Global solidarity in genomic surveillance improves early detection of acute respiratory virus threats.

As genomic surveillance is key to detecting novel respiratory viruses or variants, the highly unequal global distribution of respiratory virus sequencing infrastructure raises concerns about preparedness for future threats. Using mathematical models and global epidemic simulations, we demonstrate that attaining a global minimum sequencing capacity of two sequences per million people per week at fortnightly sequencing regularity could reduce the time to first detection of novel respiratory (variant) viruses by weeks to months compared to global sequencing efforts during the COVID-19 pandemic, even with a substantially reduced number of viruses sequenced globally. Establishing this minimum global capacity could increase the time between the virus' first global detection and the first domestic case in all countries, universally improving prospects for mitigation of potential public health impacts. Importantly, these benefits cannot be attained by siloed expansion in countries that already possess strong capacity. Our results show that operationalizing global health solidarity is key to guiding investment in health security.