Resource library: Epidemic prevention

Find guidance, case studies, advocacy tools and more

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Epidemic-Ready Primary Health Care (ERPHC) framework and technical package

Resolve to Save Lives

This technical toolkit explains how Epidemic-Ready Primary Health Care (ERPHC) ensures PHC systems can quickly identify and notify cases (speed), manage them safely (safety), and handle increased patient volume and maintain essential service (surge). It outlines capacities, core activities and outcomes for implementation and includes a proposed implementation model.

Strengthening country architecture for epidemic preparedness

Resolve to Save Lives

7-1-7: rapid improvement for early disease detection and response

7-1-7 Alliance

Considerations for the Development of a National Public Health Institute (NPHI)

Resolve to Save Lives

The true cost of failing to protect health care workers

The World Bank, Resolve to Save Lives

A landmark study from the World Bank and Resolve to Save Lives used a “cost-of-illness” methodology to measure the broader socio-economic costs of health care worker infections and deaths from COVID-19—including the costs of disruption to essential health services due to a compromised health workforce.

Unleashing the full potential of 7-1-7

7-1-7 Alliance

From signals to systems: Strengthening epidemic readiness through climate-informed strategies

Resolve to Save Lives

This issue brief outlines how Resolve to Save Lives is supporting governments to strengthen epidemic readiness by integrating climate data into health systems. Key strategies include building epidemic risk monitoring systems using real-time climate data, improving communication of climate-health risks, embedding climate-sensitive protocols into health policy and developing resilient primary health care infrastructure. These efforts aim to ensure timely, effective responses to climate-driven health threats while maintaining essential health services.

Foundations for sustainable health: A blueprint for building epidemic-ready and climate-resilient primary health care

Resolve to Save Lives and Jacobs Solutions

This blueprint outlines our model for epidemic-ready, climate-resilient and sustainable primary health care infrastructure using an all-hazard approach. We urge national governments to embed resilience into health and infrastructure planning. We call on donors to support integrated, scalable investments and help countries learn from what works. And we encourage facility leaders and communities to codesign and implement local solutions. Only through integrated action can we build primary health care systems that are prepared, equitable, and truly resilient. Developed in collaboration with our partners at Jacobs Solutions.

From 18 countries to yours: Actionable 7‑1‑7 bottleneck insights

7-1-7 Alliance

The 7-1-7 Alliance to identifies global patterns in the barriers to outbreak detection, notification and response and provides an example of how countries can leverage their own 7-1-7 bottleneck data to inform investments, prioritization and accelerate performance improvement.

Implementation guide: Enhancing health facility preparedness for prompt response to public health emergencies in Ethiopia

Ethiopian Public Health Initiative

Implementation guide to “Enhancing health facility preparedness for prompt response to public health emergencies: Ethiopia’s public health emergency at health facilities initiative.”

Executive Summary:

The implementation guide for the Public Health Emergency Management (PHEM) at the Health Facility Initiative in Ethiopia provides crucial guidance for managing public health emergencies in health facilities across the country. The primary goal of this initiative is to improve the ability to identify and respond to public health emergencies (PHEs) and ensure that health facilities are well-equipped and resilient in the face of PHEs. The guide takes a proactive approach to emergency preparedness, aiming to mitigate the impact of crises and prevent them from happening. It serves as a comprehensive resource, outlining the step-by-step process for establishing an effective PHEM framework at health facilities that aligns with the national health emergency management plan at all levels.

The PHEM at health facility implementation guide has several key components. These include the establishment of teams for emergency preparedness and response, the development of emergency preparedness and response plans, and the strengthening of surveillance systems. The guide provides detailed guidance on the roles and responsibilities of different actors involved in implementation, as well as advocacy, capacity-building, and simulations. The initiative emphasizes the importance of collaboration and coordination among various stakeholders in building effective PHEM systems. This includes local government, partners, Regional Health Bureaus (RHBs), healthcare workers, and the community. It encourages health facilities and communities to participate in emergency preparedness and response activities involving local leaders and community members. The implementation guide is not only relevant to public health emergencies but also to other emergencies that require an equal level of preparedness and response such as natural disasters or conflicts. In conclusion, the PHEM at Health Facility Initiative Implementation Guide plays a vital role in helping health institutions to establish effective emergency preparedness and response systems. It offers practical guidance and tools that can be tailored to meet local needs and circumstances.

Actionable 7‑1‑7 bottleneck insights: Resources for rapid outbreak investigation

7-1-7 Alliance

Development and Implementation of a Public Health Event Management System, Nigeria, 2018–2024

Emerging Infectious Diseases

In a study published in Emerging Infectious Diseases, Resolve to Save Lives and colleagues explore the role of event management systems (EMS) in epidemic intelligence, focusing on the Nigeria Centre for Disease Control and Prevention’s (NCDC) SITAware software. EMS are essential for integrating surveillance signals and managing incident response, though international standards for their development remain underdefined. SITAware, designed to function effectively even with limited internet bandwidth, provides capabilities for generating notifications, reports, spatiotemporal dashboards and event-level data to support real-time accountability and post-event learning. In 2022, it successfully managed approximately 300 incidents and was implemented at subnational levels by NCDC. The insights from NCDC’s experience with SITAware offer valuable guidance for the development and implementation of EMS in similar settings.

A research agenda for urban health security

Frontiers in Sustainable Cities

In a perspective piece published in Frontiers in Sustainable Cities, Resolve to Save Lives and partners outline ten key themes for strengthening health security in urban environments. Given cities’ unique vulnerabilities to infectious diseases, the paper highlights areas such as community partnerships, governance and financing, risk communication and resilient infrastructure as critical for epidemic preparedness. By intentionally advancing these themes, cities can better prevent, detect, respond to and recover from health threats—offering a roadmap for enhancing public health resilience in urban settings worldwide.

Development of a Subnational Health Security Capacities Assessment Tool: Lessons From Nigeria and Implications for the Implementation of the Integrated Disease Surveillance and Response Strategy

Health Security

In a study published in Health Security, Resolve to Save Lives and partners introduce a tool for assessing subnational health security in Nigeria that evaluates state-level capacities under the International Health Regulations (2005) (IHR). With input from public health leaders and legal experts, the team used a legislative evaluation to determine feasible IHR activities within state legal frameworks to inform the tool, which was then piloted in Kano, Enugu and Kebbi states. Using 35 indicators across 14 technical areas, the tool identifies gaps in capacities and opportunities for improvement planning at the subnational level. This approach offers a model for strengthening preparedness in federated systems and geographically diverse countries.

Using timeliness metrics for household contact tracing and TB preventive therapy

IJTLD

Can 7-1-7 help household contacts of tuberculosis patients get started on preventive therapy? In the International Journal of Tuberculosis and Lung Disease, our colleagues at International Union Against Tuberculosis and Lung Disease used a mixed-methods approach to assess the feasibility of the timeliness metric in the private sector in Chennai, India. Among 263 index patients, 90% had their household contacts (HHCs) line-listed within 7 days. Screening outcomes for 48% of the 556 were achieved in HHCs within 1 day, and 57% began TPT or received a treatment decision within 7 days. 24% of screened HHCs started TPT during the ‘7-1-7’ period, compared to 16% in historical controls. Barriers included HHC reluctance to be evaluated, private providers’ refusal to prescribe TPT, and reliance on facility-based screening instead of home visits. Overall, the introduction of 7-1-7 can effectively enhance HHC screening and management.

7-1-7 for Accountability, Monitoring and Evaluation

7-1-7 Alliance

Advocacy as easy as 7-1-7

7-1-7 Alliance

Continuous improvement with 7-1-7

7-1-7 Alliance

Why 7-1-7? The evidence behind the global target for containing epidemic threat

7-1-7 Alliance

Overview of the 7-1-7 Alliance

7-1-7 Alliance

Digital toolkit

7-1-7 Alliance

Protéger le Personnel de Santé: Il est Urgent D’agir

Resolve to Save Lives

PMEP Application

Resolve to Save Lives

Rapid Outbreak Financing to Prevent Epidemics

Resolve to Save Lives

Program Management for Epidemic Preparedness

Resolve to Save Lives

PERC Briefing on Economic Burden of COVID-19

Resolve to Save Lives

Prévention des Épidémies Ce que les Communautés, les Pays et le Monde Peuvent Faire Pour Progresser

Resolve to Save Lives

Prévenir Les Épidémies Comment les Communautés, les Pays et le Monde Peuvent S’impliquer

Resolve to Save Lives

Considérations Liées au Développement d’un Institut National de Santé Publique (INSP)

Resolve to Save Lives

How ready is your country for the next epidemic?

Resolve to Save Lives

Letter to Congressional Leaders

Resolve to Save Lives

Developing the 2024 National Action Plan for Health Security (NAPHS) Annual Operational Plan (AOP)

Resolve to Save Lives

NAPHS Tracker

Resolve to Save Lives

Operational Planning and Priority-Setting Using 7-1-7 to Strengthen Uganda’s Health Security

Resolve to Save Lives

Joint External Evaluation Overview

Resolve to Save Lives

International Health Regulations (2005) Core Capacities

Resolve to Save Lives

$113 Billion Can Prepare Low- and Middle-Income Countries to Prevent and Respond to Epidemics

Resolve to Save Lives

How to Facilitate a Training of Trainers

Resolve to Save Lives

Practical guidance on how to effectively conduct a Training of Trainers (ToT). It covers essential tips and best practices for facilitating interactive, engaging, and impactful training, including preparation strategies, fostering participant engagement, and ensuring knowledge transfer.

How to Effectively Lead Groups Online

Resolve to Save Lives

Conseils pour la mise en place d’une communauté virtuelle de pratique

Resolve to Save Lives

How to Build a Virtual Community of Practice

Resolve to Save Lives

How to Adapt In-Person Training for Online Settings

Resolve to Save Lives

Letter to Congress

Resolve to Save Lives

Guide D’action de Plaidoyer: Un Référentiel Pour Les Campagnes De Plaidoyer Stratégiques

Global Health Advocacy Incubator

Dedicated Preparedness Teams

Resolve to Save Lives

Advocacy Action Guide: A ToolKit for Strategic Policy Advocacy Campaigns

Resolve to Save Lives

Public Health Media Advocacy Action Guide: Elements Of A Media Advocacy Campaign

Resolve to Save Lives

A ToolKit for Strategic Policy Advocacy Campaigns: Concluding Your Campaign: A Checklist

Resolve to Save Lives

Plaidoyer – Guide d’action. Outils Pour Des Campagnes De Plaidoyer Stratégiques.

Global Health Advocacy Incubator

Évaluation Externe Conjointe

Resolve to Save Lives

Le Règlement Sanitaire International (2005)

Resolve to Save Lives

Fast-Tracking Funding for Epidemic Preparedness in the Democratic Republic of Congo (DRC)

Resolve to Save Lives

Droits et obligations des États Parties au Règlement sanitaire international (2005)

Resolve to Save Lives

Comment gérer efficacement les groupes en ligne

Resolve to Save Lives

Comment animer une formation de formateur

Resolve to Save Lives

12 Characteristics of an Effective Public Health Emergency Law

Resolve to Save Lives

Revealing the Toll of COVID-19: A Technical Package for Rapid Mortality Surveillance and Epidemic Response

Resolve to Save Lives

Guide for Analysis of Respiratory Syndromic Surveillance Data

Resolve to Save Lives

Annex 1: How to create a COVID-19 alert-level system and supporting communication tools in resource-constrained settings

Resolve to Save Lives

Prévention et contrôle des infections contre la maladie à virus Ebola et la COVID-19

Resolve to Save Lives

Infection Prevention and Control for Ebola (EVD) and COVID-19

Resolve to Save Lives

A ToolKit for Strategic Policy Advocacy Campaigns Strategic Planning: Talking with Policy-Makers

Resolve to Save Lives

A ToolKit for Strategic Policy Advocacy Campaigns Strategic Planning: How-to Guide

Resolve to Save Lives

A ToolKit for Strategic Policy Advocacy Campaigns Strong Partnership Coordination: A 5-Step Process

Resolve to Save Lives

Elements Of A Media Advocacy Campaign: What You Need to Know

Resolve to Save Lives

A ToolKit for Strategic Policy Advocacy Campaigns: Elements of a Policy Advocacy Campaign

Prevent Epidemics

“Voices” of Long COVID Stress the Urgency of COVID-19 Vaccination

Resolve to Save Lives

Strengthening Epidemic Preparedness at the Country Level

Resolve to Save Lives

Renforcer la préparation aux épidémies au niveau national

Resolve to Save Lives

International Health Regulations FAQ’s

Resolve to Save Lives

PMEP 2023-2024: Questions Fréquemment Posées

Resolve to Save Lives

PMEP 2023-2024: Frequently Asked Questions

Resolve to Save Lives

PMEP Overview

Resolve to Save Lives

Présentation de PMEP

Resolve to Save Lives

7-1-7 Pilot Project

Resolve to Save Lives

The 7-1-7 framework helps countries strengthen their outbreak detection and response by setting clear targets: 7 days to detect a suspected outbreak, 1 day to inform public health authorities, and 7 days to initiate a response. This pilot project tested the framework in three countries to improve pandemic preparedness and guide performance improvements.

Messages clés de prévention et contrôle des infections (PCI) pour la maladie à virus Ebola dans les structures de soins de santé

Resolve to Save Lives

Key Infection Prevention and Control (IPC) Messages for Ebola Virus Disease (EVD) at Health Care Facilities

Resolve to Save Lives

International Health Regulations (IHR) Overview

Resolve to Save Lives

Joint External Evaluation

Resolve to Save Lives

Measures to Improve COVID-19 Response

Resolve to Save Lives

A step- by-step framework to use in analyzing and improving their systems of epidemic control. This outlines targets for key completeness measures and time intervals between activities, based on mathematical models of case investigation and contact tracing, to effectively reduce COVID-19 transmission.

Building resilient populations in the face of COVID-19

Resolve to Save Lives

This document highlights the need to reduce noncommunicable disease (NCD) risk factors—such as poor nutrition, tobacco, alcohol use, and air pollution—in order to protect populations from severe COVID-19 outcomes and future pandemics. It recommends evidence-based policies, like trans fat elimination and tobacco control, to build resilience and promote healthier, longer lives.

Urban pandemic response: Survey results describing the experiences from twenty-five cities during the COVID-19 pandemic

PLOS Global Public Health

How do local governments contribute to pandemic response? For PLOS Global Public Health, Resolve to Save Lives collaborated with colleagues at Center for Global Health Science & Security and Vital Strategies to assess government responsibilities, the timeline of response activities, challenges faced during the COVID-19 pandemic among members of the Partnership for Healthy Cities. Among the 25 participating cities, national authorities primarily led pandemic activities but local governments were crucial in risk communication and community coordination. Most activities occurred after COVID-19 confirmation, highlighting challenges in proactive preparedness; nearly all local authorities expressed a desire for greater involvement in future pandemic preparedness and response.

Understanding, preventing, and stopping epidemics

The Lancet

The Smithsonian exhibition, Outbreak: Epidemics in a Connected World, shows that the world cannot afford to wait for the next epidemic—we must act on the information that we have now to end preventable outbreaks. Writing for the Lancet, Resolve to Save Lives reflects on the impact of epidemics over the past century, from Nipah virus to HIV and Ebola. It underscores the importance of coordinated global efforts in epidemic preparedness, emphasizing the lessons learned from previous outbreaks. Despite progress, significant gaps remain in disease surveillance, community engagement, and health care capacity. A safer future for all will require ongoing education, collaboration, and a global commitment to addressing vulnerabilities.

Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya

IJTLD OPEN

In a study published in the International Journal of Tuberculosis and Lung Disease, our colleagues at the International Union Against Tuberculosis and Lung Disease and the Respiratory Society of Kenya evaluated the feasibility of implementing a “7-1-7” timeliness metric for screening and initiating TB preventive therapy (TPT) among household contacts (HHCs) of index patients with tuberculosis (TB) in Kiambu County, Kenya. Over six months in 12 health facilities, 95% of 508 index patients had their HHCs line-listed within 7 days, and 68% of 1,115 HHCs were screened for TB within one day. Only 62% of eligible HHCs initiated TPT within 7 days, compared with 58% in a historical cohort. Main barriers to TPT uptake included HHCs not presenting for treatment or being unwilling to initiate TPT, and drug shortages. Health care workers reported that a timeliness metric was valuable for streamlining management and proposed “3-5-7” as an alternative.

The world must prepare now for the next pandemic

BMJ Global Health

In a commentary for BMJ Global Health, Resolve to Save Lives takes lessons from the COVID-19 pandemic and proposes an updated understanding of pandemic preparedness. Moving forward, we must secure increased and sustained funding from governments, while enhancing technical capacities and operational excellence in public health systems worldwide. Strengthening our global health architecture demands a commitment from countries, effective governance, and responsible use of resources. We need strong, accountable global leadership and robust technical support, backed by substantial new funding and efficient financial mechanisms. Ultimately, success hinges on fostering collaboration, recognizing our interdependence, and establishing mutual accountability in our efforts.

The road to achieving epidemic-ready primary health care

The Lancet Public Health

A new model for integrating public health and health care delivery— epidemic-ready primary health care—that can identify and stop outbreaks, maintain essential services during disruptions, strengthen population resilience, and ensure health worker and patient safety. For the Lancet Global Health, we argue that strengthening primary health-care capacities for detection, vaccination, treatment, and coordination with public health would improve health security significantly. We anticipate that progress will be stepwise, driven by agreements on core services, optimized funding mechanisms, and health improvement incentives. Advocacy from health workers and civil society will be essential, as is political consensus. To achieve robust epidemic-ready primary health care, we must commit to substantial financial and structural reforms, ensuring that we are prepared for future health challenges.

The Centrality of Communities and Civil Society in Epidemic and Pandemic Prevention. A Framework for Improved Preparedness and Response

Prehospital and Disaster Medicine

Large-scale epidemics and pandemics threaten global health security and community resilience, especially concerning emerging infectious diseases and the resurgence of previously controlled conditions. Communities play a vital role in preventing, detecting, and responding to these threats, as demonstrated in recent outbreaks. Effective community involvement enhances government efforts and mitigates negative impacts. This study emphasizes the importance of collaborative partnerships among civil society, the private sector, and government, highlighting that pre-established systems and trust are crucial. Through case studies from the Red Cross and Red Crescent movement, best practices for community engagement in epidemic preparedness and response are presented, showcasing effective participation and joint planning.

The amended international health regulations: Implications and challenges for domestic legal frameworks

The International Journal of Health Planning and Management

In The International Journal of Health Planning and Management, Resolve to Save Lives argues that the amendments to World Health Organization’s International Health Regulations (WHO IHR)—especially the emphasis on multisectoral coordination and strengthening subnational capacities— offer an important opportunity for countries to bolster their public health systems. As demonstrated by the COVID-19 pandemic, it is critical for national legal frameworks to include a coordinating authority and ensure strong capacities at local levels. Adopted at the national level, these legal reforms can make it easier for countries to prevent, detect and respond to health emergencies, improving health security worldwide.

TB preventive therapy: uptake and time to initiation during implementation of ‘7-1-7’

IJTLD OPEN

Can the 7-1-7 target increase the number of household contacts (HHCs) of tuberculosis patients initiated on preventive therapy? In this letter published in he International Journal of Tuberculosis and Lung Disease, our colleagues at International Union Against Tuberculosis and Lung Disease describe how the 7-1-7 metric was adapted for TB preventive therapy (TPT), requiring HHCs to be listed within 7 days, screened within 1 day, and started on TPT within 7 days of screening. In a study involving 1,635 HHCs across sites in India, Pakistan and Kenya, the median initiation time for TPT was 6 days. However, persistent challenges included low attendance at health facilities and hesitance among health workers to prescribe TPT, underscoring the urgent need for enhanced support systems and targeted interventions to boost TPT uptake.

Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

BMJ Global Health

While an infection prevention and control initiative improved COVID-19 infection rates for health care workers in Africa, ongoing challenges demonstrated the need for long-term investments in sustainable IPC programs. In BMJ Global Health, Resolve to Save Lives examines an infection prevention and control (IPC) initiative implemented in 22 African countries from April 2020 to January 2021. The initiative provided training, personal protective equipment (PPE) and ongoing supervision to over 42,000 frontline health care workers at 8,444 facilities. Despite achieving short-term improvements in IPC practices, suspected health care worker infections peaked at 41.5% during the pandemic’s first wave in July 2020. The study emphasizes that protecting health care workers requires comprehensive IPC programs, integrated training approaches, enhanced data systems, and sustained investment in PPE.

Reviewing Health Security Capacities in Nigeria Using the Updated WHO Joint External Evaluation and WHO Benchmarks Tool: Experience from a Country-Led Self-Assessment Exercise

Health Security

Nigeria’s experience with a self-assessment of pandemic preparedness underscored the need for investment and stakeholder involvement to strengthen health systems. Writing for Health Security, our colleagues at Nigeria Centres for Disease Control and Prevention reviewed Nigeria’s experience conducting a midterm self-assessment of its pandemic preparedness using a modified World Health Organization (WHO) Joint External Evaluation (JEE) framework and the WHO benchmarks tool. The assessment identified improvements in 11 out of 19 technical areas between 2017 and 2019 and culminated in the development of a 12-month operational plan aimed at enhancing Nigeria’s pandemic readiness.

Rapid scale-up of COVID-19 training for frontline health workers in 11 African countries

Human Resources for Health

Effective outbreak response requires sustained investments in health systems—going beyond training to include adequate equipment, space and staffing levels. For Human Resources for Health, our colleagues at ICAP at Columbia University analyzed a COVID-19 response training program for health care workers in 11 African countries in mid-2020. While confidence in managing COVID-19 increased, barriers like limited access to testing kits, PPE, space for isolation, and understaffing persisted.

Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey

BMJ Open

Trust in authorities, a sense of control over one’s environment and behavior, and access to resources influenced adherence to public health and social measures during the COVID-19 pandemic. Writing in BMJ Open, experts at Resolve to Save Lives analyzed psychosocial and sociodemographic factors influencing COVID-19 public health and social measure (PHSM) adherence through a cross-sectional survey in 18 African Union countries. We found that women, older adults, and those with higher education showed better adherence to personal measures like mask wearing, while rural residents and those with access to running water adhered more to community measures like gathering restrictions. Trust in hospitals, the president, and knowledge about face masks were reliable predictors of adherence. Our findings underscore the importance of building institutional trust and addressing resource disparities to improve adherence in future public health crises.

Protecting the world from infectious disease threats: now or never

BMJ Global Health

There is an urgent need for global cooperation, leadership, and sustainable financing to address critical gaps in health preparedness as revealed by the World Health Organization (WHO)’s Joint External Evaluation (JEE). Writing in BMJ Global Health, experts at Resolve to Save Lives highlight the results of WHO’s JEE process, in which 100 countries assessed their ability to handle epidemics and ultimately identified over 7,000 priority actions to address critical gaps. Despite these diagnoses, few actions have been addressed, exposing significant vulnerabilities in global health systems. We emphasize the urgency of strengthening core capacities such as laboratory surveillance and workforce training, as well as the need for global coordination, donor support, and effective leadership to ensure readiness for future outbreaks, as well as more sustainable, long-term financing to bolster public health infrastructure.

Preparing for pandemics and other health threats: societal approaches to protect and improve health

Journal of the American Medical Association

There is an urgent need for sustained funding and coordinated global efforts to strengthen health security capacities and prevent future pandemics. Writing in the Journal of the American Medical Association, experts from Resolve to Save Lives analyze critical lessons from the COVID-19 pandemic, highlighting gaps in preparedness that led to millions of deaths, economic losses, and educational setbacks. We stress the importance of building core capacities—prevention, detection, and response—at local, national, and global levels, with particular attention to low-resource settings. We advocate for sustained investment over the next 5-10 years to address these health security gaps, emphasizing that effective global collaboration is the key to preventing future pandemics.

Nigeria’s joint external evaluation and national action plan for health security

Health Security

Nigeria’s adoption of the World Health Organization’s Joint External Evaluation (JEE) and National Action Plan for Health Security (NAPHS) will strengthen its national health security efforts. Writing in Health Security, experts at Resolve to Save Lives document the process of completing a JEE with partners in Nigeria in 2017 and subsequently creating a NAPHS to improve prevention, detection, and response in 2018. The process included developing a 5-year implementation plan, creating management teams, drafting outbreak legislation and training professionals at subnational and local levels. Strategic use of international assistance, coupled with reviews of major outbreaks, will strengthen Nigeria’s ability to prevent and respond to health security threats, and regular review and adaptation of its 5-year plan will be essential to ensure sustained progress.

Multisectoral resilience for the next global health emergency

BMJ Global Health

Pandemics are more than public health emergencies; they are multisectoral crises that touch every aspect of public and private life. Therefore, multisectoral coordination—especially by enabling stakeholders to share and coordinate information, resources and personnel—enables appropriate policy responses during crises. Writing in BMJ Global Health, experts at Resolve to Save Lives and our partners identify six low-income and middle-income countries that acted quickly to foster coordinated multisectoral collaboration in their COVID-19 response, which boosted preparedness and action and ensured that policy responses were equal to the magnitude of the crisis. Countries who have demonstrated extraordinary progress provide crucial lessons that should not be ignored as we build a global health architecture that facilitates multisectoral, interdisciplinary, sustainable coordination and cooperation.

Modelling the economic burden of SARS-CoV-2 infection in health care workers in four countries

Nature Communications

SARS-CoV-2 infections among health care workers caused up to 8.38% of total health expenditures in five low- and middle-income countries, underscoring a need for stronger protection measures for frontline workers, who faced increased risk of infection during the COVID-19 pandemic. Writing in Nature Communications, experts at Resolve to Save Lives used a a cost-of-illness (COI) approach to model the economic burden associated with SARS-CoV-2 infections in five low- and middle-income sites (Kenya, Eswatini, Colombia, KwaZulu-Natal province, and Western Cape province of South Africa) during the first year of the pandemic. Our analysis revealed higher infection rates among health care workers compared to the wider population, with significant secondary transmissions and related deaths and impacts on maternal and child mortality. These societal burdens highlight the importance of adequate infection prevention and control (IPC) measures to keep health care workers, and the rest of us, safe during crises.

Investing in global health security: Estimating cost requirements for country-level capacity building

PLOS Global Public Health

A targeted investment of $124 billion over five years will enable 196 countries to strengthen their core capacities across the World Health Organization (WHO)’s Joint External Evaluation (JEE) indicators. Writing in PLOS Global Public Health, experts at Resolve to Save Lives estimated the costs required to strengthen country-level health security and identified associated cost drivers. The cost of building public health capacity was estimated based on investments needed, per country, to progress towards “demonstrated capacity” across all WHO JEE indicators. Personnel costs, including skilled health, public health, and animal health workers, are the single most influential cost driver, comprising 66% of total costs. These findings provide cost estimates to inform ongoing health security financing discussions at the global level and highlight the significant need for sustainable financing mechanisms.

Implementation of the 7-1-7 target for detection, notification, and response to public health threats in five countries: a retrospective, observational study

The Lancet Global Health

The 7-1-7 target supports timely detection, notification, and response to outbreaks. Writing in the Lancet Global Health, experts from Resolve to Save Lives assessed 41 public health events in Brazil, Ethiopia, Liberia, Nigeria, and Uganda between 2018 and 2022 to understand the frequency at which targets for detection (7 days), notification (1 day) and respones (7 days) are being met following implementation of the target. Results showed that 54% met the 7-day detection target, 71% met the 1-day notification target, and 49% completed early response actions within 7 days. Most bottlenecks and enablers were identified at the health facility level, highlighting the need for increased investments in primary health care to enhance outbreak detection and response capabilities.

Impact of a Newly Established Revolving Outbreak Investigation Fund on Timeliness of Response to Public Health Emergencies in Nigeria

Health Security

Revolving outbreak investigation funds (ROIF) can accelerate outbreak response times when coupled with streamlined approval processes. Writing in Health Security, experts from Resolve to Save Lives analyze the impact of ROIF in Nigeria, which were established by our partners at Nigeria’s Centre for Disease Control and Prevention (NCDC) in 2019. Comparing outbreak responses before and after ROIF’s introduction, the median time to response decreased from 6 days to 2 days, highlighting the importance of having immediate access to funds and efficient approval mechanisms during public health emergencies. The study suggests national governments should allocate budgets to sustain such funds, and offers a model for improving outbreak preparedness and response globally.

Identifying and Interrupting Superspreading Events—Implications for Control of Severe Acute Respiratory Syndrome Coronavirus 2

Emerging Infectious Diseases

Strict adherence to infection prevention and control measures, and timely implementation of nonpharmaceutical interventions, can help prevent and control COVID-19. Writing in Emerging Infectious Diseases, experts at Resolve to Save Lives examine the role of superspreading events (SSEs) in the rapid spread of SARS-CoV-2, highlighting their potential to accelerate outbreaks and prolong transmission. We emphasize the importance of timely public health action, particularly in healthcare settings, to identify and manage these high-risk events. Understanding transmission dynamics and implementing strict infection prevention and control (IPC) protocols are critical to preventing future outbreaks.

COVID-19 / In-Depth Science Review: February 14, 2022 Annex

Resolve to Save Lives

COVID-19 severity and vaccine effectiveness in the era of the Omicron variant.

This annex is an accompaniment to the InDepth Science Review released on February 14, 2022. It provides further details on the studies that informed the review.

This science review is a snapshot of the new and emerging scientific evidence related to COVID-19 during the period specified. It is a review of important topics and articles, not a guide for policy or program implementation. The findings captured are subject to change as new information is made available.

COVID-19 / In-Depth Science Review: February 14, 2022

Resolve to Save Lives

COVID-19 severity and vaccine effectiveness in the era of the Omicron variant.

COVID-19 / In-Depth Science Review: December 22, 2021

Resolve to Save Lives

What do we know about the Novavax vaccine?

COVID-19 / In-Depth Science Review: November 1, 2021

Resolve to Save Lives

The glut of COVID-19 vaccines is a myth: How we can — and must — remove barriers to vaccinating the world against COVID-19

COVID-19 / In-Depth Science Review: September 1, 2021

Resolve to Save Lives

Update: Opening K-12 schools for in-person learning amidst vaccines and variants: what have we learned and how can this guide us?

COVID-19 / In-Depth Science Review: August 20, 2021

Resolve to Save Lives

Protecting the Immunocompromised: The Evidence for an Additional Dose of COVID-19 Vaccine.

COVID-19 / In-Depth Science Review: August 2, 2021

Resolve to Save Lives

A Hidden Toll: The Mental Health Impacts of COVID-19 on the Public Health Workforce.

COVID-19 / In-Depth Science Review: July 16, 2021

Resolve to Save Lives

Opening K-12 schools for in-person learning amidst vaccines and variants: what have we learned and how can this guide us?

From lionizing to protecting health care workers during and after COVID‐19—systems solutions for human tragedies

The International Journal of Health Planning and Management

Frontline health care workers need full protections in the form of infection prevention and control (IPC) measures, water, sanitation and hygiene (WASH) programs, and expanded training opportunities. Writing in the International Journal of Health Planning and Management, experts at Resolve to Save Lives review health care worker infections and deaths during previous epidemics, illustrating the high human and economic costs of neglecting their safety. The study advocates for comprehensive investment to strengthen healthcare infrastructure and cultural shifts to safeguard those on the frontlines of global health crises.

COVID-19 / In-Depth Science Review: June 4, 2021

Resolve to Save Lives

In it for the Long Haul: More Questions than Answers on the Lasting Health Effects of COVID-19

Feasibility, enablers and challenges of using timeliness metrics for household contact tracing and TB preventive therapy in Pakistan

PLoS One

Experts from Resolve to Save Lives expamined the feasibility of adapting the 7-1-7 target to control tuberculosis in Karachi, Pakistan through timely provision of TB preventive therapy (TPT). From January to June 2023, we successfully line-listed 92% of 450 index patients’ household contacts within seven days of initiating anti-TB treatment. Additionally, we determined screening outcomes for 84% of 1,342 contacts within one day. However, we found that only 35% of eligible contacts received further evaluation and treatment within seven days, facing challenges such as travel costs and fear of diagnosis. Our field staff reported that these timeliness metrics motivated prompt action and recommended their integration into national guidelines to improve TB management within households.

Digital Point Solutions for Extending Contact Tracing Capacity

Sexually Transmitted Diseases

In the wake of the COVID-19 pandemic, Resolve to Save Lives collaborated with U.S. jurisdictions to create four digital solutions that enhance the efficiency of case investigation and contact tracing to reduce the spread of infectious diseases by enabling more precise outreach, timely interventions, and better confidentiality: Epi Viaduct, Epi Contacts, Epi Locator, and Epi Viewpoint. Epi Viaduct dramatically sped up the transfer of 7.4 million records from over 2.5 hours to under 1 minute. Epi Contacts improved contact elicitation, resulting in 18,700 contacts from 9,440 index cases. Epi Locator facilitated 134,410 searches with a 75% success rate. These technologies, while developed for COVID-19, can also be adapted for managing any communicable disease.

COVID-19 / In-Depth Science Review: April 17 – May 13, 2021

Resolve to Save Lives

COVID-19 in Africa: Are reported cases and deaths only the eyes of the hippo?

COVID-19 / In-Depth Science Review: March 18 – April 16, 2021

Resolve to Save Lives

How genomic surveillance helps us understand SARS-CoV-2

COVID-19 / In-Depth Science Review: March 3 – 17, 2021

Resolve to Save Lives

COVID-19 in Brazil: Developments, Warnings and Lessons

COVID-19 / In-Depth Science Review: February 22 – March 2, 2021

Resolve to Save Lives

The latest on COVID-19 treatments: evidence, approvals, guidelines and the implications of new variants.

Development of a simple and effective online training for health workers: results from a pilot in Nigeria

BMC Public Health

A modular, self-paced, mobile-friendly online course on foundational infection prevention and control (IPC) was developed for health workers (HWs) in Africa, addressing challenges in accessing training. Evaluated in Nigeria, the course comprised 10 modules utilizing IPC vignettes and short assessment questions. Of the 372 learners who enrolled, 59% completed all modules, demonstrating significant pre-test (29%) to post-test (54%) score improvements (effect size 1.22). User experience was rated positively, with a Net Promoter Score of +62. These results suggest that scalable online training can effectively bridge IPC knowledge gaps among HWs in the region.

COVID-19 / In-Depth Science Review: January 30 – February 17, 2021

Resolve to Save Lives

In depth: Should second doses of COVID-19 vaccines be delayed?

Defining collaborative surveillance to improve decision making for public health emergencies and beyond

The Lancet

Public health emergencies such as COVID-19 and other large-scale outbreaks (cholera, measles, and mpox) are occurring with increasing frequency, magnitude, and complexity, compounded by devastating natural disasters, conflicts, and other humanitarian crises. Timely and effective intelligence is vital for decision-makers to assess risks, prepare, and respond appropriately. Experts from Resolve to Save Lives and partners discuss how collaboration across sectors is essential to strengthen integrated disease surveillance and ensure timely and effective solutions to global challenges.

COVID-19 / In-Depth Science Review: January 16th-29th, 2021

Resolve to Save Lives

Should everyone wear medical masks to prevent the spread of COVID-19?

COVID-19 / Análisis científico a fondo: 19 de diciembre de 2020 – 8 de enero de 2021

Resolve to Save Lives

Principales resultados en la implementación temprana de la vacunación contra la COVID-19

Esta revisión científica ofrece un panorama de la evidencia científica nueva y emergente relacionada con la COVID-19 durante el período especificado. Se trata de una revisión de temas y artículos importantes, no de una guía para la implementación de políticas o programas. Los hallazgos recopilados están sujetos a cambios a medida que se disponga de nueva información.

COVID-19 / Revue scientifique approfondie : 19 décembre 2020 – 8 janvier 2021

Resolve to Save Lives

Les pays les plus performants en matière de déploiement précoce de la vaccination contre la COVID-19

Cette revue scientifique présente un aperçu des données scientifiques récentes et émergentes relatives à la COVID-19 au cours de la période indiquée. Il s’agit d’une revue de sujets et d’articles importants, et non d’un guide pour la mise en œuvre de politiques ou de programmes. Les conclusions présentées sont susceptibles d’être modifiées à mesure que de nouvelles informations sont disponibles.

COVID-19 / Revisão Científica Aprofundada: 19 de dezembro de 2020 a 8 de janeiro de 2021

Resolve to Save Lives

Os primeiros resultados da vacinação contra a COVID-19

Esta revisão científica é um panorama das novas e emergentes evidências científicas relacionadas à COVID-19 durante o período especificado. Trata-se de uma revisão de tópicos e artigos importantes, não um guia para a implementação de políticas ou programas. Os resultados obtidos estão sujeitos a alterações à medida que novas informações forem disponibilizadas.

COVID-19 / In-Depth Science Review: December 19, 2020 – January 8, 2021

Resolve to Save Lives

Early COVID-19 vaccination rollout top performers

Protecting Health Care Workers: A Need for Urgent Action

Resolve to Save Lives

How do local-level authorities engage in epidemic and pandemic preparedness activities and coordinate with higher levels of government? Survey results from 33 cities

PLOS Global Public Health

Engaging local governments in epidemic preparedness will strengthen global health security by ensuring better coordination between local and national authorities. Writing in PLOS Global Public Health, Resolve to Save Lives and partners explore local-level involvement in epidemic preparedness before the COVID-19 pandemic. The research, based on responses from 33 cities in the Partnership for Healthy Cities, shows that while national governments played a dominant role in preparedness, many cities conducted vital risk assessments and developed response plans. By incorporating local governments more actively in future preparedness efforts, we can better coordinate responses for stronger overall health security.

COVID-19 / Análisis científico a fondo: 12-18 de diciembre de 2020

Resolve to Save Lives

Marco nacional de niveles de alerta de la COVID-19

COVID-19 / Revue scientifique approfondie : 12-18 décembre 2020

Resolve to Save Lives

Cadre national des niveaux d’alerte COVID-19

Cette revue scientifique présente un aperçu des données scientifiques nouvelles et émergentes liées à la COVID-19 pendant la période indiquée. Il s’agit d’une revue de sujets et d’articles importants, et non d’un guide pour la mise en œuvre de politiques ou de programmes. Les conclusions présentées sont susceptibles d’être modifiées à mesure que de nouvelles informations sont disponibles.

COVID-19 / Revisão Científica Aprofundada: 12 a 18 de dezembro de 2020

Resolve to Save Lives

Uma estrutura nacional de nível de alerta para COVID-19

Esta revisão científica é um panorama das novas e emergentes evidências científicas relacionadas à COVID-19 durante o período especificado. Trata-se de uma revisão de tópicos e artigos importantes, não um guia para a implementação de políticas ou programas. As conclusões obtidas estão sujeitas a alterações à medida que novas informações forem disponibilizadas.

COVID-19 / In-Depth Science Review: December 12 – 18, 2020

Resolve to Save Lives

A national COVID-19 alert level framework

COVID-19 / Revisão Científica Aprofundada: 5 a 11 de dezembro de 2020

Resolve to Save Lives

Passaportes de Imunidade

Esta revisão científica é um panorama das novas e emergentes evidências científicas relacionadas à COVID-19 durante o período especificado. Trata-se de uma revisão de tópicos e artigos importantes, não um guia para a implementação de políticas ou programas. As descobertas coletadas estão sujeitas a alterações à medida que novas informações forem disponibilizadas.

COVID-19 / Análisis científico a fondo: 5-11 de diciembre de 2020

Resolve to Save Lives

Pasaportes de Inmunidad

COVID-19 / Revue scientifique approfondie : 5 au 11 décembre 2020

Resolve to Save Lives

Passeports d’immunité

COVID-19 / In-Depth Science Review: December 5 – 11, 2020

Resolve to Save Lives

Immunity Passports

COVID-19 / Análisis científico a fondo: 14 de noviembre – 4 de diciembre de 2020

Resolve to Save Lives

Estimación del número real de casos de COVID-19 y la tasa de detección de casos en Estados Unidos

COVID-19 / Revisão Científica Aprofundada: 14 de novembro a 4 de dezembro de 2020

Resolve to Save Lives

Estimativa do número real de casos de COVID-19 e da taxa de detecção de casos nos Estados Unidos

COVID-19 / In-Depth Science Review: November 14 – December 4, 2020

Resolve to Save Lives

Estimating the true number of COVID-19 cases and the case detection ratio in the United States

COVID-19 / In-Depth Science Review: November 7 – 13, 2020

Resolve to Save Lives

Tracking COVID-19 in the United States: Progress and Opportunities

COVID-19 / In-Depth Science Review: October 31 – November 6, 2020

Resolve to Save Lives

Declining death rates among people severely ill with COVID-19

COVID-19 / In-Depth Science Review: October 10 – 30, 2020

Resolve to Save Lives

COVID-19 and mass transit

COVID-19 / In-Depth Science Review: October 3 – 9, 2020

Resolve to Save Lives

Mask mandate effectiveness

COVID-19 / In-Depth Science Review: September 26 – October 2, 2020

Resolve to Save Lives

COVID-19 / In-Depth Science Review: September 19 – 25, 2020

Resolve to Save Lives

COVID-19 vaccine prioritization in the U.S.

PERC Brief

Resolve to Save Lives

Building National Health Security Through a Rapid Self-Assessment and Annual Operational Plan in Uganda, May to September 2021

Health Security

While long-term planning for health security is indispensable, focused short-term operational planning can be a tremendous asset for developing actionable and realistic strategies to improve readiness for public health emergencies. Despite limited funding and an overwhelming list of action items, Uganda successfully enhanced its epidemic readiness by 20% with a focused 1-year operational plan developed after a rapid self-assessment, tackling 72 of the 264 activities in their 5-year NAPHS. By concentrating on a smaller number of high-impact activities, Uganda demonstrated that it is possible to strengthen long-term health security capacities with focused short-term planning, showcasing a model for other countries facing similar challenges.

Association Between Preparedness and Response Measures and COVID-19 Incidence and Mortality

medRxiv

The COVID-19 pandemic was the most disruptive global health crisis in a century. Analysis of publicly available data by experts from Resolve to Save Lives revealed that alongside preparedness capacities, governance and leadership capacities independently contributed to lower COVID-19 cases and deaths. Both preparedness and governance are essential for effective pandemic control, requiring stronger public health systems and leadership.

COVID-19 Risk Alert Levels

Resolve to Save Lives

This briefing note explains why alert-level systems for COVID-19 are effective, compares models from several countries, and provides the key principles and potential pitfalls to be aware of when developing these systems. It is intended to provide guidance to local, regional and national governments on best practices for alert-level systems, and on how to clearly communicate what behaviors people should adopt in response to changing COVID-19 conditions in their community.

COVID-19 / In-Depth Science Review: March 28 – April 3, 2020

Resolve to Save Lives

Syndromic surveillance should be explored as an early signal for COVID-19

Assessing and reducing risk to health care workers in outbreaks

Health Security

Identiftying critical points of failure within the health system and during emergencies is the first step to mitigating future risk exposure. The West African Ebola epidemic (2014-2016) revealed alarming gaps in infection prevention and control for health care workers, highlighting a major vulnerability in global health security. Experts from Resolve to Save Lives propose a two-pronged soluion: prioritizing IPC as a global epidemic preparedness measure and conducting rapid risk assessments to adapt strategies for health care worker protection. Improved global support and targeted interventions are vital to strengthen health systems and safeguard frontline workers.

COVID-19 / In-Depth Science Review: January 9th-15th, 2020

Resolve to Save Lives

The utility and limitations of large-scale surveys during the COVID-19 pandemic

Applying ‘timeliness’ to the screening and prevention of TB in household contacts of pulmonary TB patients

IJTLD OPEN

Timeliness is essential in preventing and controlling infectious diseases like meningococcal meningitis and tuberculosis (TB). Experts from resolve to save lives explored adapting the global 7-1-7 target for outbreak control to the management of household contacts of TB patients. Applying the metric in India, Pakistan, and Kenya improved TB preventive therapy (TPT) initiation rates, though logistical and health care barriers persisted. Field staff recommended a “3-5-7” metric to enhance screening and TPT delivery. Timeliness metrics provide structure and urgency, offering a valuable tool for improving HHC management and global TB prevention efforts.

Addressing the challenges of implementing evidence-based prioritisation in global health

BMJ Global Health

In a roundtable discussion with health practitioners, funders, academics, and policy-makers, experts from Resolve to Save Lives identified key areas for improving global health practices. We emphasized the importance of evidence-based frameworks that are adaptive and responsive to prioritised health needs. Key recommendations include enhancing information-sharing, increasing social engagement, and promoting diversity in decision-making processes. We also highlighted the need for collaboration with both hyperlocal and global entities to strengthen global health capabilities. Since pandemic drivers extend beyond the health sector, integrating expertise from various fields is crucial for effective decision-making. We outline seven points to improve evidence-based prioritisation and enhance global health outcomes.

Action-based costing for national action plans for health security: accelerating progress toward the International Health Regulations (2005)

Health Security

Implementing the International Health Regulations (IHR 2005) can be a cumbersome process, and costs vary widely from country to country. To support facilitating this complex work, experts from Resolve to Save Lives tested several new tools designed to estimate the resources needed for implementing the IHR. Using Nigeria’s National Action Plan for Health Security (NAPHS) as a case study, we compared cost estimates generated through the World Health Organization (WHO) Costing Tool, Georgetown University’s IHR Costing Tool, and CDC’s Priority Actions Costing Tool (PACT). While the tools suggested similar activities for implementation, cost estimates varied due to differences in procurement and human resource needs. We found that a strategic approach, prioritizing major cost drivers based on resource availability, could help accelerate the implementation of health security plans.

7-1-7: an organising principle, target, and accountability metric to make the world safer from pandemics

The Lancet

Clear, universal performance standards for outbreak detection, reporting and control can improve accountability, save lives, and accelerate global readiness for future pandemics. For The Lancet’s Viewpoint, experts from Resolve to Save Lives propose 7-1-7 as a global target for timely response to infectious disease outbreaks: detecting a suspected outbreak within 7 days, reporting and initiating a response within 1 day, and mounting an effective early response within 7 days.

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