Fifth Implementation Report highlights some progress, but warns that fragile systems, uneven investment and pipeline stagnation threaten the world’s ability to respond to another pandemic within 100 days
Key points:
- The Fifth Implementation Report of the 100 Days Mission (100DM) finds that the 100-day target is not yet achievable in many areas, with significant gaps persisting across diagnostics, therapeutics, vaccines and the systems required to deliver them rapidly and equitably.
- The 100DM Scorecard 3.0 highlights continued pressure on global R&D pipelines, declining investment in pandemic countermeasures, and heavy reliance on a small number of funders.
- Major reductions in global health and research budgets in 2025 have exposed structural vulnerabilities, disrupted development pipelines, and weakened preparedness.
- A series of outbreaks in 2025, including mpox, H5N1, Ebola, Marburg, Rift Valley Fever, Chikungunya and measles, demonstrated persistent weaknesses in early detection, coordination and access.
- The report identifies 2026 as a decisive year as France begins its G7 presidency, calling for coordinated action to operationalise therapeutics development, close diagnostics gaps, sustain vaccine investment, and secure the future of preparedness monitoring.
- Global experts are convening today in Paris to discuss the report’s findings. Join the event virtually via our Zoom livestream.
Paris, France, 27 January 2026 – The International Pandemic Preparedness Secretariat (IPPS) today launches the Fifth Implementation Report of the 100 Days Mission, warning that global pandemic readiness is becoming increasingly fragile at a time of growing biosecurity and geopolitical risk.
The report is being launched at an international event at PariSanté Campus in Paris, hosted in partnership with the French National Research Agency for HIV, Viral Hepatitis, Tuberculosis and Emerging Infectious Diseases (ANRS MIE/Inserm) and the Pasteur Network, and livestreamed to a global audience.
The 100 Days Mission aims to ensure that safe, effective and affordable diagnostics, therapeutics and vaccines (DTVs) can be developed, approved and made available for scale-up within 100 days of a pandemic threat being identified. The Fifth Implementation Report assesses global progress toward this ambition during a year of major political, financial, and epidemiological change.
In 2025, the adoption of the WHO Pandemic Agreement marked a significant step forward, establishing the first global framework for equitable preparedness and response. However, the report finds that implementation now represents the decisive test. At the same time, sharp contractions in global health and R&D funding, including reduced commitments from major donors and the closure of several large programmes, have disrupted pipelines and revealed how dependent the preparedness ecosystem remains on a narrow funding base.
The 100DM Scorecard 3.0, developed in collaboration with Impact Global Health, shows that overall investment in pandemic countermeasure R&D continued to decline through FY2024, with the steepest impacts seen in therapeutics. Pipelines across diagnostics, therapeutics and vaccines remain uneven and clustered in early stages, with limited progression into mid-stage and late-stage development. Progress on enabling systems, including regulatory preparedness, clinical trial readiness, data-sharing frameworks and manufacturing coordination, remains slow.
A succession of outbreaks in 2025 reinforced these findings. Mpox remains a continental health emergency in Africa, H5N1 has demonstrated zoonotic spillover risk, and outbreaks of Ebola, Marburg, Rift Valley Fever and Chikungunya have placed renewed pressure on public health systems. These events highlighted persistent challenges in early detection, coordination and equitable access to countermeasures.
For the first time, and in response to calls for more detailed analysis from Low- and Middle-Income Countries (LMICs), the 100DM Scorecard includes a ‘deep dive’ assessment of pandemic preparedness and response (PPR) capacity in Africa. This new analysis evaluates the continent’s capabilities in clinical trials, laboratory systems, regulatory frameworks and manufacturing, providing a clearer picture of the regional strengths needed to support the 100 Days Mission.
Despite the significant pressures highlighted, the report also identifies areas of meaningful progress. Advances in platform technologies, including mRNA, monoclonal antibodies and artificial intelligence, continue to offer opportunities to accelerate development. Regional capacity has expanded, particularly in Africa, with growing regulatory maturity and manufacturing capability. Rwanda’s integration of the 100 Days Mission framework and Scorecard into national preparedness planning is highlighted as an example of how the mission can be operationalised at country level.
With the mandate of IPPS concluding in 2027, the report identifies four priority action areas for 2026:
- Operationalising the Therapeutics Development Coalition to address persistent gaps in antiviral R&D.
- Enhancing coordination across the diagnostics ecosystem and implementing recommendations from the Global Diagnostics Gap Assessment.
- Sustaining vaccine investment and strengthening alignment across diagnostics, therapeutics and vaccines.
- Agreeing a sustainable mechanism for pandemic preparedness monitoring, including a long-term path for the 100 Days Mission Scorecard beyond the IPPS mandate.
The Paris launch comes at a critical political moment, as France assumes the G7 presidency, and will host a major summit on One Health in April, and the international community prepares for the UN High-Level Meeting on Pandemic Prevention, Preparedness and Response in September.
Dr Mona Nemer, Chair of the IPPS Steering Group and Chief Science Adviser of Canada, said: “The science needed to respond faster to pandemics continues to advance, but this report makes clear that progress in applying these advances to deliverig effective tools is insufficient. Today, despite the landmark WHO Pandemic Agreement, the world remains vulnerable to funding shocks, uncoordinated R&D efforts and fragile development pipelines – particularly for therapeutics.
The 100 Days Mission was designed to move us from panic to preparedness. Achieving it will require sustained investment, stronger integration across diagnostics, therapeutics and vaccines, and the political resolve to translate global commitments into operational readiness. The coming year is decisive: without action now, the opportunity to build a faster, fairer and more resilient response to future pandemics will narrow further.”
IPPS warns that 2026 represents a narrowing window to convert ambition into durable, operational systems capable of delivering faster, fairer and more coordinated responses to future pandemic threats.
ENDS
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- QUOTE SHEET –
Shingai Machingaidze, IPPS Science and Technology Expert Group (STEG) and Head of Africa Strategy and Engagement at CEPI, said: “The turbulence and unpredictability of 2025 has shown how quickly global preparedness can be undermined when political instability and economic contraction translate into reduced investment and fragmented coordination. Regions that have made hard-won progress in strengthening health systems, R&D innovation, regulatory maturity, and manufacturing remain exposed to decisions taken far beyond their borders.
True preparedness requires long-term, predictable investment, genuine partnership and a collective will to work together. Strengthening regional ecosystems and aligning diagnostics, therapeutics and vaccines is not only a matter of equity, it is essential to building a response system that can withstand economic and political volatility and deliver at speed when outbreaks occur.”
Dr Victor Dzau, IPPS Science and Technology Expert Group (STEG) and President of the U.S. National Academy of Medicine, said: “The findings of this report come at a moment of profound political and economic uncertainty. In 2025, shifting geopolitical priorities and fiscal pressures translated directly into disrupted funding, stalled pipelines and weakened preparedness systems. These are not abstract risks, they are structural vulnerabilities that slow our ability to move from scientific discovery to real-world impact.
If the 100 Days Mission is to be achievable, preparedness must be treated as a strategic investment, not a discretionary expense. That means sustaining R&D, maintaining clinical trial and regulatory readiness, and ensuring systems are resilient to political and economic shocks before the next crisis emerges.”
Dr Yazdan Yazdanpanah, Director of ANRS MIE, said: “As a key player in preparing responses to future infectious threats, ANRS MIE is honoured to host IPPS for the launch of the Fifth Implementation Report of the 100 DM. This launch is critical as it comes at a time when global health and research budgets are shrinking, the risk of emerging infectious diseases remains greater than ever, and biosecurity and geopolitical risks are increasing. But it also comes as an opportunity, at a time when France takes over the presidency of the G7 and will host the next One Health Summit. The 100DM mission report underlines more than ever the importance of international and global initiatives in the fight against infectious diseases.”
Dr Rebecca Grais, Executive Director of Pasteur Network, said: “With IPPS concluding in 2027, France assuming the G7 presidency, and the UN High-Level Meeting ahead, 2026 represents our opportunity to translate frameworks into functioning systems. The Pasteur Network stands ready to support this work through our collaborative ethos, regional presence, and shared commitment to global health solidarity.”
Dr Nick Chapman, CEO of Impact Global Health, said: “Now in its third year, the 100 Days Mission Scorecard has become an essential tool for leaders working to strengthen pandemic preparedness at national and global levels. At a time of growing risk, it provides a clear, evidence-based view of where progress is being made and where gaps remain. This year, Impact Global Health is pleased to add a pilot deep-dive assessment of pandemic preparedness and response capacity in Africa, offering an essential snapshot of the continent’s readiness. Together, these tools provide the clarity needed for implementation and underscore the need for leaders to act now with purpose and urgency.”
Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care (DHSC), UK Government, said: “The publication of IPPS’ Fifth Implementation Report is a timely moment to take stock of what has been achieved through the 100 Days Mission. The report highlights meaningful progress made to further scientific innovation. However, it also underscores the significant challenges that remain as we work to strengthen our collective pandemic preparedness, for the benefit of people across the globe.
The UK remains committed to the Mission and to advancing global health security through continued investment in diagnostics, therapeutics, and vaccines.”
Dr Aurelia Nguyen, Deputy CEO of CEPI, said: “The message in the IPPS’s latest 100 Days Mission report is clear: rapid pandemic response is only possible if we keep investing between crises. For CEPI, that means continued investment in vaccines as part of an integrated system that builds real-world readiness, strengthens regional capacity and embeds equity at every stage. With new tools like AI and networks of ready-to-activate labs, manufacturing partners and clinical sites, we can make rapid, equitable pandemic response a global norm. What matters now is sustained commitment to ensure that we have the vaccines and the required capabilities ready to deliver when the next pandemic threat emerges.”
Dr Ifedayo Adetifa, CEO of FIND, said: “Diagnostics are the foundation of any effective outbreak response, yet they remain the least funded part of global preparedness. The 100 Days Mission for diagnostics is achievable if we invest now in innovative research and development (R&D) to build flexible platform technologies, champion technology transfer and regional manufacturing, as well as strengthen health systems and enable them to adopt the new tools. This means every test developed can be delivered and used where it matters most.”
Dr Luis Pizarro, Executive Director of Drugs for Neglected Diseases initiative (DNDi), said: “This report highlights that progress toward the 100 Days Mission is uneven and fragile – with the state of the therapeutics pipeline particularly dire. This is why DNDi supports the creation of the Therapeutics Development Coalition: to address the critical need to fill the empty antiviral pipeline for pandemic-prone diseases. Success will depend upon securing sustained, end-to-end investments in R&D projects – particularly open-science, collaborative discovery initiatives – to discover and develop broad-spectrum antivirals that are affordable and accessible to everyone, without exception, as a key design feature. We invite all donors to join this effort, especially for the hardest-to-fund stages of R&D and for the most neglected pathogens, patients, and communities.”
Jimmy Rosen, CEO of READDI: “This latest 100 Days Mission Implementation Report is further proof that pandemic preparedness is a funding problem, not a science problem. Considering the millions of deaths and more than $16 trillion in global economic losses caused by COVID-19, the case for investing in medical countermeasures is indisputable. I am hopeful the work we have put into building the Therapeutics Development Coalition will convince global funders to invest in sustained therapeutics R&D to make the world safer and more economically secure.”
Charles Gore, Executive Director, Medicines Patent Pool, said: “As the 2025 100 Days Mission report makes clear, equity must be embedded in pandemic preparedness. This means having the know-how and manufacturing capacity in place in low- and middle-income countries before outbreaks emerge. MPP’s work on support and technology transfer of vaccines, medicines and diagnostics, as well as platforms such as mRNA, is geared to moving countries to that stage of readiness.”
Dr David Reddy, Director-General of IFPMA, said: “Medicines and vaccines developed by pharmaceutical companies were central to ending the COVID-19 pandemic, and will be central to our response when the next pandemic hits. If we are to respond at the speed and scale required to meet the “100 Days” ambition, we need to design systems that do not hinder innovation, and establish mechanisms that ensure scientists have rapid and open access to pathogens.”
Eloise Todd, Executive Director & Founder, rani (Resilience Action Network International), said: “Our collective resilience to pandemic and biological threats remains critically under-supported and under-resourced six years after the COVID pandemic hit. Shortsighted cuts to global health only heighten vulnerability as geopolitics makes our world increasing volatile – ongoing outbreaks of mpox, Ebola, Marburg, and other deadly viruses will continue to thrive without a comprehensive strategy. This year, leaders must heed these warnings and invest in our collective health and security.”
Aggrey Aluso, Executive Director of RANA, said: “Africa’s resilience to pandemic threats depends on our collective action to advance the 100 Days Mission. It is time to double down on surveillance, globally-focused R&D, distributed manufacturing, and community systems to achieve this vision – for Africa and the world.”
James Anderson, Chair of the INTREPID Alliance, said: “Alongside surveillance, diagnostics and vaccines, antivirals are indispensable tools for managing outbreaks. The current antiviral R&D pipeline is fragile, and without increased focus and investment in antiviral drug development, the world remains dangerously at risk of future outbreaks from both new and known viruses. Science isn’t the bottleneck – policy and incentives are, and the 100 Days Mission Implementation report underlines the importance of urgently addressing these factors.”
Professor Mario Moreira, President of Fiocruz, Chair of the Pasteur Network and IPPS Steering Group member, said: “I would like to congratulate IPPS and all the organizers for this timely and important report. The 100 Days Mission report is not only an assessment, but a critical source of information that helps us understand where we stand and where fragmentation is still holding us back. And it is essential to the global action of Fiocruz and for the The Global Coalition. We now have a shared responsibility to use this evidence to guide decisions, mobilize political will, align investments, and move from ambition to coordinated action across diagnostics, vaccines, and therapeutics.”
About the International Pandemic Preparedness Secretariat (IPPS):
IPPS is an independent entity formed to catalyse scientific exchange and facilitate multidisciplinary engagement in support of the 100 Days Mission and accelerated DTV development. The Secretariat seeks to empower the community of implementation partners to maintain ambition, continuity, and accountability towards the achievement of the 100 Days Mission. IPPS is a time-limited entity due to complete its work in 2027.
About the 100 Days Mission:
Launched in 2021, the 100 Days Mission seeks to minimize the impact of pandemics by ensuring that safe and affordable diagnostics, therapeutics, and vaccines are ready for global deployment within 100 days of the identification of a pandemic threat. The implementation of the initiative is led by the IPPS in collaboration with governments, academia, and international organisations.