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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