Table 2.

Recommendations to accelerate pathogen genomic surveillance in Asia

Key constraints	Recommendations
FINANCING: insufficient and unsustainable domestic financing; over-reliance on donors/external partners.	∙ Develop national investment cases for pathogen genomic surveillance. ∙ Prioritize genomic surveillance in country applications to global financing mechanisms (The Global Fund, the Pandemic Fund). ∙ Pooled procurement support for genomic surveillance commodities through established global procurement catalogues.
POLICY and GUIDELINES: few LMICs in Asia have updated comprehensive national strategic plans that integrate pathogen genomics into wider surveillance efforts.	∙ Establish multipartner national coordination mechanisms that leverage capacity between national public health institutions, academic bodies and other stakeholders. ∙ Support national planning in the design of cost-efficient systems for pathogen genomic surveillance that optimize public health impact. ∙ Define where pathogen genomics should take place in routine systems vs research. ∙ Enable cross-sectoral collaborations for One Health surveillance that include pathogen genomics.
SUPPLY CHAIN: procurement, supply and distribution bottlenecks for NGS equipment, consumables and reagents limit the timeliness of response and impact of pathogen genomic surveillance.	∙ Enhance regional supply chains to support regional manufacturing, warehousing and distribution of genomics commodities. ∙ Track procurement lead times. ∙ Address customs/tax-exemption challenges through coordinated national engagement. ∙ Establish mechanisms for supply chain problem solving between manufacturers and country partners.
LABORATORY INFRASTRUCTURE: pathogen genomics remains a novel and rapidly evolving technology with on-going training needs. Timeliness of sequencing and reporting remains constrained among most LMICs in Asia.	∙ Coordinate regional efforts to enhance laboratory capacity in genomic sequencing for endemic and novel pathogens. ∙ Facilitate joint capacity development efforts between human and animal laboratories. ∙ Design, test and share system-level innovations that reduce the time between specimen collection, pathogen sequencing and reporting.
QUALITY ASSURANCE: laboratories undergo limited national/international accreditation and are not undergoing External Quality Assessments (EQA).	∙ Define national accreditation standards for pathogen genomics. ∙ Establish low-cost regional EQA.
BIOINFORMATICS AND DATA SHARING: bioinformatics capacity remains limited. Data quality standards need to be strengthened to ensure high utility of sequences shared regionally and globally.	∙ Enhance in-country bioinformatics infrastructure and capacity. ∙ Work with global partners to develop and implement meta-data standards for samples used in pathogen genomic surveillance.