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HOME > Osong Public Health Res Perspect > Volume 15(6); 2024 > Article
Editorial
 The urgency of improving research infrastructure and institutional frameworks for the next pandemic
Jong-Koo Leeorcid
Osong Public Health and Research Perspectives 2024;15(6):477-478.
DOI: https://doi.org/10.24171/j.phrp.2024.0361
Published online: December 30, 2024

National Academy of Medicine of Korea, Seoul, Republic of Korea

Corresponding author: Jong-Koo Lee National Academy of Medicine of Korea, 51 Seochojungang-ro, Seocho-gu, Seoul 06654, Republic of Korea E-mail: docmohw@snu.ac.kr
• Received: December 22, 2024   • Accepted: December 25, 2024

© 2024 Korea Disease Control and Prevention Agency.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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As we reflect on the year 2024, numerous voices within the healthcare and scientific communities have highlighted the critical need to improve research infrastructure and institutional frameworks in preparation for the next pandemic. Observations of the amendments to the World Health Organization’s International Health Regulations and the ongoing negotiations surrounding the Pandemic Agreement make it clear that a coordinated development action plan, based on a comprehensive blueprint of Korea’s research priorities, will be necessary.
First, how can 100-Day Challenges be realistically implemented for the next pandemic?
A key question for pandemic preparedness is whether vaccines and therapeutics can be developed within 100 days of an outbreak. In recent years, the Korean government has shown a strong commitment to creating a domestic mRNA vaccine platform. This initiative has involved partnerships with relevant industries and has led to the advancement of 4 pre-clinical trials, 4 Phase 1 clinical trials, 2 Phase 2 trials, and 1 or 2 Phase 3 trials.
To achieve this goal, industry, academia, and research institutions have identified and discussed obstacles in 3 critical areas: how to expedite the creation of antigens, how to swiftly produce vaccines and therapeutics, and how to ensure the rapid delivery of manufactured products.
To accomplish this within 100 days, we can learn from the examples of Japan and the United States, which illustrate the importance of addressing this issue. At the joint 2nd forum held by the National Academy of Medicine of Korea and the Korean Academy of Science and Technology this year, experts discussed strategies for vaccine development, including analyzing the effectiveness of COVID-19 vaccinations and preparing for future outbreaks.
Second, can real-time mortality surveillance be launched?
Recently, Statistics Korea released the 2023 Annual Report on the Causes of Death Statistics [1]. The total number of deaths decreased by 20,428 to 352,511, marking a 5.5% decline compared to the previous year. Notably, the rate of coronavirus disease 2019 (COVID-19)-related deaths per 100,000 population decreased from 61.0 in 2022 to 14.6 in 2023. The actual number of COVID-19 deaths dropped from 31,280 to 7,442, a significant reduction of 76.2%, resulting in 23,838 fewer deaths.
However, there has been a notable increase in deaths attributed to pneumonia, sepsis, and lower respiratory tract infections. While the exact causes remain unclear, it is suspected that these deaths may be indirectly related to COVID-19, potentially due to long COVID or the systemic strain on healthcare systems. Further investigation is essential to determine the specific causes. Building real-time mortality surveillance systems, whether related to the cause of death or not, and establishing infrastructure for assessing health system performance related to mortality are urgent priorities for timely policy evaluation.
Third, how should we address the impacts of the health and healthcare research infrastructure due to the health sector crisis?
With the pandemic subsiding, the burden on the healthcare system has lessened, and society is gradually returning to normalcy. However, unexpected crises in the medical sector have emerged, prompting the government to escalate the health and medical disaster emergency warning from “alert” to “severe.” As part of a policy aimed at balanced regional development, the South Korean government has increased medical school enrollment quotas, especially at regional universities. This initiative is supported by the Act on the Development of Local Universities and Colleges and Regional Human Resources, enacted in 2014. The act allows for special admissions processes and mandates that universities incorporate these processes into their bylaws. A similar policy in Japan has sparked ethical debates regarding the government-led distribution of physicians to rural areas [2].
However, the sudden expansion of special admission quotas has led to significant issues, including disparities in regional healthcare coverage. This is primarily because many hospital trainees and medical school students have abandoned their positions. Therefore, this shift has negatively impacted the management of complex diseases and emergencies in tertiary hospitals, as well as ongoing medical research. Although research budgets are anticipated to rebound next year, the severe setbacks in basic, clinical, and translational research raise concerns about strategic objectives and Korea’s global competitiveness over the next decade. This pressing matters must be settled without delay, by active investigation, investment and involvement of National Institute of Health in the Republic of Korea.
Lastly, it is necessary to strengthen legal and ethical frameworks for the rule of law.
While legislation related to the research, development, and procurement of vaccines and treatments has been appropriately updated, disagreements persist regarding the application of test-trace-isolate-quarantine strategies and social distancing, particularly concerning privacy and human rights. These issues highlight the need for institutional improvements. Even with a focus on the precautionary principle, policies must maintain proportionality to minimize risks while infringing minimally on rights. The South Australian Public Health Act 2011 serves as a valuable reference [3]. In the enforcement of preventive measures against respiratory infections, it is necessary to involve the community and ensure equitable implementation. However, excessive administrative actions, such as overly broad contact tracing or quarantine measures, have led to arbitrary practices and unclear accountability. Problems have arisen, including inadequate privacy protection with the exposure of sensitive patient information, and unequal access to medications and vaccinations. Quarantine measures should respect individual dignity, ensuring that restrictions are proportionate to the risk posed and that adequate support is provided during home or facility isolation. To address these challenges, comprehensive reforms are necessary in the classification of infectious diseases, the preventive measures for respiratory infections, and the management of personal data. Principles must be upheld in enforcement and mandatory education should be implemented for public officials on infection prevention and control, as specified in the Infectious Disease Prevention and Control Act.
By tackling these challenges with systematic reform and proactive collaboration, Korea can enhance its preparedness for future pandemics while protecting public health and individual rights.

Ethics Approval

Not applicable.

Conflicts of Interest

Jong-Koo Lee has been the editor-in-chief of Osong Public Health and Research Perspectives since October 2021.

Funding

None.

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      The urgency of improving research infrastructure and institutional frameworks for the next pandemic
      The urgency of improving research infrastructure and institutional frameworks for the next pandemic
      PHRP : Osong Public Health and Research Perspectives
      © Korea Disease Control and Prevention Agency.
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