Working together to build capacity

In this video, Dr Tomas Poklepovich Caride from the National Center of Genomics and Bioinformatics, Argentina, tells us what the requirements for efficient pathogen monitoring in a laboratory facility are, including storage space and bioinformatics.

A robust healthcare system and infrastructure are vital for prevention, preparedness, early detection and response to pathogens. Thus, it is necessary to build a robust, comprehensive, and integrated surveillance programme.

Although the efficient implementation of surveillance programmes needs to consider social, economic, environmental, and technical conditions in the health landscape, not all surveillance systems are suitable for all countries or regions. Robust surveillance programmes depend on national healthcare infrastructure at the primary and reference level, as well as logistics, political and geographical realities.

The emergence of new diseases, conditions and events drive the review of public health priorities and strategies. After the COVID-19 pandemic, the incorporation of new technologies, including genomics surveillance and new networks added another level of complexity to pathogen monitoring.

The One Health concept has been increasingly discussed in the past two decades. It leverages a global health security approach by improving coordination, collaboration, and communication at the human-animal-environment interface. One Health addresses global health threats such as zoonotic diseases, antimicrobial resistance, and food safety among others.

To extend surveillance approaches, it is essential to engage and apply multi and transdisciplinary expertise. For example, a limnologist represents a valuable asset to better understand the ecology of vector or waterborne diseases. However, anthropologists could be advantageous in a field investigation, as the relationship between the community and the water is completely different according to history and cultural backgrounds.

One of the major lessons learnt from the COVID-19 pandemic is that multidisciplinary teams are key to responding to a global threat. The scientific community working together with epidemiologists, public health laboratories, stakeholders and decision-makers was essential for a strong pandemic response.

In the context of genomic surveillance, bioinformatics and IT team members must be included in the decision-making process, so that they can rethink the informatics architecture and ensure that translate genomics results to feed the surveillance systems into measurable actions. We also need to consider how to develop a surveillance system that engages with national reference laboratories, provincial or regional laboratories, academics and universities, for all, will input genomics information into the system.

Although access to core genomic facilities and bioinformatics expertise is still limited in public healthcare facilities in low-and-middle-income countries and many in high-income countries, the need to respond to COVID-19 enabled the improvement of genomic structures across the globe. These resources can be repurposed to provide genomic surveillance response of all pathogens of public health importance and also some non-transmissible diseases diagnosis.

Effective disease surveillance requires the collaboration of multiple teams, including genomics specialists, disease reference laboratories, bioinformatics, epidemiologists, and physicians; they also need to be aligned with national plans, which can add another layer of complexity. The challenge encountered by multidisciplinary teams includes not only disease detection, long-term surveillance, data reporting, management and analytics. They also must liaise with other stakeholders, including industry, and need to be prepared for information dissemination, logistics and continuous capacity building and training.

The pharmaceutical industry also played a major role in the COVID-19 response team in vaccine development and scale-up production. Industry capacity needs to be considered in the surveillance scheme of each disease’s dynamics. For example, if we are implementing a vector control strategy, it’s important to consider:

• Is the industry able to provide the insecticide chosen?
• Is it available for local production? If not, can it be promoted by the programme?

What do you think about working with professionals from different backgrounds in a multidisciplinary way? In your experience, has this changed since the COVID-19 pandemic? Please share in the comments.