“CHARTING THE PATH FORWARD IN GLOBAL HEALTH:
NKENGASONG’S FIVE P’S OF PANDEMIC PREPAREDNESS”

By: Aly Diana

Recently, at the opening session of the American Society of Tropical Medicine & Hygiene Conference 2023, John Nkengasong shared invaluable insights from his hands-on experiences with two of the world’s most pressing health challenges: HIV/AIDS and COVID-19. Nkengasong, a key figure in Africa’s public health sector, has established a significant presence in global health, leveraging his deep experiences with these challenging pandemics. His path, from directing the Africa Centers for Disease Control and Prevention to adopting a crucial role in U.S. health diplomacy, has been defined by unwavering dedication and innovation amid health crises. Nkengasong’s recent ascension to leadership in the U.S. Bureau of Global Health Security and Diplomacy, serving as the Global AIDS Coordinator and Special Representative for Health Diplomacy with the President’s Emergency Plan for AIDS Relief (PEPFAR), paves the way for his ongoing impact on international health policies and initiatives.

John Nkengasong’s insights from his vast experience with both the HIV/AIDS and COVID-19 pandemics underscore crucial elements in managing global health crises. His “five P’s” framework—politics, population, policy, partnership, and pathogen—highlights the multifaceted nature of effective responses to such emergencies.

1. Politics: Nkengasong emphasizes that political will and action are pivotal in driving large-scale health initiatives. Without the support of governments and international bodies, scientific advances and healthcare strategies can’t be effectively implemented. His example of President George W. Bush’s role in PEPFAR under-scores how political leadership can catalyze global efforts, facilitating resources like antiretroviral drugs that drastically reduced AIDS-related deaths in Africa.
2. Policy: The creation and enforcement of policies directly affect public health outcomes. Nkengasong points out that restrictive or punitive policies can hinder access to crucial health services for vulnerable populations, as seen with certain HIV policies in Africa. Progressive and inclusive policies are essential to ensure comprehensive healthcare access, especially during pandemics.
3. Partnership: Collaboration across countries sectors, and industries is vital. Nkengasong’s anecdotes about partnerships in both the HIV and COVID-19 responses illustrate that respectful, transparent collaboration can lead to innovative solutions, such as the Africa Medical Sup-plies Platform and improvements in HIV care for girls and young women in Tanzania.
4. Population: Understanding the demographics of those affected by a health crisis allows for targeted, efficient allocation of resources. Recognizing gaps in care or prevention among certain population groups, such as the high HIV infection rates in African youths, is essential for effective intervention strategies. This principle also extends to understanding public sentiments, like vaccine acceptance, to tailor communication and outreach efforts.
5. Pathogen: Scientific understanding of the disease-causing organism itself is fundamental. Research into the mechanisms of HIV and SARS-CoV-2 has led to life-saving drugs and vaccines. Continuous investment in scientific research is crucial for current and future interventions.

Source:

• Nkengasong J. Keynote Address: HIV/AIDS and COVID-19 Pandemics: Implications for Global Health Security. American Society of Tropical Medicine & Hygiene (ASTMH) 2023, Chicago, IL, USA.
• Burness MD. The Five P’s of Pandemic Preparedness: Politics, Populations, Policies, Partnerships and Pathogens. ASTMH ANNUAL MEETING 2023. https://iamtropmed.org/blog/2023/10/18/pandemic-preparedness.