Five years ago today, the World Health Organization declared COVID-19 a global pandemic. Almost overnight, the world changed, with governments, public health institutions, medical professionals and scientific researchers scrambling to understand the situation and find solutions – all while millions tragically lost their lives.

LSHTM’s experts were at the forefront of national and international efforts, from modelling the spread, control measures and impact of the virus, to tracking attitudes and sentiments around vaccines. Clinically-trained staff and students immediately returned to work in the NHS, while staff and alumni based in Africa scaled up surveillance, diagnostic and testing capacity, and supported national governments and Ministries of Health on mitigation efforts.

The dedication our staff showed during the pandemic has continued in the years since, bringing about advancements that will ensure we are better prepared for future pandemics.

Five years on, we spotlight five examples of progress.

Faster outbreak modelling and surveillance

Modelling and analysing a disease during an outbreak are key to understanding the threat we’re facing and what impact different control measures might have. Our experts have learnt a lot since COVID-19, realising that previous efforts were often fragmented and inefficient, with duplication of work, bottlenecks in time-sensitive analysis, and high barriers to entry for new users and collaborators.

Spearheaded by LSHTM and MRC Unit The Gambia, the Epiverse-TRACE initiative launched in late 2021, aiming to help build a more sustainable and effective ecosystem of software tools for epidemics. Since then, the tools have been used to estimate epidemic risk in Gaza, quantify key features of influenza H5N1 and connect wider global efforts at the WHO Pandemic Hub to respond to new threats in real-time.

Epiverse-TRACE member, LSHTM Professor and Co-Director of the Centre for Epidemic Preparedeness and Response at LSHTM, Adam Kucharski, said: 

“When a new epidemic threat arrives, we want specialists to be able to focus on the thorny new problems that really matter, not waste time on common tasks – like data cleaning or finding information on similar pathogens – that we could have predicted ahead of time.

“In recent years, we’ve been working on new Epiverse tools to fill crucial gaps in our analytics capabilities, as well as linking up with wider software efforts globally. As a result, we’re increasingly seeing users – from new students to experienced practitioners – hitting the ground running faster and delivering insights and impact sooner.”

The pandemic also highlighted the importance of fast and rigorous surveillance to track viral variants and transmission rates and inform appropriate responses.

However, to truly fight this threat we need all the facts. Currently only a small proportion of the sequencing database includes African genomes - a major gap in discerning appropriate health responses for different groups of people.

To address this, The MRC Unit The Gambia at LSHTM, has worked to develop genomics facilities, spearhead training and build capacity so the lab was ready to contribute key genetic sequencing insights for The Gambia national response to COVID-19. 

Dr Abdul Sesay, Assistant Professor and Head of the Genomics Strategic Core Platform at the MRC Unit The Gambia at LSHTM, who drove the initiative in The Gambia said: 

"It doesn’t stop at COVID-19 - we should be able to repurpose the technology for other diseases and pathogens. 

“What excites me about the future are the people I work with. When they started they were enthusiastic and very focused, but they were raw. They develop into independent people that I’m learning from.

“What does the future hold? It’s for these people to all become independent scientists and do their work in Africa, because we have more samples, we have more diseases, sadly. We have diversity, and the work can be done. In Africa, the impact is direct. So whatever we do has a direct public health impact, and that’s important.”

Opening more doors to training in pandemic preparedness

Following the pandemic, LSHTM founded the Centre for Epidemic Preparedness and Response to bring together global expertise, knowledge, research and teaching to help humanity adapt faster to outbreaks of disease.

At the time of its creation, the Centre was welcomed by World Health Organization (WHO) Director General and LSHTM alumnus Dr Tedros Adhanom Ghebreyesus who said: 

“You have rightly understood that we must connect more dots, encourage new and innovative ways to collaborate and work more effectively across disciplines.”  

Since its formation, the Centre has broken down barriers by championing early career talent within academia, particularly individuals from low resource settings. For instance, the Centre is supporting two Peter Piot Fellows focusing their research on chikungunya and malaria in The Gambia and Uganda respectively, as well as a Data Science Fellow to develop data science and Artificial Intelligence (AI) tools to help inform decision makers and prevent the future spread of infectious diseases.

The Centre holds annual prizes recognising research by early career scientists across LSHTM from developing an early warning system for Marburg virus in Guinea to using social science to understand refugee experiences of disease outbreaks.

The Centre will also be running a new short course on Outbreak Analytics and Applied Modelling in R in July 2025, ensuring that the next generation of public health practitioners can gain hands-on-experience with efficient tools to analyse infection data and epidemic dynamics. This builds on the toolbox of pandemic preparedness skills and knowledge already available to postgraduate students through LSHTM’s MSc Epidemiology course which is taught by global specialists including leading epidemiologists and working public health professionals with links to industry in the UK and abroad. 

Greater emphasis on listening to communities

Community distrust, rumours and tensions can become heightened during disease outbreaks, posing a serious barrier to stopping the spread  – COVID-19 was no exception. Since the pandemic, it has becoming increasingly clear that emergency outbreak responses cannot be successful if they do not win and maintain trust of directly affected communities.

The UK Public Health Rapid Support Team (UK-PHRST), an innovative partnership between LSHTM and the UK Health Security Agency funded with UKAid by the Department of Health and Social Care, is putting this into practice through its work across its triple remit of outbreak response, research and capacity strengthening.

Between 2021 and 2024, the UK-PHRST, alongside several in-country partners, carried out a research study in Sierra Leone and Tanzania to track rumours and concerns about COVID-19. Thanks to the partnership’s work, the researchers showed that what is often dismissed as rumours, myths or misinformation frequently reflects very real concerns community members have about the unequal impact epidemics have in affected societies, the interventions promoted to contain their spread, and the quality of care.

To develop more effective outbreak response and address community concerns, the project team developed a freely available community feedback triage toolkit, which can be used to facilitate workshops and focus group discussions in any outbreak.

Professor Shelley Lees, Social Scientist at the UK-PHRST and Professor in Anthropology of Public Health at LSHTM said: 

“COVID-19 showed us that rumours and misinformation are universal, affecting communities no matter where they are. Our extensive social science research shows that these concerns are not unique to COVID-19, but rather that they always emerge during epidemics and subsequent public health responses.

“We hope that our toolkit will help equip public health professionals with the tools to quickly and effectively address rumours and misinformation, preventing their spread during future disease outbreaks.” 

Nutrition plays a vital role in pandemic preparedness

The closure of schools worldwide during the COVID-19 pandemic precipitated the largest education crisis in history, leaving 1.6 billion children out of school and without access to other services vital for their health and wellbeing. Between January and April 2020, schools were closed in 199 countries, and an estimated 370 million children worldwide were immediately deprived of their daily school meal, for many their only substantive meal of the day.

In response, in 2021 the School Meals Coalition was established by (now) 108 countries whose governments made a pledge to rebuild, improve, or scale up their national school health and nutrition programmes. The Research Consortium for School Health and Nutrition is the research initiative of the School Meals Coalition, With a secretariat based at LSHTM, the consortium provides policymakers with access to independent evidence and guidance on the most effective approaches to building successful school health and nutrition programmes.

In the last five years, school meals have been increasingly recognised by governments as a strategic investment in the health, wellbeing, and education of their children—with long-term positive effects on the health and prosperity of the nation. Since 2022, the Research Consortium has worked closely with Ukraine to support the government’s intention to improve access to nutritious school meals during times of war.

Professor Donald Bundy, Director of the Research Consortium for School Health and Nutrition and Professor of Epidemiology and Development at LSHTM, said:

“Once seen primarily as a way to address hunger and food insecurity among the most vulnerable children, we now understand that school meals also have the potential to promote child wellbeing, improve learning outcomes, and reduce inequities, all of which contribute to a nation’s human capital. By ensuring every child has access to nutritious meals at school, countries can lay the foundation for healthier societies, which are essential for both long-term development and pandemic preparedness.”

Looking to the future – a world better prepared for pandemics

The next five years and beyond will no doubt bring many challenges. At LSHTM, we will continue to face them head on. Our experts are already helping shape public health policy and opinion in the UK and globally by providing their vital insights and knowledge to the ongoing UK COVID-19 Inquiry, championing the importance of future global agreements like the WHO’s Pandemic Treaty and speaking out against health misinformation to make sure the world is better prepared for the next pandemic. Professor Liam Smeeth, the Director of LSHTM said:

“The fight against pandemics is like counter-terrorism, we must use similar approaches such as gathering and sharing the best intelligence on global disease threats and joining forces to confront outbreaks before they become pandemics.”

Our experts will continue to bring together collaborations around key areas of research and education to increase understanding of threats and outbreaks. By studying the long-term health effects of diseases like Congenital Zika Syndrome and long COVID while also looking at new and emerging pandemic threats like bird flu, oropouche and mpox we’ll help the world see further ahead and act faster – helping to create a healthier, sustainable and equitable world for everyone.