based influenza prevention and control policies.
• 51 of the 63 countries supported wrote, tested or are developing national pandemic influenza preparedness plans.

The investments made had a measurable, positive impact on the COVID-19 response.

• 107 countries have integrated COVID-19 surveillance into influenza sentinel systems.
• More than six million people are enrolled on the OpenWHO platform, which was first developed with PIP support and rapidly scaled up to meet the demand for information during the pandemic. It now contains 42 COVID-19 courses in several languages.
• 46 of the 48 PIP-supported countries were enabled to authorize COVID-19 vaccines within 15 days of WHO emergency use listing.