Preparing for the Next Epidemic: 3 Key Lessons Learned from COVID-19

No matter where you lived in the world, the COVID-19 pandemic likely had some effect on your life, health, or livelihood. Globally, and seemingly overnight, many aspects of commerce, education, and social interaction came to a halt. While COVID-19 took a devastating toll on humanity in so many ways, the global health community gained valuable lessons during and after the pandemic.

As the International Day of Epidemic Preparedness approaches this year, I’m reflecting on some of these lessons learned from COVID-19 and how they enabled us to strengthen the gaps in our health systems ahead of future epidemics.

1. Strengthened Disease Surveillance and Diagnostic Tools

As the COVID-19 pandemic unfolded, many countries increased investments in their disease surveillance systems. These investments were initially focused on strengthening sample collection and testing for swift COVID-19 case identification, thereby reducing the spread of the virus. With the continued threat of a new pandemic, these country surveillance systems have remained operational and highly vigilant, resulting in rapid identification of outbreaks caused by other emerging and re-emerging diseases. 

Thus, in sub-Saharan Africa, improved surveillance systems and diagnostic capacity have increased countries’ ability to identify disease outbreaks, resulting in faster reporting on transmission of both novel and known infectious agents. For example, outbreaks of Ebola were rapidly identified in Guinea in 2021 and Uganda in 2022, an outbreak of Marburg virus was swiftly detected in Rwanda in 2024, and an outbreak caused by different clades of the mpox virus was identified early in the Democratic Republic of the Congo (DRC) in 2023. More recently, the DRC’s Ministry of Health reported an outbreak of a flu-like virus—ultimately identified as severe malaria—in the Kwango province that, as of the writing of this blog, has resulted in more than 500 reported cases and over 140 deaths. It is clear that the speed of pathogen detection and reporting has undeniably increased as a result of developments spurred by the COVID-19 pandemic.     

Nonetheless, many countries in sub-Saharan Africa still lack a comprehensive and coordinated plan to quickly respond to an outbreak once it is identified. Additionally, countries often lack the capacity to assess the effectiveness of interventions that can curb the spread of infectious agents. Gaining a better understanding of the impact of response interventions could help countries develop more effective strategies to reduce the spread of diseases. 

To address that need, RTI developed a sophisticated epidemiological modeling framework, called "RTI Cassandra™" to simulate the spread of emerging and re-emerging infectious diseases regionally, nationally, or sub-nationally. Designed to be easily deployed to support ministries of health during outbreak periods, RTI Cassandra simulates the spread of an infectious disease among a population, accounting for population demographic characteristics and movement across the country. RTI Cassandra has already been deployed in several countries to support assessment and improvement of their surveillance and intervention activities targeting COVID-19, mpox, and Ebola.

2. Improved Vaccination Development, Dissemination, and Acceptance

Vaccines are a critical tool in preventing and managing epidemics. Widespread vaccination campaigns successfully mitigated the spread and negative impacts of the COVID-19 pandemic, preventing, in their first year of use, up to 19.8 million deaths globally. The scientific community applied groundbreaking methods to develop and produce the COVID-19 vaccines at a record pace, which also boosted vaccine research and spurred the development of new vaccine platforms targeting several other diseases, such as malaria. 

The pandemic also highlighted the critical need for vaccine equity; vaccines need to be available and accessible on a global scale, particularly in geographies and for populations that need them most. The COVID-19 vaccination effort included a commitment to produce vaccines in African countries rather than relying on imports, positioning Africa as a future global hub for vaccine development and production. This has been one of the pillars of the World Health Organization’s Medicines Patent Pool and the Act-Accelerator/COVAX initiative: to make Africa less dependent on international vaccine providers. The efforts of the Act-Accelerator/COVAX are working to establish vaccine production hubs like the one built in Cape Town, South Africa. By 2040, the African Union aims to be able to supply 60% of the vaccine doses needed on the continent. 

As Africa continues to build vaccine development and production capacity, countries are becoming highly capable of tailoring pipelines to supply vaccines to prevent the spread of mpox, dengue, Ebola, and other diseases. Vaccine delivery capabilities have also been strengthened, especially in rural areas, by increasing refrigeration capabilities during storage and transport, and improving follow-up inoculations for vaccines that require multiple doses. 

The effectiveness of vaccination campaigns in Africa, like in many other regions, is affected by misinformation tactics that foster vaccine hesitancy, stoking mistrust and conspiracy theories around treatments, often those developed by “Western” corporations. Locally led public education and outreach campaigns, as well as wider availability of regionally produced vaccines, should improve acceptance of this lifesaving intervention.

3. Increased Focus on One Health

Tropical and temperate regions with extensive biodiversity, from Latin America and the Caribbean to Southeast Asia, are extremely vulnerable to the spillover of infectious agents from wildlife to humans. The origins of the COVID-19 pandemic, Ebola, Marburg, and mpox outbreaks brought to the forefront how viruses can move along the human–animal interface. As human presence expands and encroaches on wild animal habitats, potential human interactions with wildlife increase. The bird flu (H5N1) has been infecting millions of birds around the globe for the last couple of years, and there are increasing reports of sporadic cases in humans.

In addition, geographies around the word are experiencing greater impacts from climate change, which heightens the risk of pandemics. For example, changes in global weather patterns foster the wet, warm weather that allows mosquitoes and other disease-carrying vectors to flourish and move into new regions, while climate-related disasters, such as flooding, can push animals and humans closer together and facilitate the transmission of pathogens. Dengue has expanded its distribution range and is increasingly found in previously non-endemic, sub-tropical areas, including Europe and the United States.

A One Health approach is an essential framework for understanding and addressing the interface between humans, animals, and the natural environment. Expanding monitoring and surveillance by integrating testing and reporting activities to include animal populations, for instance, aids early detection of pathogens and helps prevent their transmission to humans. Given the complexity of the transmission dynamics of many zoonoses, the One Health approach requires the involvement of several government departments and ministries across many fields (e.g., public health, agriculture, environment, and wildlife) to build an effective surveillance and response system. Thus, it becomes critical to promote activities to assemble global, regional, and local teams comprising health professionals, veterinarians, environmental specialists, biologists, and others to work together to rapidly detect and respond to pandemic risks.

Local Leadership Remains Key to Epidemic Preparedness

While COVID-19 forced the global public health community to advance pandemic preparedness and response efforts in new and better ways, it is important to understand how countries and their local health systems can and should be in the driver’s seat when preparing for and responding to outbreaks before they turn into epidemics—or worse—pandemics. 

Countries across the Americas, Africa, and Asia have a long history of resilience to disease outbreaks. Moving forward, the global health community must focus on supporting countries to continue building the local capacity to handle health threats as they emerge. Given the high level of global, regional, and in-country population movement; increased contacts along the human–animal interface; and climate change, providing technical support aimed at strengthening countries’ capacity to improve system pandemic preparedness will strengthen not only countries’ health security, but also that of the rest of the world.