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Science for Pandemic Preparedness: A Precautionary Framework.

David Kriebel1, Rok Ho Kim2, Trisha Greenhalgh3

  • 1Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, Massachusetts, USA.

Journal of Evaluation in Clinical Practice
|November 2, 2025
PubMed
Summary
This summary is machine-generated.

Health agencies should adopt a precautionary approach to pandemic preparedness, acting on potential risks even with uncertain science. This proactive strategy, incorporating public input, enhances pandemic response and prevents future health emergencies.

Keywords:
COVID‐19decision makinghealth policypandemic preparednesspragmatismprecautionary principle

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Policy

Background:

  • Early pandemic responses in 2020 were delayed due to insufficient evidence of human-to-human transmission and uncertainty regarding exposure routes.
  • A 2021 review highlighted a bias towards inaction in pandemic alert systems, advocating for a shift to precautionary, presumptive action.
  • The risk of future pandemics, such as avian influenza A (H5N1), necessitates urgent improvements in preparedness.

Purpose of the Study:

  • To propose incorporating the principle of precaution into public health agency decision-making for pandemic preparedness and response.
  • To outline a pragmatic framework for utilizing scientific uncertainty in policy development.

Main Methods:

  • Summarizing the historical development of precautionary policy frameworks.
  • Identifying and presenting four key components of a precautionary approach.
  • Drawing lessons from past pandemic responses and missed opportunities.

Main Results:

  • The proposed precautionary framework includes: acting on large potential risks despite scientific uncertainty, carefully considering the burden of proof, broadly defining problems to include diverse scientific fields, and increasing public participation.
  • Implementing these components can lead to more rapid, transparent, and effective policy decisions.

Conclusions:

  • Health agencies should reverse the bias towards inaction by adopting a precautionary principle for pandemic preparedness.
  • Integrating precaution into policy-making, alongside public engagement, is crucial for effective pandemic response and mitigating future health threats.