Every public health action during a health emergency – from implementing public health and social measures to mobilizing response teams – relies upon decision-makers having access to prompt and robust public health intelligence, including disease and other relevant surveillance data. The COVID-19 pandemic and other health emergencies demonstrated the need for data from multiple health and non-health sources to inform decisions. Countries recognized that no single surveillance system can address all the information needs during a health emergency and took opportunities to strengthen collaboration as well as their surveillance system capacities. Learning from the pandemic and other recent health emergencies, public health surveillance systems are expanding and introducing innovative approaches at local, national and regional levels.
Under the Asia Pacific Health Security Action Framework (APHSAF) endorsed by Member States of the World Health Organization (WHO) South-East Asia and Western Pacific regions in 2023, WHO prioritizes a multi-source surveillance approach in which data and insights are gathered and synthesized from diverse sources across human, animal and environmental health. These include vaccine coverage, people movement, border crossings, transportation, economic data and social listening. Multi-source surveillance takes a whole-of-society approach, leveraging the strengths of multiple sectors, surveillance sources and methods, to inform comprehensive decision-making and response.
Innovations in multi-source surveillance across Asia Pacific
During an APHSAF Stakeholders Meeting held from 23 to 25 July 2024, WHO, Member States and partners explored new frontiers in multi-source surveillance. Dr Triya Novita Dinihari, Head of the Surveillance Department at Indonesia’s Ministry of Health, described how the country had successfully conducted its first multi-source collaborative surveillance workshop to respond to increasing dengue cases and improve preparedness for upcoming outbreaks.
Dr Paul Pronyk, Deputy Director of the Duke-NUS Global Health Institute in Singapore, presented on a genomic sequencer that can run up to 50 specimens at a time and produce genetic data within hours. This early detection tool plugs into the back of a laptop and can be deployed anywhere − without the need for a specialized laboratory − and is foundational for developing new diagnostics and vaccines. It is an example of a country-centred, cost-efficient tool that can be easily accessed during an emergency to inform public health action.
Another innovation discussed was the use of artificial intelligence (AI) for event-based surveillance in India. The WHO country office in India and India’s Ministry of Health collaborated to develop the Integrated Health Information Platform (IHIP) – a web-based, open-source, real-time information platform that integrates data from many sources and across levels. In 2022, India deployed AI technology through IHIP to enhance its media-scanning and event-based surveillance. Dr Pavana Murthy, who works on high-threat pathogens as part of the Health Emergencies Programme in the country office, demonstrated how the platform reviews data from more than 90 000 sources in 13 different languages and then generates alerts that may call for a response. “The platform facilitates formal outbreak investigations and response from informal sources and provides seamless data-sharing across all levels of the Ministry and across sectors, enabling comprehensive, evidence-based decision-making during a health event,” said Dr Murthy.
Building on these examples, Dr Bryan Kim, Scientific Deputy Director of the Division of Emerging Infectious Disease Response at the Korea Disease Control and Prevention Agency (KDCA), described recent efforts to improve data analytics and to use surveillance and other data in forecasting the spread of disease. Until 2023, the Republic of Korea’s surveillance systems for health information, points of entry and disease reporting had operated in silos. From 2024 onwards, KDCA has worked to integrate these systems so that a case can be followed from the point of entry to its clinical outcome. Citing recent innovations, Dr Kim noted: “COVID-19 was an opportunity for us to apply various forecasting models to enable better decision-making. We are now expanding this tool to other infectious diseases in collaboration with external partner institutions.”
Expanding workforce capacities in multi-source surveillance
Besides sharing innovations in genomic sequencing, AI and forecasting, APHSAF stakeholders also described efforts to build health workforce surveillance capacities, both within their own borders and beyond.
Additionally, WHO is working with the United States Centers for Disease Control and Prevention, the Centre for Pathogen Genomics at the University of Melbourne and the Duke-NUS Global Health Institute to build Member State capacities in using genomic surveillance to inform public health responses for high-priority pathogens in the Asia Pacific region. Furthermore, Monash University is partnering with WHO to build infectious disease modelling capacities in other countries across the Asia Pacific region.
APHSAF provides a regional platform for stakeholders working to advance health security to convene, co-create interventions, collaborate, share good practices, leverage common platforms and implement solutions. These national and transnational efforts to strengthen surveillance capacities are an example of APHSAF’s multisectoral approach.