Preparedness requires building countermeasures before crisis

This week’s Expert View, from Jo Taylor, VP, corporate and government affairs at Shionogi, argues that true pandemic preparedness depends on having day-one-ready medical countermeasures, not just fast vaccine development. She outlines why antivirals and other therapeutics should be planned, funded, and stockpiled in advance, alongside diagnostics and surveillance, so early outbreak response is not left to chance.

Vaccines are necessary, not sufficient

As leaders gather in Davos, it can feel like a lifetime since three feet of distance defined daily life. Yet it was only six years ago, and the lessons of the COVID-19 pandemic remain uncomfortably relevant. Preparedness for future pandemics must embed a full range of medical countermeasures into readiness planning.

That means therapeutics, including antivirals, alongside vaccines, diagnostics, and surveillance. Nearly a decade after the Coalition for Epidemic Preparedness Innovations (CEOPI) was launched in Davos to accelerate vaccine development, one point is clear: vaccine success alone does not equal pandemic readiness.

Despite unprecedented investment and political attention during COVID-19, the world has quietly rebuilt familiar vulnerabilities. In every future outbreak, biology will move faster than manufacturing. The first months will be defined by what is already available.

Preparedness therefore depends less on scientific breakthroughs than on political and financial decisions made before a crisis begins. We now know that vaccines alone cannot carry the weight of the next pandemic. We need to bridge the gap during the months vaccines take to develop and distribute.

That means integrating antivirals as part of a wider, day-one medical countermeasure toolkit.

The first 100 days decide the trajectory

The global economic loss from the COVID-19 pandemic has been estimated at more than $12.5 trillion, in addition to the devastating impact on health systems and society. The first 100 days of any outbreak are the most critical, and while vaccines are vital, they take time.

COVID-19 exposed how difficult it is to scale essential tools at the speed an outbreak demands. It also revealed a research gap in broad-spectrum antiviral efficacy, where pipelines remain thin and evidence inconsistent. European strategy documents and research calls have only recently begun to grapple with that deficit.

Securing timely access to effective diagnostics and therapeutics, including antivirals, can help keep societies open while protecting frontline workers and vulnerable populations.

In 2021, the G7-backed 100 Days Mission highlighted the need for a coordinated approach to improving responses to pandemic threats. It recognizes the need for rapid access to point-of-care diagnostics, an initial regimen of therapeutics, and vaccines ready to be produced at scale.

The mission has aligned governments on ambition, but what remains unresolved is delivery: who pays, who stockpiles, and who guarantees access before demand spikes.

More recently, Europe’s Medical Countermeasures Strategy has emphasized rapid access to lifesaving tools, including vaccines, therapeutics, diagnostics, and protective equipment.

Leaders at Davos now need to commit to pushing these strategies from paper to practice, ensuring day-one access to a full suite of countermeasures.

Pay for readiness, not consumption

Preparedness fails when markets reward consumption rather than readiness. This is not solely a health policy concern; it is a pillar of societal and security resilience. Investments made before a crisis strengthen civilian systems, reduce pressure on emergency response, and improve readiness across society.

The challenge is identifying procurement and access models that enable rapid deployment of multiple countermeasures, while sustaining long-term innovation across the health care ecosystem.

There is no single fix, but there are instructive examples of partnership-driven approaches. Shionogi (TYO:,4507) has used global health licensing arrangements in antimicrobial resistance, working with third-sector organizations to expand access to critical treatments in low- and middle-income countries.

Subscription-style antibiotic agreements in the UK and Sweden also show how public-private partnerships can help revive antibiotic innovation.

In the UK, the National Health Service pays manufacturers a fixed annual fee based on an antibiotic’s value to the health system, effectively delinking revenue from sales volume so lifesaving drugs can be conserved.

Sweden offers guaranteed minimum revenues in exchange for assured availability, helping keep critical antibiotics on the market even when use is deliberately kept low.

More recently, Italy’s decision to introduce pull incentives in its 2025 Budget Law illustrates how innovative funding models can support sustained investment across the research and development pipeline.

These approaches treat preparedness as infrastructure, rather than something to be bought in panic once systems are already under strain.

Benefit sharing must include therapeutics

Without strong benefit-sharing mechanisms, some countries risk being left unprotected in the first wave of the next pandemic. As World Health Organization member states continue work on the Pathogen Access and Benefit Sharing system, which is expected to form part of the Pandemic Agreement, leaders at Davos should stay focused on making it workable.

If benefit-sharing frameworks exclude therapeutics, the next pandemic will again divide the world into those who can respond and those who must wait.

Any system will need to deliver public benefit while giving governments and industry the clarity and certainty required to plan, invest, and scale rapidly in an emergency.

Davos should be about delivery

Davos provides a moment to align political, industry, and global health leaders around a practical pathway for pandemic readiness.

Preparedness at this scale cannot be delivered by any single actor. It depends on coordinated action across public and private sectors, aligned incentives, and shared accountability.

The evidence is clear, models exist, and the costs of inaction are staggering. Now we must build a preparedness system strong enough to withstand what comes next, one that recognizes the importance of planning for those crucial first 100 days, with antiviral readiness as a core pillar within a broader countermeasure strategy.

The next outbreak will not wait for political cycles, budget negotiations, or manufacturing scale-up. Readiness will not emerge by default. It must be designed, funded, and maintained deliberately. Preparedness is not just a lesson to remember. It is a system to build.