Last May, leading health experts on the Independent Panel for Pandemic Preparedness and Response released a comprehensive report declaring that current systems at the international and national level are “clearly unfit to prevent another novel and highly infectious pathogen, which could emerge at any time, from developing into a pandemic.”

This assessment was the result of an in-depth analysis by the 13-member group co-chaired by Ellen Johnson Sirleaf, former president of Liberia, and Helen Clark, former prime minister of New Zealand. The World Health Organization Director General established the Panel in response to a May 2020 World Health Assembly resolution that called for an impartial evaluation of the events that led to the COVID-19 pandemic, as well as lessons learned from the global response, and recommendations for improving future global preparedness, prevention, and response.

Salma Abdalla (SPH’16), research fellow and doctoral student in the Doctor in Public Health (DrPH) program, was appointed to serve as an analyst to the Independent Panel’s own independent Secretariat. The eight-member team was charged with producing analytical reports and research to inform and support the panel’s report, meeting biweekly from September 2020 to May 2021.

Abdalla brought her expertise in social epidemiology and social determinants of health to the Secretariat, conducting scientific and technical analyses of the scores of data that the Secretariat collected and dissected over the eight-month period—data that changed almost daily in the rapidly evolving crisis.

“We were always vigilant of new information being published, and we had to become comfortable with knowing that we would never have ‘perfect’ data,” says Abdalla. “We focused on determining which information was most relevant and helpful in moving the decision-making process forward for recommendations on what the global community can do to tackle the current pandemic and prevent a future crisis of this level.”

The Independent Panel report identified immediate and long-term actions that the international system and countries should take to create or improve vaccine distribution, national surveillance and alert systems, national preparedness plans, international financing for preparedness and response, platforms for tools and supplies, and more.

In her role, Abdalla focused on the the global social and economic impact of the pandemic, analyses of 28 countries’ COVID-19 response, and the importance of community engagement. The countries that fared best changed as the pandemic evolved, she says, but the most effective responses came from countries that responded quickly, maintained solid public health infrastructures, and/or learned from previous infectious disease outbreaks.

“At the beginning of the pandemic, many Asian and African countries benefitted from prior experiences with pathogens, so they had plans on how they could deal with such pathogens,” says Abdalla. “For example, during the Ebola outbreak, Liberia set up systems and worked directly with communities, so they were able to gain trust quickly, and that made it easier for them to implement interventions to address the COVID-19 pandemic.”

Regardless of these early responses, the Independent Panel report made it clear that the pandemic caused worldwide devastation. The global community needs to address not only the healthcare issues surrounding COVID-19, but also the longstanding issues that made it possible for the pandemic to have such a catastrophic impact, Abdalla says.

“We have to acknowledge who gets affected by a pandemic,” she says. “In a lockdown, people who live in slums in Nairobi aren’t able to physically distance. And what happens to people who miss work or lose their job?” Governments that invest in social welfare policies now will gain the trust of communities and ensure cooperation from the public when the next crisis occurs, she says.

“We have landed in a place where governments and institutions put the onus on communities to trust politicians, instead of working to build their trust,” says Abdalla. “That’s one change we hope to see in the future.”

COVID-19 vaccines became available about four months after the formation of the Panel and Secretariat, which Abdalla describes as a “satisfying moment.” The final report concludes that vaccines were developed at an unprecedented speed, and offers recommendations on vaccine development and distribution, such as a commitment from high-income countries to provide one billion doses to low and middle-income countries by September 2021, and two billion doses by mid-2022.

“This work made me realize the power of diplomacy,” Abdalla says. “The Independent Panel worked with many stakeholders including governments and global institutions to get them to understand that vaccines need to be distributed to low- and middle-income countries. This work also taught me a lesson on the limitations of research if not followed by action—if it wasn’t for the advocacy of the panel and co-chairs, the Independent Panel work would have been another report sitting on the shelves of decision-makers rather than a document that can be used for achieve tangible results. Of course, most countries are yet to fulfill their pledges, which highlights the need for continuous advocacy efforts.”

Regarding COVID-19 booster shots, Abdalla distinguishes between scientific and ethical perspectives on whether additional shots should be administered to vaccinated people.

“Scientifically, there might be an argument about whether booster shots benefit individuals, something that is beyond my expertise” she says. “But as someone who has family in Sudan, and friends who are healthcare workers there but have not received the vaccine, it’s difficult to make the case to give booster shots to people who are already vaccinated, before giving them to people on the front lines in high-risk communities in low- and middle-income countries.”

In the months ahead, the Panel and Secretariat members plan to publish additional papers on specific aspects of their research. In late May, Abdalla co-led a paper in Nature Medicine that called on countries to invest in health systems resilience framework that emphasizes community engagement.

“This pandemic is a global test,” Abdalla says. “It is a wake-up call for the global community as we face other crises such as climate change or the inevitable next disease outbreak. We need to understand that no global issue can be fixed through nationalized and siloed strategies. We have much more work to do, but I’m hopeful that we can do better.”