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.
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.
How to use the mosaic framework?
This framework is to be used in electronic format and is divided into two parts.
What is new about this framework?
For the first time, this framework:
Figure 1: Vision, domains and aims of the Mosaic framework
Figure 2: Summary of priority surveillance objectives for each domain
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.
This framework is complemented with country case studies, which may be accessed here:
(Under development)
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.