Funding crisis threatens early warning system that alerted world to Covid-19

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An influential early warning system for identifying emerging infectious diseases is in danger of financial collapse, raising concerns over experts’ capacity to track future pandemics despite pledges by policymakers to learn lessons from Covid-19.

The Program for Monitoring Emerging Diseases (ProMED) was among the first to detect viral outbreaks including Sars, Mers and Covid-19, which it flagged in late 2019. But the system’s operators are considering selling its Brookline, Massachusetts office as they struggle to find fresh sources of funding to cover costs.

The free web and email-based notification service, which uses medical specialists to flag, interpret and share reports on infectious human, animal and plant diseases to aid mitigation efforts, has only raised $20,000 nearly a year after launching a $1mn fundraising campaign.

“ProMED is in dire financial straits,” its staff warned as they announced plans to introduce passwords and attract paying subscribers, limit web scraping of its data and restrict access to its archive.

Linda MacKinnon, executive director of the International Society for Infectious Diseases, itself a small non-profit organisation that has run ProMED since 1999, said: “We just cannot go on like this. We need sustainable funding. Right now it’s just keeping the lights on.”

The free service, which launched in 1994 and sends out 4mn emails a month to over 20,000 recipients, is widely consulted by medical researchers, public health officials and others in governments and international agencies, as well as many commercial organisations including pharmaceutical groups, insurers, banks and travel companies.

However, while ProMED continues to be respected for its expert analysis, widespread scraping of social media have led to the emergence of multiple competitors such as Bluedot and EpiTech Consultants, while sharing of data between countries has increased.

As well as tracking early signs of respiratory diseases such as Covid-19 and Mers, ProMED was among the first to alert health officials to mosquito-borne diseases Zika and Chikungunya.

ProMED has functioned on a budget of less than $1mn a year to pay employees and stipends to a network of expert contributors. It has received sporadic grants for particular projects such as nine non-English language versions of its services and has some core funding, notably from the Wellcome Trust up to 2025.

Its latest strategic plan aims to raise $3mn a year to support the modernisation of its website, collect additional data sets and integrate and automate different aspects of its operation, but it has failed to generate significant financial commitments from public sector funders or philanthropists.

Other surveillance systems have emerged that often integrate ProMED reports, including the World Health Organization’s Epidemic Intelligence from Open Sources. ProMED has complained that commercial companies also re-use its data for their own benefit or sale beyond the terms of their licences.

“After 30 years I still think it has a unique niche and has proven itself as an early warning mechanism repeatedly,” said Professor Lawrence Madoff at the University of Massachusetts Medical School and editor emeritus at ProMED. “It needs to be controlled by an organisation that has strong infrastructure and financial backing like a university.”

Prof Heidi Larson at the London School of Hygiene and Tropical Medicine, said: “ProMED has been a pioneer. Its global network of local reporters, investigators and contributors gives a different level of confidence to the real-time alerts and reports it delivers.”