In this interview, News-Medical talks to Henry Fingerhut, a senior science and innovation policy analyst at the Tony Blair Institute for Global Change, about genomic surveillance and its associated opportunities and challenges. In collaboration with Professor Derrick Crook of the Oxford Department of Medicine in Nuffield, Henry recently published Global Governance of Genomic Pathogen Surveillance, a paper that describes recent history and future opportunities internationally.
Can you please introduce yourself and tell us about your career and your current role at the Institute for Global Change?
I am a senior science and innovation policy analyst at the Tony Blair Institute for Global Change. I come from an interdisciplinary background. At TBI, I work on a number of technology policy issues, such as health, biotechnology and UK innovation policy, with the aim of helping governments leverage technology for the social good.
Most recently, I completed my PhD. in Technology, Management, and Policy at MIT with research on how healthcare providers use evidence-based practice and incorporate new technologies into clinical care.
As part of the Global Health Security Consortium, the Institute for Global Change advocates a holistic approach to genomic surveillance. Could you explain the process of genomic surveillance, its importance and how it contributes to global public health security?
Genomic pathogen surveillance identifies and systematically monitors pathogens to understand how they develop, mutate, and spread. This process includes every step, from the swab — when a sample of an infected person is taken — to public health decisions. Incorporates 1) sampling of potentially infected individuals, 2) sequencing of this sample to obtain the genome of the underlying pathogen, 3) a series of systematic data analysis steps to isolate the genome of the pathogen, remove personally identifiable information about the patient and compare it with other pathogens. , 4) and store and share this data between laboratories and public health officials to generate public health knowledge.
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Genomic surveillance complements the current public health infrastructure to help public health officials quickly identify and assess new pathogens and variants of concern. A comprehensive global network with worldwide data sequencing and analysis capabilities, as well as government standards to ensure that data is analyzed consistently and shared ethically, would help alert officials nationwide and global on new outbreaks and variants. It would also help researchers and pharmaceutical companies understand the dynamics of pathogens and develop effective treatments.
Genomic surveillance has been an integral part of the management of the COVID-19 pandemic. How has genomic surveillance and its associated sequencing technologies / methods changed since the beginning of the pandemic?
The COVID-19 pandemic helped draw global attention to this need and rapidly advancing global initiatives. There have been a number of philanthropic initiatives to develop genomic sequencing capacity in low- and middle-income countries during COVID-19, and the new Berlin Pandemic and Epidemic Intelligence Hub and the 10-year strategy for global genomic surveillance, both launched last year, will help build this critical infrastructure after the pandemic to control other pathogens and related concerns such as tuberculosis and antimicrobial resistance.
In your study entitled “Global Governance of Genomic Pathogen Surveillance”, you talk about the opportunities and challenges in this field. What are the current challenges of global governance of genomic pathogen surveillance and how can these challenges be overcome in the future?
The paper outlines three challenges: governing ethical and geopolitical concerns about the exchange of genomic data, establishing and adopting technical standards, and expanding capacity worldwide. All of them require global cooperation and confidence-building, especially to ensure that technical providers or beneficiaries of data sharing, often from high-income countries, respond to the concerns of low- and middle-income countries that they provide data to the network. But, as we point out in the paper, structures such as the new WHO Hub will play an important role in convening an effective and responsible global network.
Global public health security includes proactive approaches to minimizing public health disasters such as pandemics. How genomic pathogen surveillance can help healthcare professionals prepare for a pandemic.
Genomic pathogen surveillance can help public health officials and health professionals prepare for a pandemic. For public health officials, a well-designed genomic surveillance network will help quickly identify new pathogens and worrying variants, monitor their population dynamics within and between countries, and, when securely and anonymously linked to clinical data, routine, control its virulence and symptomatology.
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For healthcare professionals, this data could also help inform diagnostic and treatment decisions, both by accessing this public health data and, hopefully, by developing precision treatments targeting a specific variant of the pathogen.
Overall, the COVID-19 pandemic indicated how important it is to coordinate and collaborate in the areas of research, clinical, policy, and public health to improve health outcomes; to do this, the infrastructure needs to share data securely and anonymously. Genomic pathogen surveillance is a piece of this puzzle and could help establish best practices for broad-based cross-sectoral collaboration.
The COVID-19 pandemic highlighted global health inequality patterns. How can health innovation policies improve health inequalities, especially with regard to the escalation of genomic sequencing worldwide?
As noted in the paper, the global genomic surveillance community has been sensitive to the valid concerns of health inequality over the past decade, especially raised by low- and middle-income countries, especially Indonesia in 2008. vulnerable groups are represented in the data collection to allow us to know how the pathogens spread between different groups and how their symptoms develop.
But it is also important that this data collection and exchange is done responsibly, taking into account their autonomy, commitment as partners and profit sharing. The 2010 Nagoya Protocol ensures many of these principles of fair and equitable benefit-sharing, but it will be essential to develop mechanisms to build local capacity and share benefits effectively.
You work with the Ellison Institute for Transformative Medicine and the University of Oxford. How important is collaboration between partners in addressing global public health issues?
The COVID-19 pandemic demonstrated the importance of collaboration in global public health, including the academic, political, and private sectors and at the local, national, and global levels. The GHSC is a new type of partnership, bringing together political, scientific and technological expertise to drive progress in global health, and with this paper, we wanted to highlight the need for such cooperation in global genomic surveillance.
Of course, collaborating on this scale is challenging. However, we hope that this document will help to identify some ways forward for a critical modern infrastructure that can not only protect us from pandemics, but also build much greater capabilities in the fight against communicable diseases and help to revolutionize microbiology.
What are the next steps for the Global Health Security Consortium and its ongoing work on genomic pathogen surveillance?
We have a handful of initiatives in this area, ranging from mental leadership to facilitating cross-sectoral partnerships to advancing global genomic surveillance efforts. This includes looking at how national governments can build genomic surveillance capabilities and participate in effective and mutually beneficial data exchange. But it also includes an international commitment to ensure that the momentum does not slow down as political and public attention to the pandemic declines.
We have come a long way in accelerating the digital infrastructure in response to COVID. Still, there is an important opportunity to build 21st century technology that will not only help us fight future variants and pandemics, but has much broader potential impacts, even in areas such as tuberculosis. It is an opportunity we must seize: the economic and health benefits of doing so are likely to be substantial in the future.
Where can readers find more information?
You can find out more about the Global Health Security Consortium and current initiatives here. And the Tony Blair Institute is also working on a range of broader policy issues, such as health and biotechnology, available here.
About Henry Fingerhut
Henry is a senior science and innovation policy analyst at the Tony Blair Institute for Global Change. He comes from an interdisciplinary background at the intersection of science and politics. In particular, it focuses on how social and political factors affect scientific projects (such as genomic pathogen surveillance initiatives) and how technical details can affect policy outcomes. At TBI, he works on a number of technology policy issues, such as health, biotechnology and UK innovation policy, with the aim of helping governments leverage technology for the social good.
Before joining TBI, he completed my PhD. in Technology, Management, and Policy at MIT with research on how healthcare providers use evidence-based practice and incorporate new technologies into clinical care.