NUS–Lancet Commission calls for new approach to pandemic readiness centred on people and equity
A new NUS–Lancet Commission report is calling for a fundamental shift in how countries prepare for pandemics — moving beyond technical plans and capacities to ensure that people and communities are protected in practice when a crisis strikes.
The NUS–Lancet Pandemic Readiness through Institutions, Mobilising Communities and Equity (PRIME) Commission launched its report, “Transforming Pandemic Readiness for Equity”, on 21 September 2026 at Instituto Cervantes, New York, during the United Nations General Assembly High-Level Week. The launch advances a broader approach to pandemic readiness that focuses on how pandemic readiness can better incorporate equity, whole-of-society action and the protection of communities.
Professor Teo Yik Ying, NUS Vice President (Global Health) and Dean of the Saw Swee Hock School of Public Health, participated as a panellist at the launch. He is also a member of the NUS–Lancet PRIME Commission and a co-author of the report.
Based on the report’s findings, the Commission advised that conventional measures of pandemic preparedness — including surveillance, laboratories, stockpiles and emergency plans — remain essential, but do not by themselves guarantee protection when systems come under pressure. Instead, it defines pandemic readiness as a whole-of-society capacity to prevent, prepare for, respond to, recover from and redress the effects of pandemics while protecting people's wellbeing.
From preparedness on paper to protection in practice
The report draws on research across 20 countries, engaging stakeholder from government, civil society and the private sector, as well as six evidence reviews, future scenarios and epidemiological modelling. It brought together expertise spanning infectious diseases, health emergencies, health systems, governance, social protection and community engagement.
Its findings point to five systemic vulnerabilities that can leave communities unprotected during crises: (1) insecurity in basic needs; (2) housing insecurity and crowding; (3) administrative exclusion from healthcare and social protection; (4) distrust of institutions and health information; and (5) fragile health and social systems. The Commission calls for attention to the systems that create vulnerability, rather than labelling particular groups as “vulnerable”.
The Commission’s modelling of a hypothetical future influenza A pandemic found that rapid vaccine development could reduce deaths by 59 per cent, from 58.5 million to 23.9 million, even under scenarios where countries with greater purchasing power received vaccines first. Population-based vaccine allocation could further avert 2.7 million deaths, particularly in middle-income countries, while measures to improve vaccine confidence could save another 1.9 million lives.
Singapore’s efforts and NUS leadership for global pandemic readiness
Established by NUS and The Lancet, PRIME reframes pandemic readiness around the equitable protection of all people before, during and after a crisis. It offers countries 10 priority areas for planning, six Foundational Blocks to build readiness, and a PRIME Test to assess whether policies and investments will actually protect people in practice.
NUS has played a central role in convening this international effort. In January 2026, the Asia Centre for Health Security, headquartered at NUS Saw Swee Hock School of Public Health, hosted a PRIME Commission meeting at NUS involving representatives from 22 countries. NUS researchers are also represented in the Commission’s scientific coordination group, and they will be part of the leadership driving the international partnership on implementation of the report’s recommendations.
Prof Teo shared, “For NUS to partner The Lancet on the PRIME Commission reflects strong global recognition of NUS’ leadership in global health. The Commission’s recommendations are intended to ensure that countries focus not only on strengthening technical capabilities, but also on investing in the social and community infrastructure necessary to provide genuine protection for their populations. More importantly, the Commission proposed a practical framework to address systemic weaknesses and, in so doing, help prevent the unnecessary loss of millions of lives worldwide.”
Explaining the relevance of the findings to Singapore, Prof Teo shared that the report builds on existing strengths in disease surveillance, laboratory testing, healthcare delivery and emergency coordination by examining whether these systems continue to protect people under prolonged pressure.
Singapore entered the COVID-19 pandemic with strong capabilities in disease detection, laboratories, and contact tracing, but the crisis underscored the importance of translating technical preparedness into systems that protect people in practice. The country’s experience showed how pandemic readiness extends beyond healthcare: wage support and business continuity measures helped protect livelihoods and made public health measures more sustainable, while collaboration among government, scientific and community stakeholders supported service delivery and public communication.
Rather than replacing Singapore’s existing disease-agnostic, modular pandemic preparedness framework, the PRIME Test could complement it by stress-testing whether measures protect health, livelihoods and wellbeing; reach people facing financial, administrative, housing or digital barriers; incorporate the perspectives of affected communities and frontline stakeholders; and anticipate consequences across healthcare, social services, businesses and families. Applying these questions to different pandemic scenarios could help determine whether measures remain feasible, trusted and equitable under pressure.
Prof Teo cited Singapore’s response to the COVID-19 outbreak in migrant worker dormitories, where authorities worked with migrant worker leaders to build trust, as an example of involving the communities being protected. He also highlighted transparent communication and trust as foundations that need to be built before a crisis, rather than only during one.
Turning recommendations into action
To translate its findings into practice, PRIME proposes 10 integrated recommendations, six “Foundational Blocks” and a “PRIME Test” to assess whether policies, plans and investments protect wellbeing, advance equity, strengthen trust and voice, and anticipate effects across systems.
The report is intended as a first step. Through the proposed PRIME Collective — a global platform for collaboration, shared learning and implementation — the Commission plans to work with countries and communities to apply the PRIME Test, adapt its approach to different contexts, develop practical implementation plans and measurable indicators, and support continued learning and accountability.
The next phase is about moving “from paper to action”, with NUS continuing in a leadership role as PRIME moves into implementation.
Please refer to the full NUS-LANCET PRIME Commission report here.
