In this interview, News-Medical talks to Henry Fingerhut, Senior Policy Analyst for Science and Innovation at the Tony Blair Institute for Global Change, about genomic surveillance and the opportunities and challenges associated with it. Together with Professor Derrick Crook from the Nuffield Department of Medicine in Oxford, Henry recently published Global governance of genomic pathogen surveillancea document describing recent history and future opportunities at the international level.
Can you introduce yourself and tell us about your professional background and your current role at the Institute for Global Change?
I’m a senior policy analyst for science and innovation at the Tony Blair Institute for Global Change. I come from an interdisciplinary background. At TBI I work on a range of technology policy issues, including health, biotech and UK innovation policy, with the aim of helping governments harness technology for social good .
More recently, I completed my doctorate. in Technology, Management, and Policy at MIT with research on how health care providers use evidence-based practice and integrate 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 systematically identifies and tracks pathogens to understand how they develop, mutate and spread. This process includes all steps, from swabbing – when a sample is taken from an infected person – to public health decisions. It includes 1) the sampling of potentially infected individuals, 2) the 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 to other pathogens. , 4) and store and share this data between laboratories and public health officials to generate public health information.
Genomic surveillance complements current public health infrastructure to help public health officials quickly identify and assess emerging pathogens and variants of concern. A comprehensive global network with capabilities for sequencing and data analysis around the world, as well as governance standards to ensure data is analyzed consistently and shared ethically, would help alert officials at national levels and global on new epidemics and variants. It would also help researchers and pharmaceutical companies understand pathogen dynamics and develop effective treatments.
Genomic surveillance is an integral part of managing the COVID-19 pandemic. How have genomic surveillance and its associated sequencing technologies/methods evolved since the start of the pandemic?
The COVID-19 pandemic has helped bring global attention to this need and rapidly advance global initiatives. There have been a series of philanthropic initiatives to build genomic sequencing capacity in low- and middle-income countries during COVID-19, and the new WHO program Berlin Hub for Pandemic and Epidemic Intelligence and 10-year strategy for global genomic surveillanceboth launched last year, will help build this critical post-pandemic infrastructure to monitor other pathogens and related issues such as tuberculosis and antimicrobial resistance.
In your study titled “Global Governance of Genomic Pathogen Surveillance,” you discuss the opportunities and challenges in this area. What are the current challenges to the global governance of genomic pathogen surveillance, and how can these challenges be overcome in the future?
We outline three challenges in the paper: managing ethical and geopolitical concerns about sharing genomic data, establishing and adopting technical standards, and scaling capabilities across the globe. These each require global cooperation and trust-building, particularly to ensure that technical providers or recipients of data sharing, often from high-income countries, address the concerns of low- and middle-income countries that provide data to the network. But as we point out in the document, structures such as the new WHO center will play an important convening role in bringing together an effective and accountable global network.
Global public health security includes proactive approaches to minimizing public health disasters like pandemics. How genomic pathogen surveillance can help healthcare professionals in their pandemic preparedness.
Genomic pathogen surveillance can help public health officials and health professionals pandemic preparedness. For public health officials, a well-designed genomic surveillance network will help to rapidly identify emerging pathogens and variants of concern, track their population dynamics within and between countries and, when linked securely and anonymous to routine clinical data, to monitor their virulence and symptomatology.
For healthcare professionals, this data could also help inform diagnostic and treatment decisions, both through access to this public health data and hopefully through the development of precision treatments targeted at a specific pathogenic variant.
Generally speaking, the COVID-19 pandemic has indicated how important it is to coordinate and collaborate in research, clinical, policy and public health to improve health outcomes – this requires Infrastructure to share data securely and anonymously. Genomic pathogen surveillance is one piece of this puzzle and could help establish best practices for large-scale cross-sector collaboration.
The COVID-19 pandemic has exposed patterns of health inequity around the world. How can health innovation policies improve health inequalities, especially with regard to scaling up genomic sequencing around the world?
As we highlight in the paper, the global genomic surveillance community has been sensitive to valid concerns of health inequity over the past decade, raised particularly by low- and middle-income countries, including the United States. Indonesia in 2008. It is essential that vulnerable populations are represented in data collection to allow us to learn how pathogens spread between different groups and how their symptoms develop.
But it is also important that this collection and sharing of data is done in a responsible way, taking into account their autonomy, their commitment as partners and the sharing of benefits. The 2010 Nagoya Protocol guarantees many of these principles of fair and equitable benefit sharing, but it will be essential to develop mechanisms to build local capacity and effectively share benefits.
You work in collaboration with the Ellison Institute for Transformative Medicine and the University of Oxford. How important is collaboration among partners when it comes to solving global public health issues?
The COVID-19 pandemic has demonstrated the importance of collaboration in global public health – including across academia, policy and private sectors and at local, national and global levels. The GHSC is a new kind of partnership, bringing together political, scientific and technological expertise to advance global health – and with this article we wanted to highlight the need for such cooperation in global genomic surveillance.
Of course, collaboration on this scale poses challenges. Nonetheless, we hope this paper will help identify some paths forward for critical modern infrastructure that can not only protect us from pandemics, but can also build capacity to fight communicable diseases and help revolutionize microbiology.
What are the next steps for the Global Health Security Consortium and its ongoing work in genomic pathogen surveillance?
We have a handful of initiatives in this area, ranging from thought leadership to facilitating cross-industry partnerships to advance global genomic surveillance efforts. This includes examining how national governments can build capacity for genomic surveillance and engage in efficient and mutually beneficial data sharing. But it also includes a commitment at the international level to ensure momentum does not slow as political and public attention to the pandemic wanes.
We’ve come a long way in accelerating digital infrastructure in response to COVID. Yet there is a significant opportunity to build 21sta technology of the century that not only helps us fight future variants and pandemics, but has much wider potential impacts, including in areas like tuberculosis. This is an opportunity we must seize: the health and economic benefits are likely to be substantial in the future.
Where can readers find more information?
You can find more information about the Global Health Security Consortium and ongoing initiatives here. And the Tony Blair Institute also works on a range of broader policy issues, including health and biotechnology, available here.
About Henry Fingerhut
Henry is a senior policy analyst for science and innovation 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 the impact of social and political factors on scientific projects (such as genomic pathogen surveillance initiatives) and on the impact of technical details on policy outcomes. At TBI he works on a range of technology policy issues, including health, biotech and UK innovation policy, with the aim of helping governments harness technology for social good. .
Before joining TBI, he completed my PhD. in Technology, Management, and Policy at MIT with research on how health care providers use evidence-based practice and integrate new technologies into clinical care.