The expert groups at NITI Ayog analyzed the COVID-19 situation in India and has come up with recommendations in the form of the Pandemic Preparedness and Emergency Response Framework (PPER) for action. The PPER emphasizes the importance of the first 100 days of an outbreak of a new pathogen and the need to develop a robust system capable of making strategic decisions and actions. The recommendation are framed under four pillars:

1. Governance, Legislation, Finance and Management :

• The expert group recommends the enactment of a Public Health Emergency Act

• Establishment of an empowered governance framework for public health response and a continuous monitoring group

• Preparing a plan for action for rapid response

• Initiating a PPER fund for all activities concerning preparedness and response.

2. Surveillance, Management of Data and Early Predictive Warning :

• A robust surveillance network linking data on human, animal and environment in the form of epidemiologic, genomic and clinical data

• Setting up more BSL3 and BSL4 laboratories for priority and unknown pathogens

• Leveraging Forecasting and Modelling for early prediction of emerging threats

3. Research and Innovation, Infrastructure, Capacity building :

• Developing countermeasures based on Research on priority pathogens

• Expanding production capabilities for drugs, vaccines, and diagnostic tools

• Strengthening supply chain and logistic management through infrastructure development and robust action plan for countermeasures

• Establishing institutes of innovation for research on diagnosis and management and for appropriate human capacity building.

4. Partnership, Community engagement and risk communication :

• Developing strategic plan for risk communication and community engagement

• Collaborating with private sector and international organizations.

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