Strategic Investment in Surveillance for Pandemic Preparedness: Rapid Review and Roundtable Discussion

Efforts in pandemic preparedness can be strategically guided by understanding the potential costs and benefits of interventions for surveillance, which we call the “best buys” of surveillance. This policy paper examines the state of knowledge on investing in the “best buys” of surveillance for pandemic preparedness and specifically for respiratory infections. We focus on respiratory infections because of their potential for global spread as well as the World Health Organization (WHO)’s Preparedness and Resilience for Emerging Threats (PRET) initiative initial focus on pandemics of respiratory pathogens. We conduct a rapid literature review to assess the state of knowledge on the costs and benefits of investing in four selected types of surveillance for respiratory infections (laboratory networks, sentinel surveillance, notifiable disease surveillance, and health facility event-based surveillance) considered as “core” surveillance by the WHO’s Mosaic Framework (which listed a total of ten types of surveillance). We discussed early results with an expert panel during a CGD roundtable discussion. Overall, cost data on surveillance programs remains very limited. Of the four types of surveillance examined, there are more studies reporting costs for sentinel surveillance than other types of surveillance. Studies did not standardize measures of effectiveness of surveillance, making comparisons across surveillance types challenging. The effectiveness of investments is not easily assessed before a pandemic, highlighting the need for rigorous, independent evaluation of the value and impact of preparedness investments (including for surveillance) on pandemic response. In order to inform future pandemic preparedness and response efforts, more knowledge is needed on the costs and effectiveness of surveillance of respiratory infections and related diseases.