Original content on University World News
Helen Clark, former prime minister of New Zealand and co-chair of an international independent panel of experts on pandemic preparedness and response, has urged universities to be part of a new global system to respond faster to disease outbreaks to prevent future pandemics.
The Association of Pacific Rim Universities (APRU), with some 60 research-intensive universities in the Asia-Pacific, North America and Latin America, has come up with an ambitious plan to put this into action after Clark addressed the group in September last year, calling on universities to offer global leadership on pandemic prevention.
She noted that universities would be heard in global policy circles. They can help improve global governance and feed into improved public health policies and sharing of intellectual property on biomedical advances.
The Independent Panel, which handed its report, COVID-19: Make it the last pandemic, to the World Health Organization (WHO) in May last year, identified a failure to take preparation seriously, a virus that moved faster than the existing surveillance and alert systems, a lack of urgency and effectiveness in early responses as well as a failure to sustain the response.
The panel called for stronger leadership and better coordination at national, regional and international levels and investment in preparedness now, and not when the next crisis hits.
“With the recommendations of the independent panel of the WHO, they are trying to get a global process in place for preventing the next pandemic. And part of that process is public policy documents, agreements at the UN level and so on.
“But it’s also engaging what has to happen around different jurisdictions, and universities have been playing very important roles at a national level,” said APRU Secretary General Christopher Tremewan.
“Many countries don’t have research resources … so we are engaging across not only advanced economies, but middle-income economies as well, and hopefully lower-income regions.
“The ambition is to use a network strategy, not only of universities, but in partnership with public health strategies, and with the development of international public policy, so that it produces far more integrated and timely interventions.”
Santa Ono, vice-chancellor of the University of British Columbia (UBC) in Vancouver, Canada, is co-chair of the APRU working group of university presidents on pandemics set up earlier this year in response to Clark’s call to action.
“Helen Clark approached APRU because she felt that the group of over 60 universities around the Pacific Rim could play a particular role in preparing the world for any future pandemics. She was very convincing,” he noted.
“She felt that although each institution has considerable assets, no one particular institution on its own has all the technology, biomedical research, biomedical engineering and public health expertise to create a playbook on how to respond to the next pandemic,” Ono said.
“If that were the case, then there would be nations that would be dealing very well with the pandemic. Yet, some of the wealthiest countries with the strongest universities in the world are still struggling with a sixth [COVID] wave even as we speak.”
The APRU working group has identified some of the major issues around the pandemic to focus on.
These include assembling a research database of biomedical technologies and therapeutics from APRU member universities as a major global resource for responding quickly to the next pandemic; drawing up strategies to combat the ‘infodemic’ through science and media literacy courses and other initiatives; and compiling a handbook on pandemic crisis management in diverse societies drawing on lessons from COVID-19 while also looking to what is needed in a future world affected by inequality and climate change.
Shortly after the APRU meeting with Clark, at APRU’s request, academic publisher Elsevier provided the working group with a list of the 100 universities that have published most in the field of COVID.
“It turns out that 20 of them are APRU members, so that’s one-third of our member universities,” said APRU Vice-Chair Rocky Tuan, vice-chancellor of the Chinese University of Hong Kong (CUHK), who also co-chairs the pandemic working group.
APRU – A ‘powerhouse’ of knowledge
“APRU is truly a powerhouse in terms of COVID knowledge. So it’s really imperative, almost a moral responsibility, for us to respond to her [Clark’s] call and do something.
“One thing we all learned through the epidemic is that evidence-based approaches are the best, the most appropriate, and evidence comes from knowledge. And universities are at the forefront of knowledge. They acquire knowledge, disperse knowledge, apply knowledge,” said Tuan.
One major task of the working group is to create what Ono calls an “assets lab” – a database of the cumulative strengths of the institutions within the APRU network.
Specifically tasked with this, Ono said: “We started at UBC to create this database – a directory of which institutions in APRU have expertise in fundamental research and translational research and clinical medicine, and pharmaceutical science and drug discovery, X-ray crystallography, virology, vaccine development and animal models.
“So, if something happens again, they can all come together to move more quickly in a future pandemic.
“There is a finite number of virus families that exist in the world; theoretically we need to have a library of all the proteins from all the pathogenic viruses somewhere,” he noted.
Such a global repository has not so far been brought together around pandemic resources that are easily accessible, and there are still many gaps, according to Ono, himself a biomedical scientist.
International repositories can be expensive to create. But “in future, this will hopefully accelerate the response. If we all come together and share the cost, we can create a repository for the whole world that none of us as a single nation can afford,” he said.
“We’ve already had three virtual meetings with vice-presidents of research and individuals [were] identified in each of the universities that are carrying out research that we think will be important for the future response together,” Ono said.
Once set up, the repository will be available to the APRU network, but Ono said it was also possible “that we’ll make it available to others around the world who might want to collaborate with us”. These others could include governments, public health organisations, WHO, medical research funding bodies, and even pharmaceutical companies that want to work with the university network.
Battling misinformation and building trust
An important plank of the APRU presidential working group is battling the ‘infodemic’.
As United Nations Secretary General António Guterres said in March 2020: “Our common enemy is COVID-19, but our enemy is also an ‘infodemic’ of misinformation. To overcome the coronavirus, we need to urgently promote facts and science, hope and solidarity over despair and division.”
According to Tremewan, universities “came into public focus very strongly because of their research capabilities and the high expectations of research that came forward. At the same time, the infodemic undermined public trust, both in science and in public policy process. So that’s why we have this in the presidential working group, aimed at creating a new level of public trust.
“APRU already, as a network, thinks about science, literacy and critical verification of critical resources and sources.
“The other side of it is equity. You can’t have public trust developing if only the wealthy can get hold of the remedies,” said Tremewan.
“University presidents are very much aware of their own societies,” he noted. “But behind all this is the weakening of institutions for political ends – conspiracy theories, use of science, etc – by unscrupulous politicians.
“All these things can be addressed if [responses are] done in concert and are prepared well.”
Dawn Freshwater, vice-chancellor of the University of Auckland, New Zealand, who heads the APRU working group’s work on misinformation around pandemics, said: “Although the pandemic brought misinformation and disinformation on a global scale to public health, with devastating consequences, we were already concerned – both as a university and as a network – about the impact of misinformation, disinformation, and the overload of information on democratic systems.”
Clark had urged APRU to think about how to combat the infodemic of misleading social media posts. “She was particularly focused on social media, which she felt seriously impedes public health strategies, undermining trust,” noted Freshwater.
“During COVID we were really starting to work with our institutions around the difference between information, misinformation and disinformation as people really needed to understand the difference between those three,” she said.
“We don’t know what the next pandemic is going to be. But we do know we’re going to need every type and element of communicative skill to bring people together to respond and to prepare for whatever the next outcome will be.”
Economic impact of misinformation
The working group unit headed by Freshwater is looking at whether there is a way of understanding the economic impact of misinformation and disinformation at a global level, examining its impact on the delivery and outcomes of the Sustainable Development Goals (SDGs), such as the links to poverty, health and food.
She is also looking into how universities can provide science literacy education and training which is important for combating misinformation and “which takes account of diverse cultural settings and the digital divide and assists with people’s understanding of the future pandemic and ways in which to manage misinformation.
“If we’re bringing economists, academics, CEOs and the United Nations together on these sorts of subjects, if the outcome is that we’re better able to communicate content and the way we form that content as a result, then that’s a great outcome,” Freshwater said.
“We think there’s also a hindrance through the infodemic to the United Nations achieving its SDGs across all of the 17 goals globally. We want to show what could be done in order to address those sorts of issues,” she added.
“We’ve pulled in universities that are not necessarily part of our network as well. We’re pulling in experts … We do a lot of horizon scanning, analysis of mega trends, and rather than just talk about the problem, we need to actually move towards solutions that other people can contribute to, and see that they can be part of and add to.”
Social and cultural factors
CUHK’s Tuan is leading the working group’s efforts on crisis management, particularly taking into account social and cultural factors that can affect public health strategies.
“The idea is to look at the social and cultural determinants, meaning, if you do something and you have some response, what determined that response? What are the responses and are they important? And if so, how can we massage it next time?” said Tuan.
“We are looking at strategies and responses including lockdowns, contact tracing and surveillance, public health messaging, protective behaviours and vaccination. Those are the five things I thought we will start with. Obviously, if you have others, we can add and look at the response and look at what determined the response that we can learn from.”
“People respond differently in different countries and in different societies. So, what makes them respond differently? And if so, does it affect effectiveness? That’s the kind of study we want to do.”
“Some of these social-cultural determinants are cultural tightness, collectivism versus individualism, socio-economic stratification, compliance, incentive, incentivisation … things like that.”
He describes it as putting together a “living document” that can be added to. “We need to track everything and we just keep letting it grow. At some point we’ll be pretty close to what we want.”
Tuan points to low vaccination rates in Hong Kong among the elderly due to traditional beliefs. “In the elderly this is a very deep-rooted belief. It was the Achilles’ heel of our recent [COVID] wave [in Hong Kong]. Young people are fine,” he said pointing to an 80% vaccination rate, but the rate was less than 30% in the elderly.
“People are studying this,” he said. “So, in the future, you can deal with a society that has these elements.”
The working group is aiming to have a document ready by November to present at a global university conference on preventing the next pandemic as part of the Asia-Pacific Economic Cooperation (APEC) summit in Thailand which brings together 21 governments of the Pacific Rim.
But the paper itself is not the most significant outcome.
“The more important thing is we are assembling our capabilities in a coherent way by doing this. So, this isn’t the endpoint. We’re going to have a strategy for doing it. That’s the next phase,” noted Tremewan.
Ono said: “Hopefully, we as institutions will benefit from that and we’ll be able to be more nimble and more impactful. Hopefully, we will be an example to the world of networks: international networks are part of the solution.
“In respect of the most pressing, existential problems, the world will require that institutions and nations work together as opposed to being at odds with each other,” added Ono.
With COVID-19, individual researchers – whether in science or health fields – were clear on what they wanted to say but were not heard in full or only when it suited policy-makers, said Tremewan.
With the work of the APRU working group, “I would expect to have institutions come up with much clearer preparatory strategies and policies to support such individuals, but also to play a leadership role by the way they act themselves. I think that can only be for the good,” he said.