Africa was predicted to be hardest hit by the COVID-19 pandemic, given its poor health systems. However, this outcome has not been the case. Despite the U.S. being the highest spender on health care globally, COVID-19 has shown that its primary care infrastructure is in much need of strengthening. But we should not mistake COVID-19 as the biggest pandemic of our time. If anything, it is only a dry run, with other epidemics brewing on the horizon. Therefore, if the global community is serious about epidemic preparedness, global health security, and protecting the most vulnerable, we need to redesign health systems for resilience. Africa’s lessons from the COVID-19 pandemic, as well as from concurrent outbreaks of cholera, Ebola virus disease, yellow fever, and chikungunya, could provide a roadmap.

Eleven months have passed since COVID-19 was declared a global pandemic by the World Health Organization (WHO). As we rang in the new year, the world surpassed two million deaths due to COVID-19. While it is encouraging that 77 countries have distributed 168 million COVID-19 vaccine doses, only a small fraction of these are in low-income countries. Vaccinations may not be widely distributed in most of sub-Saharan Africa until 2022-2023. Furthermore, the new COVID-19 variant recently discovered in South Africa is estimated to be 50 percent more contagious, underscoring the need for a collaborative international response.

“No single individual, discipline, sector or ministry can preempt and solve complex health problems.”

The COVID-19 pandemic underscores the importance of multisectoral action to contain and mitigate the effects of the virus. Presently, during crisis conditions or “war time,” in the language of outbreak experts, multisectoral efforts—including actions traversing health, education, labor, finance and other sectors—are readily apparent. But when policymakers perceive crises have passed, during so-called “peacetime,” governance structures that enable multisectoral collaboration tend to diminish or languish.

Scenario planning—a powerful method for communicating and examining uncertainty—is once again in vogue as a result of the COVID-19 pandemic. Despite the growing interest in this approach, however, its use is still limited, deployed predominately by the intelligence, business, and military communities.

“I think we have to remember not to forget what these diseases did in the past and to actively collaborate, to work with each other, and to communicate well that vaccines work,” said Dr. Paul Duprex, Director of Pitt’s Center for Vaccine Research and Professor of Microbiology and Molecular Genetics at a recent Wilson Center event on the development of a COVID-19 vaccine, co-sponsored by the University of Pittsburgh (Pitt), March of Dimes, and the Jonas Salk Legacy Foundation.

Each year, 700 women in the United States die as a result of pregnancy-related complications. In fact, the United States has the highest maternal mortality ratio of all high-income countries—16.7 maternal deaths per 100,000 live births. For Indigenous/Alaskan Native women, that number is even higher: Indigenous/Alaska Natives are 2.3 times more likely to die from pregnancy-related complications than their white counterparts. While recent years have seen growing national attention to the U.S. maternal mortality crisis, research and advocacy for Indigenous peoples’ maternal health in the United States has been limited. This research gap includes the Alaskan Native peoples—Iñupiat, Yupik, Aleut, Eyak, Tlingit, Haida, Tsimshian, and multiple Diné tribes.