The Advance Warning and Response Exemplars (AWARE) project was inspired by the success of the COVID-19 Response project under the Exemplars in Global Health research program. As the COVID-19 pandemic underscored the importance of early detection and rapid response systems, the need for implementing and scaling up these systems for a more comprehensive approach to pandemic preparedness became clear. Recognizing this need, the AWARE project was born, designed to investigate positive outliers in Advance Warning and Response (AW&R) systems that are essential for mitigating infectious disease threats with epidemic and pandemic potential, including climate-sensitive infectious diseases (CSIDs). 

The AWARE project aligns with the Pandemic Center’s mission to enhance global health security by improving the timeliness and accuracy of identifying emerging health risks. It aims to identify both the barriers and facilitators to the development, implementation, and sustainability of successful AW&R systems, with a focus on integrating climate and digital data to predict and respond to outbreaks. The project not only strengthens the knowledge base around advanced warning in low-resource settings, but it also promotes evidence-based policymaking to prepare for future infectious disease emergencies.

AWARE is particularly focused on identifying best practices and core capacities in low-resource environments to support multi-sectoral outbreak response and informed decision-making. Our country partners – Brazil, Kenya, Vietnam, and South Africa – have been selected for their innovative use of surveillance systems, integration of climate, meteorological, or environmental data, and demonstrated capacity for effective outbreak response. Through these partnerships, we aim to provide actionable insights to strengthen global preparedness efforts, directly contributing to the Pandemic Center’s mission. 

Project timeline: January 2023 - September 2025 

We are currently in the in-country research phase, where our ICRPs are conducting qualitative research and quantitative analysis over the coming months. This phase is expected to conclude at the end of Summer 2025, with findings available September 2025.

Our co-investigators include Dr. Natalia Pasternak Adjunct Senior Research Scholar Center for Science & Society, Columbia University, Dr. Rachel Baker Assistant Professor School of Public Health, Institute at Brown for Environment and Society, Brown University, and Dr. Irene Papanicolas Director of the Center for Comparative Health Systems, Brown University. 

The Brown University project team is collaborating with our co-funders the Gates Foundation, Gates Ventures, and Wellcome to work closely with in-country research partners (ICRPs) in Brazil, Kenya, South Africa, and Vietnam.

Our ICRPs

Our ICRPs include top researchers at the following universities: 

Oxford University Clinical Research Unit, Ho Chi Minh City

Oxford University Clinical Research Unit is a large-scale clinical and public health research unit with site offices in Viet Nam, Indonesia, and Nepal. It was established in Ho Chi Minh City in 1991. It is hosted by the Hospital for Tropical Diseases, which is the referral hospital for infectious diseases for all southern Viet Nam.

Principal Investigator: Jennifer Ilo Van Nuil, PhD, Head of Social Science Implementation Research, OUCRU

University of São Paulo, São Paulo 

University of São Paulo is recognized for its “scientific productivity” and has campuses across Brazil. It is also “affiliated with the State Secretariat of Economic, Scientific and Technological Development”. The university has an international office and over a thousand international agreements.

Principal Investigator:  Lorena G. Barberia, PhD, Professor in the Department of Political Science, University of São Paulo

University of the Witwatersrand, Johannesburg

University of the Witwatersrand has a vision of innovation and values space for collaboration. Its purpose is to advance global knowledge and create a positive global impact. The university lays out a commitment to using the knowledge development there for the advancement of the community and the rest of the world.

Principal Investigator: Janan Dietrich, PhD, Associate Professor, Wits

Washington State University Global Health-Kenya, Nairobi

WSU Global Health-Kenya is an NGO promoting public health, health equity, and opportunity for all people and providing innovative solutions to global health and development challenges through research, education, global outreach, and disease control.

Co-Principal Investigators: Njenga Kariuki Professor, WSU / KEMRI, Isaac Ngere Medical Epidemiologist, WSU-GH

Our partners are taking a mixed-methods research approach to determine the foundational infrastructure, capabilities, policies, and processes necessary for effective surveillance and response in low and middle income countries (LMICs). 

• Conference on Public Health in Africa (CPHIA) in Lusaka, Zambia - 2023
• Global Health Security Conference in Sydney, Australia - 2024
• World One Health Congress in Cape Town, South Africa - 2024
• World Health Summit 2024 in Berlin, Germany - 2024