Despite some progress, global pandemic preparedness is at risk of backsliding, warns the Fifth Implementation Report of the 100 Days Mission (100DM).
The report, released earlier this week in Paris by the International Pandemic Preparedness Secretariat (IPPS), evaluates progress towards the 100DM’s goal to ensure that diagnostics, therapeutics and vaccines (DTVs) are ready for production within 100 days of a pandemic threat being identified.
It highlights persistent gaps across all the three areas, and weaknesses in the systems required to deliver them, alongside declining investment in pandemic countermeasures and continued pressure on global R&D pipelines. Notably, the gap between scientific capabilities and the willingness of political and economic systems to support pandemic preparedness R&D is growing.
PSI and OVG Investigator Professor Teresa Lambe, who contributed to the report as a member of the 100 Days Mission Science and Technology Expert Group (STEG), commented: "Outbreaks and epidemics have not gone away and we need now, more than ever, to work together to reduce the impact of future pandemics by delivering and enabling across the DTV landscape. Importantly, the report highlights the recent progress made and the priorities to deliver on in 2026.”
As the report notes, the erosion of global health and research budgets has revealed structural vulnerabilities in 2025; while a series of outbreaks – including mpox, H5N1, Ebola, Marburg, Rift Valley Fever, Chikungunya and measles – have exposed weaknesses in early detection, coordination and access.
Following the adoption of the WHO Pandemic Agreement in 2025, which established a framework to strengthen global collaboration, the report identifies 2026 as a decisive year for implementation, identifying four priority areas for action:
- Operationalising the Therapeutics Development Coalition to address persistent gaps in antiviral R&D.
- Enhancing coordination across the diagnostics ecosystem and implementing recommendations from the Global Diagnostics Gap Assessment.
- Sustaining vaccine investment and strengthening alignment across diagnostics, therapeutics and vaccines.
- Agreeing a sustainable mechanism for pandemic preparedness monitoring, including a long-term path for the 100 Days Mission Scorecard beyond the IPPS mandate.
PSI’s role in advancing pandemic preparedness
PSI is very active in discovering, creating and enabling practical solutions to infectious disease worldwide. Annex A of the Fifth Implementation Report provides an exhaustive breakdown of the role and contribution of PSI to the 100DM, spanning diagnostics, vaccines and therapeutics as well as clinical trial capacity and cross-cutting initiatives.
In the area of diagnostics, the development of prototype lateral flow devices (LFD) for mpox and Nipah virus are representative of PSI-led progress, with our institute also leading the development of Target Product Profiles for Avian flu.
PSI is active in vaccine development for priority viral families, with examples including the expansion of the ChAdOx1 platform across multiple high threat pathogens such as filoviruses, Nipah virus and Lassa fever virus.
Also noted by the report is progress in preclinical therapeutics work, with PSI advancing research towards therapeutic targets for Nipah virus; working to identify small molecule inhibitors for SARS-CoV-2, MERS, mpox, Nipah, influenza and flaviviruses; and developing Nipah-specific monoclonal antibodies.
Improvements in clinical trial capacities have also been delivered by networks and initiatives of which PSI is a member.
The PSI-hosted International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) has provided technical support for the world’s first clinical trial for Marburg treatments, the Platform Adaptive Randomized Trial for New and Repurposed Filovirus treatments (PARTNERS), and is collaborating with partners to implement mpox4C, an mpox clinical characterisation protocol.
The Global Research Collaboration for Infectious Disease Preparedness (GloPID-R), whose Research & Policy Team is hosted by PSI, has developed a monitoring, evaluation & learning framework for its Living Roadmap on Clinical Trial Coordination, and will shortly publish a regional case studies series to assist funders in supporting robust responsive clinical trial infrastructures.
The PSI-led Pandemic Preparedness Analytical Capacity and Funding Tracking Programme (Pandemic PACT) in collaboration with GloPID-R and UKCDR, has recently launched the 100 Days Mission data tracker, which tracks and visualises health investments aligned with the 100DM objectives. By tracking and analysing funding streams, this tool offers a live landscape of current research investments across DTVs, helping identifying gaps and supporting resource allocation and policy making decisions.
Partnerships, also a cornerstone of PSI’s strategy, are addressed as crucial for the success of the 100 Days Mission.
A new PSI partnership, the Africa Pandemic Sciences Collaborative, is among the cross-cutting initiatives announced by the report. Through the Collaborative, PSI, the Science for Africa Foundation and the Mastercard Foundation are aiming to strengthen the continent’s pandemic resilience by empowering an emerging generation of young African scientists.