Johns Hopkins Center for Health Security proposes 13 initiatives to improve future pandemic response

Is the United States prepared for the next pandemic?

That question has forced experts to either rethink preparedness strategies or find ways to bolster existing policy in the era of COVID-19.

For the researchers at the Johns Hopkins Center for Health Security, this has meant identifying 13 proposals that could increase preparedness and response for future public health crisis.

In the recommendations issued by the Center, three of the 13 proposals include:

• The development of medical countermeasures (MCMs) for unknown viral threats;
• Supporting innovation and stockpile strategies to provide better respiratory protective devices;
• And creating new vaccine delivery platforms to rapidly immunize millions in a pandemic.

Their recommendations were addressed to U.S. Sens. Patty Murray (D-WA) and Richard Burr (R-NC), members of the Senate Health, Education, Labor and Pensions (HELP) committee, to improve the nation’s public health and medical preparedness response programs. The bipartisan HELP committee recently announced areas of oversight to improve preparedness and response for pandemics, which include assessing supply shortages within the Strategic National Stockpile during H1N1, Ebola, and COVID-19.

“As we continue the work of ending this pandemic, I’m determined to make sure we ask the questions about how we got to this devastating point, and that we learn the lessons we need to learn so our country is never in this situation again,” said Murray, HELP committee Chair. “Questions around supply shortages, vaccine equity, and biosafety are among the many we need answered.”

Despite epidemics occurring more frequently, the development of novel antivirals, vaccines, and diagnostics is too lengthy a process at government agencies. To address speed, the Johns Hopkins researchers suggest harnessing platform technologies to develop MCMs. They also recommend establishing a government program that designs antiviral compounds for high-risk viral families, among other strategies to identify the next pandemic pathogen before a specific disease emerges. Organizations such as the Biomedical Advanced Research and Development Authority (BARDA) within the U.S. Department of Health and Human Services, and the Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (JPEO-CBRND) within the Department of Defense are “well positioned to run [antiviral] efforts, which could be coordinated through the Public Health Emergency Medical Countermeasures Enterprise,” according to the recommendations. Additionally, congressional appropriation is essential for a “robust and coordinated strategy before the next virus threatens the globe.”

Among the lessons learned from COVID-19 were that medical workers had limited supplies of respiratory protective devices. Underinvestment, lack of competition, and variable market forces meant limited progress to develop and manufacture better respirators, according to the experts. They suggest creating cost-effective, reusable, and easier-to-wear respirators could save thousands of lives and trillions of dollars in economic damage. The Strategic National Stockpile should also purchase reusable respirators for healthcare and other high-risk workers for public health emergencies. While BARDA has already established a mask innovation challenge, the report’s authors say the agency should create a similar program for respirator development.

Making headway to quickly immunize millions in a pandemic takes the development and manufacture of new platforms to deliver vaccines. Having healthcare workers physically administer them takes months rather than days or weeks. The researchers offer a different approach to vaccine distribution, one that uses microneedle patches, liquid oral preparation, tablets and pills, among other technologies to deliver vaccines faster. “Specifically, BARDA’s ‘Beyond the Needle’ program, which aims to catalyze technology development in this space, should be prioritized and supported,” as outlined in the proposals.

Recently the Johns Hopkins Center for Health Security joined 24 other organizations to submit a letter of support encouraging Congress to invest $30 billion over 4 years as part of the American Jobs Plan. The funding would be spent over four years to further protect Americans from the next pandemic and also create new U.S. jobs in public health, science and technology innovation, and domestic medical countermeasures infrastructure, according to a Center press release.