McGill Hosts Foresight Exercise on Pandemic Preparedness

On 23 May 2024, McGill Summer Institutes in Global Health collaborated with the Epidemic & Pandemic Preparedness and Prevention Department of the World Health Organization (WHO) to conduct a virtual foresight exercise. This exercise aimed to increase participants' awareness of challenges and blind spots around pandemic preparedness, ensuring the world is better prepared for future pandemics. The session was a key component of a three-day virtual course called Pandemic Preparedness, Alert, and Response, hosted by the McGill Summer Institutes in Global Health. Held from 21–23 May, the course offered participants valuable insights into epidemiology and public health, pandemic negotiations and stakeholder mapping, and culminated with the foresight exercise.

Foresight is a proactive, action-oriented approach that encourages collective ownership of the future, providing a novel approach to better pandemic preparedness. It emphasizes "thinking the unthinkable," nudging participants to consider and prepare for scenarios that may seem unlikely but could have significant impacts if they were to occur.

The foresight exercise was attended by 50 participants from over 30 countries and from diverse professional backgrounds, including clinicians, public health experts, and current university students. Participants were divided into groups to work on one of four pandemic scenarios, each characterized by different pathogen types and varying health system contexts and levels of global cooperation. The scenario contexts ranged from globally underfunded health systems to ongoing investments in health system strengthening, and from global conflict and dividedness to highly cooperative global landscapes.

During the exercise, participants were tasked with identifying the top threats, opportunities and recommendations to prepare if such a scenario should occur in the future. There were several commonalities identified across the groups, many of which included leveraging the systems and capacities that were developed or scaled up during the COVID-19 pandemic. Notably, a common theme that resonated across all groups was the need to strengthen collaboration and communication, as well as building trust with communities. In addition, the exercise helped participants generate ideas that they could implement in their setting/organization.

Excerpt of the output from the group that worked on the antibiotic resistant bacteria scenario

Foresight exercises play a crucial role in enhancing our preparedness by identifying blind spots and vulnerabilities that may not have been previously considered. This proactive approach ensures that we are not only prepared for the most likely scenarios but also for unexpected challenges, ultimately strengthening the global architecture for health security.

Reflections from the foresight exercise

"Foresight provided me with a new perspective on public health planning. This approach is crucial for developing proactive strategies and ensuring better resilience in the face of crises."

• Berger Saintius, participant from Haiti

"It's important to develop a culture of community engagement in public health approaches."

• Christine Lacroix, participant from Canada

"It's important to build strong relationships with local leaders and communities ahead of outbreaks."

• Rose Catlos, participant from International AIDS Vaccine Initiative

"Vaccines are an important part of the arsenal for vector control, but not the full solution."

• Esteban Bonilla, participant from the EPI-VAC Institute and Ministry of Public Health of Ecuador

"Pandemic prevention is a collective responsibility. By strengthening and safeguarding our local communities, fostering global-community collaboration, and promoting knowledge sharing, we lay the foundation for global health security and ensure a resilient response to future health threats."

• Nkasiobi H. Nwobi, course assistant

"Foresight is a valuable and relatively new method in public health: by anticipating different futures and identifying key drivers of change, we can develop proactive strategies to arrive at the future we wish to see. Teaching this approach to students and current public health practitioners ensures it is utilized, thereby enhancing our resilience and capacity to protect global health."

• Yassen Tcholakov, course director