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are likely to work, and the results from these evaluations should be compared to JEEs and national action plans. Results should be used to update, modify, or enhance ongoing capacity development efforts. Countries and WHO should continue to work to ensure that core capacity strengthening is viewed as a matter of priority by leaders. National budgets should reflect a commitment to capacity development. Donors should work with countries to address remaining shortfalls and to incentivize additional national investments. Member countries and WHO should support and actively participate in initiatives, such as the Global Health Security Agenda and the Alliance for Health Security, which help to normalize national and multinational actions to strengthen core capacities provide a convening platform for national leaders to maintain momentum toward IHR capacity building and to share lessons learned. 64 Data will be essential to motivate political leaders and measure progress. Additional sources of data should be sought by WHO and the GPMB that could provide ongoing assessment of global progress towards IHR capacity development, particularly in light of the current JEE timetable, which will likely require 5 or more years before countries can undergo a second JEE. The World Bank has suggested that the development of preparedness indices could help fill this gap. 2. National and global surveillance capacities should be improved, with a focus on helping improve the management of epidemic response. Even the most robust public health surveillance systems are unlikely on their own to provide sufficient information to inform the wide range of decisions that would need to occur during an epidemic or pandemic response. A key limitation in national and international surveillance systems will be their inability to fully monitor the impact of events and to support real-time decision making about the availability and mobilization of resources needed to help control the spread. Lack of fast data exchange between health facilities and public health in most countries would slow or limit understanding of key aspects of the epidemic, including what percentage of cases develop severe illness or die, what populations are proving most at risk of the disease and at risk for dying, and how healthcare systems are coping with caring for the sick. Data from the private sector will also be an important part of the full picture needed to understand the near-term impacts of events and identify and monitor availability of resources that are needed (eg, medical supplies) to support the response. If a pandemic were initiated by a deliberate event, countries and the international community would need to have in place agreements about what information needs to be shared. To answer questions about the source of an attack and the risks of subsequent ones will likely require data found outside of the health sector. This process may be quite challenging, because nations’ security concerns may limit the degree to which affected and nonaffected countries are willing to share information. Regardless of whether a high-impact respiratory pathogen occurs as the result of nature, accident, or deliberate use, there is great need for new surveillance technologies. Where appropriate and feasible, countries, philanthropies, and other international organizations should continue to encourage the uptake of molecular diagnostic testing for respiratory pathogen nucleic acids—specifically, simple, point-of-care, multiplex devices. Additionally, the development and increased use of new diagnostic tools, particularly those that can be used outside of traditional laboratories, could increase the capacity and 65 speed with which highly specific surveillance data become available. The development and fielding of technologies that could facilitate tracking of patients on a large scale would help to improve preparedness for outbreaks, epidemics, and the early stages of a pandemic. 3. Frameworks for sample and benefit sharing need to be developed that apply to high-impact respiratory pathogens beyond influenza. The PIP framework represents a milestone arrangement among WHO Member States, public health, industry, and other stakeholders by promoting access to influenza viral samples and epidemiologic data and ensuring that the benefits derived from samples and information are more equitably distributed around the globe. The framework is based on the principle of reciprocity and mutual interests, such that governments and industry all benefit from the agreement. Participation in the PIP framework has also strengthened the global network of influenza surveillance, including laboratory capacity building, the GISRS surveillance system, and national influenza centers. Despite general agreement on the principles of the framework, implementation has come under criticism by some for slow cross-border coordination, legal restrictions, and other impediments that limit the speed of viral sample sharing. It remains to be seen whether the PIP framework will remain relevant if countries do not conform by continuing to share specimens and if partnership contributions, including vaccines and other MCMs, from industry are not delivered to countries during emergencies in a timely manner. Ongoing issues surrounding advances in biotechnology (ie, sharing genetic sequencing data as a substitute for the physical virus) and the public health implications of the Nagoya Protocol to the CBD will also need to be addressed. There are also serious questions over the continued adherence to the framework during a high-impact influenza pandemic. In such an event, the slightest delay in sample sharing can potentially translate to significant global harm. Countries may be tempted to withhold samples in return for financial gain or other reward, while manufacturers may be pressured by national governments to reserve vaccines and diagnostic tools for domestic use. Pharmaceutical and diagnostic industry leaders will need to continue to participate via annual partnership contributions and follow through on their commitments to provide a percentage of product to PIP countries. Physical specimens and genetic sequencing data, will need to be shared promptly with developers. Yet, it is also the case that even with the PIP