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can help to paint a fuller picture of pandemic impacts. • Real-time decision making about the availability and mobilization of resources is needed to help control the spread and identify and monitor availability of resources that are needed (eg, medical supplies) to support the response. The development of platforms and initiatives that link applied infectious disease modelers with public health decision makers can enable a more rapid public health 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, particularly in view of security concerns that may limit the degree to which affected and nonaffected countries are willing to share information. • New surveillance technologies are needed to increase the capacity and speed with which highly specific surveillance and diagnostic data become available. Philanthropies and other international organizations should continue to encourage the development and uptake of molecular diagnostic testing for respiratory pathogen nucleic acids—specifically, simple, point-of-care, multiplex devices; diagnostic tools such as microfluidic devices that can be used outside of traditional laboratories; and technologies that could facilitate tracking of patients on a large scale. 3. Frameworks for sample and benefit sharing need to be developed that apply to high-impact respiratory pathogens beyond influenza. • Member States and industry need to continue to uphold and monitor adherence to the Pandemic Influenza Preparedness (PIP) framework, including rapid crossborder specimen sharing and the timely delivery of benefits to developing countries for building national capacity. • PIP framework stakeholders will need to work together to preserve and maintain the framework in view of recent advances in biotechnology. For example, physical specimens and genetic sequencing data should be shared promptly with vaccine developers. Stakeholders will also need to continue to address the public health implications of the Nagoya Protocol to the Convention on Biological Diversity (CBD). • Difficult past experiences in transferring virus specimens for other diseases (eg, H1N1, Zika, Ebola) across borders have underscored the difficulty of negotiating bilateral material transfer agreements in the middle of a crisis. Therefore, WHO, Member States, and industry will need to engage in pre-event negotiations to facilitate the rapid sharing of samples and epidemiologic data for respiratory diseases besides pandemic influenza, as well as the subsequent distribution of benefits across the globe. 9 • Whether or not new noninfluenza benefit-sharing agreements are directly modeled on PIP, they will need to take into account the emergence of a broad range of respiratory pathogens with high-impact potential, be based on the principle of reciprocity and mutually reinforcing interests, and involve the participation of a wide range of partners. 4. Countries and WHO need to assess and improve health systems’ readiness for infectious disease emergencies. • Countries should assess the readiness of health facilities to effectively treat patients with transmissible diseases with high case fatalities. The central role of health facilities in mitigating or amplifying disease spread during communicable disease emergencies has not played a prominent enough role in current national or international core capacity assessment efforts, such as the JEE process. • WHO should work with member countries to develop a corresponding assessment tool for health systems and facilities, aligned with countries’ ongoing work to undergo JEEs and to advance universal health care, so that countries have a means of assessing the readiness of the broader health sector for infectious disease emergencies. • WHO should lead an expert-informed process to develop technical guidance to inform the clinical management of patients with highly contagious respiratory diseases during a severe outbreak, to include recommendations on personal protective equipment (PPE), treatment courses, and disinfection guidelines, and allocation of scarce resources. This guidance should be salient in both high-income and low-income settings. • Countries should work to establish mechanisms for bi-directional information exchange between frontline healthcare providers directly treating patients and experts at external networks who can provide critical subject matter expertise, guidance, and analysis of relevant information from multiple sources to devise best practices. • An incident command/incident management system (ICS/IMS) and emergency operations centers (EOCs) that bring together public health officials and healthcare leaders should be established at local, state/provincial, and national levels to help broadly coordinate a response, rather than acting ad hoc during a crisis. • Countries should plan for the possibility of interruptions in the availability of essential basic supplies and equipment. Health facilities need plans for continuing operations in the event that supplies are no longer available from their primary sources. Countries with sufficient resources should consider establishing stockpiles of critical or high-volume products. 5. Countries and international health authorities should more fully incorporate community engagement and social science in preparedness. • WHO should develop guidance that illustrates concrete use cases for community engagement before, during, and after a potential severe outbreak of a high-impact respiratory pathogen. • Countries should incorporate community engagement into their national preparedness planning and mechanisms. Initial outreach and engagement with communities should occur before a disease outbreak so that strong existing relationships could be leveraged for good during response efforts. • National and subnational authorities will need to involve local stakeholders in decision making and preparedness planning around high-impact respiratory pathogens, and countries need to develop more inclusive plans that community leaders can take ownership of. The kind of community engagement used to help prepare for smaller outbreaks or