Surveillance for respiratory viruses of epidemic and pandemic potential

Countries must now develop sustainable surveillance strategies to monitor influenza, SARS-CoV-2, respiratory syncytial virus (RSV) and other respiratory viruses of epidemic and pandemic potential. Population expansion, travel patterns and global trade present an ongoing risk of new pandemics and a continuing need to strengthen early warning surveillance. To face these challenges, countries must increase the number of effective surveillance approaches to address diverse surveillance objectives. WHO Member States have requested a coordinated approach to sustainable monitoring of respiratory pathogens moving forward.

As it is impossible to address the many complex needs of respiratory virus surveillance with a single system, multiple fit-for-purposes surveillance approaches and complementary investigations must fit together as tiles in a “mosaic”. Only together will these approaches provide a complete picture of respiratory viruses and the impact of associated illnesses and interventions at the country level.

This mosaic framework demonstrates how surveillance approaches may be implemented as coordinated and collaborative systems, well-matched to specific priority objectives. It helps national stakeholders to identify priority surveillance objectives; identify the surveillance approaches that may be used to meet these objectives; prioritize required enhancements of existing surveillance; develop implementation plans appropriate to national context; and prioritize and align technical assistance and financial investments from partners. This framework will also help national authorities extend partnerships for surveillance and collaborative analyses of data across partners and sectors. Doing so will improve data for decision-making during interpandemic periods and to help ensure that respiratory virus surveillance is both timely and scalable in emergencies. 

Vision

All countries develop well-coordinated mosaics of multiple fit-for-purpose surveillance approaches that address priority surveillance objectives for influenza, SARS-CoV-2, and other respiratory viruses of epidemic and pandemic potential according to country context.

The framework


It is impossible to address the many complex needs of respiratory virus surveillance with a single system. Therefore, multiple surveillance systems and complementary studies must fit together as tiles in a “mosaic” to provide a complete picture of the risk, transmission, severity, and impact of respiratory viruses of epidemic and pandemic potential. This framework will assist national authorities to identify priority respiratory virus surveillance objectives and the best approaches to meet them; to develop implementation plans according to national context and resources; and to prioritize and target technical assistance and financial investments to meet most pressing needs.

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The publication is available in Arabic | Chinese | French | Spanish | Russian | Portuguese

 

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How to use the mosaic framework?

This framework is to be used in electronic format and is divided into two parts.

  • The mosaic compass (around 20 pages) provides the key recommendations of the complete mosaic framework. 
  • The complete mosaic framework may also be read as a stand-alone document. This longer document includes all descriptions and rationale for each surveillance approach, additional topics, and country-specific examples of implementation in context

What is new about this framework?  

For the first time, this framework:  

  • demonstrates how surveillance approaches may be implemented as coordinated and collaborative systems, well-matched to specific priority objectives; 
  • identifies the most important surveillance approaches needed for 1) early warning, 2) resilient inter-pandemic monitoring, and 3) informing the use of interventions, in both high and lower resourced contexts;  
  • illustrates how recent innovations from the COVID-19 pandemic may support ongoing surveillance initiatives;  
  • guides how properly focused inter-pandemic surveillance may support epidemic, pandemic and other emergency monitoring needs; and  
  • aligns technical and funding partners to focus on highest priority surveillance enhancements

Figure 1: Vision, domains and aims of the Mosaic framework 

Figure 2: Summary of priority surveillance objectives for each domain 

Implementation and monitoring

This framework sets a 10-year horizon for implementation; however, an update may be undertaken during the next 5 years if necessary. 

The framework’s key measure of success is that:

By 2033 (10-year horizon), over 90% of WHO Member States will have implemented their own context-appropriate mosaics of complementary surveillance systems for respiratory viruses with epidemic and pandemic potential that can meet their defined national surveillance objectives.

Countries experience

This framework is complemented with country case studies, which may be accessed here:

Tools

(Under development) 

Virtual repository of existing supportive guidance and tools

This framework is complemented by a virtual repository of guidance and tools, which may be accessed on WHO website here. This framework ensures access to latest versions of any documents that will support countries to define and implement their respective surveillance mosaics.

Partners collaboration:

  • Bill & Melinda Gates Foundation (BMGF)
  • European Centre for Disease Prevention and Control (ECDC)
  • The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund)
  • The Rockefeller Foundation
  • United States Centers for Disease Control and Prevention (US CDC)


Communication materials

 

Brochure (Download PDF)

 

Contact

World Health Organization
Avenue Appia 20
1211 Geneva
Switzerland 
Email: mosaic@who.int