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security and foreign affairs officials to determine how the world can address the threat of a lethal respiratory pathogen pandemic, as well as managing preparedness for disease outbreaks in complex, insecure contexts. 29 Ultimate objectives: There is no ambiguity or delay in the United Nations systemwide response to a global health emergency. There are clear rules, roles and responsibilities, along with a designated leader, empowered with the authority to coordinate across the system and experienced in leading a global response through regular simulations or actual events. WHO can rapidly mobilize countries and partners early in an outbreak or health emergency. This report and the monitoring framework it sets out were prepared by a research team from the Harvard Global Health Institute (HGHI), Georgetown University Center for Global Health Science and Security, and the Harvard Kennedy School (HKS). The research team comprised of Olga Jonas (HGHI), Rebecca Katz (Georgetown University Center for Global Health Science and Security), Peter Sands (Harvard Kennedy School), Shana Yansen (HGHI), and Ambika Lall (HGHI) under the leadership and direction of Dr. Ashish K. Jha, Director of HGHI. The research team is deeply grateful for the advice and inputs from more than fifty experts from around the world in the development of this report and monitoring framework (see Annex 7 for complete list). We hope that the broad participation by experts from around the world sets a precedent for future monitoring of global health security and pandemic preparedness. Our aim is to engage with as many scholars and practitioners as possible from every region of the globe to share the ownership and use of this framework. The groundwork for this report was laid by a workshop co-hosted by the National Academy of Medicine (NAM) and HGHI on April 18th, 2017 with leading experts from around the world (Annexes 7 & 8). We are grateful to Dr. Victor Dzau, President of NAM, and NAM staff Dr. Ceci Mundaca-Shah, Ayano Ogawa, and T. Ahn Tran for their valuable contributions to that workshop and in reviewing a draft version of this report. Prior to the workshop, a draft framework (with measurable indicators) was prepared by HGHI, HKS, and Georgetown University. We would like to thank Liana Woskie (HGHI) for developing an early draft of the monitoring framework. During the workshop, more than fifty leading experts from around the world discussed the draft framework and its indicators, the operationalization of monitoring mechanisms, data collection, and results dissemination. This report synthesizes more than 350 comments from these experts both during and after the workshop. REPORT REVIEWERS We would like to thank the reviewers of this report, all of whom were chosen for their technical expertise and diverse perspectives. The reviewers who contributed their insights in response to an early draft of the report (Phase I) and when the report was being finalized (Phase II) were: Phase I Elizabeth Cameron, Nuclear Threats Initiative Alain Dehove, World Organisation for Animal Health Keiji Fukuda, University of Hong Kong, School of Public Health Richard Hatchett, Coalition for Epidemic Preparedness Innovations Ceci Mundaca-Shah, National Academy of Medicine Ayano Ogawa, National Academy of Medicine Peter Piot, London School of Hygiene and Tropical Medicine Devi Sridhar, University of Edinburgh Anas El Turabi, Harvard University Gavin Yamey, Duke Global Health Institute ACKNOWLEDGEMENTS iv Phase II Rebecca Bunnell, U.S. Centers for Disease Control and Prevention Elizabeth Cameron, Nuclear Threats Initiative Alain Dehove, World Organisation for Animal Health David Fidler, Indiana University Dylan George, In-Q-Tel Lawrence Gostin, Georgetown University Kendall Hoyt, Dartmouth University Niranjan Kanesa-Thasan, Kanesa, LLC Outi Kuivasniemi, JEE Alliance Kaisa Lähdepuro, JEE Alliance Nicole Lurie, U.S. Department of Human and Health Services Ryan Morhard, World Economic Forum Jennifer Nuzzo, Johns Hopkins Center for Health Security Michael Osterholm, Center for Infectious Disease Research and Policy Richard Seifman, Consultant Gillian SteelFisher, Harvard T.H Chan School of Public Health Oyewale