Table 5 Enablers to data sharing. Numbers in this table refer to the numbers shown in Supplementary Material 1
Indisputable Enablers, facilitating data sharing |
1. Political commitment from national authorities for transparency in and endorsement for data sharing: • at the national level to share data across public and animal health stakeholders to stimulate (One-Health) collaboration. For instance, through the establishment of a dedicated One-Health Joint field investigation team unifying the Ministries responsible for public and animal health (1a); • stimulating and engaging in collaboration and data sharing with international and global stakeholders (1b) |
2. Pre-existing collaborations and networks facilitated the response and helped to further build trust necessary for data sharing between stakeholders, and included networks involving: • The public health and animal health stakeholders that was established during previous outbreaks at national level (2a); • The public health and partners of research laboratories that was established during previous outbreaks or as part of ongoing research at national level (2b); • The national and international stakeholders through the WHO network (e.g. reference centers) (2c); • at the international level established through previous research activities and consortia (2d) |
3. Confidential meetings that allowed for direct, rapid, and confidential sharing of state-of-the-art information and data through open conversations between stakeholders, facilitating and/or building forward on a certain level of trust. Such meetings were relevant: • when data sharing and data access in collaborations were not (yet) formalized (3a); • to inform authorities and provide guidance on how to handle safety concerns, like shipments (3b); • to share novel scientific and outbreak-related data that could potentially be crucial for the outbreak response but were not yet published (3c) |
4. Reciprocity and bilateral data sharing ensured mutual benefits, fairness, and respectful collaborations. One example is sharing data by the national authorities with international partners in return for the capacity building and the technical expertise, like training and diagnostics |
5. Setting good examples through showing the benefits of data sharing: • Countries with political commitment for data sharing—of which the national authorities were timely reporting cases and notifying under the IHR, and shared data openly—getting rapid technical assistance in return for data sharing particularly during the first period of an unfolding outbreak of an emerging pathogen, set a positive example followed by some other countries (5a); • sharing potentially crucial research/outbreak data before publication in scientific journals in the interest of rapid public health response, for example during confidential meetings, helped building trust in consolidating the technical partnerships and set a good example that was followed by other scientists (5b) |
6. Expedited publication process: fast-track reviews of manuscripts by scientific journals, and acceptance of pre-published data in publications seemed to have enabled sharing of crucial outbreak related information without jeopardizing scientific reward |
7. Development of diagnostic kits and materials with non-infectious abilities, ensured biosafety and helped overcome safety concerns related to the import of potentially infectious materials and allowed distributing of kits to (countries with) labs compatible with their biosafety levels, empowering local diagnostic capacity |
Situational enablers, depending on the situation/ context facilitating or hampering data sharing |
8. Rigor in public risk communication: Careful, unified public messaging in communicating risks: • the carefulness not to adopt a solo-authority rhetoric blaming a particular thing, group, or an activity of cultural value to the community where an outbreak is unfolding, seemed to have enabled continued collaboration and data sharing. During MERS-CoV, public health authorities worked together with the Animal Health Department to release the carefully designed and jointly cleared public messages as camels had an economic, cultural, and social importance in the local community. This practice allowed building trust with the animal sector to facilitate the subsequent investigation and research (animal sampling and collection, and sharing of related data) (8a); • however, the ambiguous language that was used (by the public health stakeholders) in the public communication reflecting the scientific uncertainty on the potential role of camels as reservoir animals may have delayed the recognition of the animal source. This inherited insufficient engagement of the animal sector and subsequently caused poor sense of urgency to initiate quick and adequate response to this zoonotic threat (8b) |
9. Establishment of ownership agreements: • memorandum of Understandings (MoUs) and MTAs brought legal clarity for sharing parties. This clarity of rights and obligations seemed to have enhanced the readiness to sharing data (9a); • however, when negotiations were long, and terms were strict, delays in sharing practices ensued (9b) |
10. Clear (hierarchical) coordination and communication chains in data sharing: • MERS-CoV seemed to have stimulated the discussion of accountability in data sharing. Consequently, concerned officials were clear with whom outside their departments to share data, and who was responsible within their institutions to approve such data sharing (10a); • however, if built upon hierarchical processes of approval, this led to delays, and limited flexibility and empowerment of stakeholders, in data sharing (10b) |
11. Pressure for data sharing from international stakeholders: • promoted change in attitude for data sharing from certain stakeholders, as this pressure was in favor of the technical officials to convince their leaders to respond to the international requests of sharing data, using the expected mutual benefits as a solid argument (11a); • but this is subject to the relationship of the national authority with the other international/ regional bodies and countries. It has led to a defensive position of some stakeholders to protect their interests (11b) |
Tentative enablers, unstable enablers pertaining to their implementation |
12. The tripartite WHO, WOAH (former OIE), FAO collaboration motivated and created a platform for One-Health collaboration and data sharing; but this initiative could have been improved by enhancing coordination, guidance, and proactivity during the first epidemic phases to avoid “lateness”, which seemed to have originated from conflicts of interests and mandate discussions |
13. Formal notification channels (WHO/WOAH) improved sharing of case- and outbreak-related data; but could have been improved in clarity and detail in the guidance for notification, enforcement, and—for the WOAH channel—timely implementation |
14. Informal notification under the IHR (WHO) helped confidential sharing of suspected cases and getting support from WHO in the investigations and reporting; creating more awareness about this possibility and how to use it could have further improved data sharing |