EMARIS Conference 2023: Convergence of Science, Policy, and Practice on Acute Respiratory Infections in Post COVID‐19 Eastern Mediterranean Region

Acute respiratory infection (ARI) is consistently ranked among the leading causes of morbidity and mortality worldwide. It kills more than 4 million people each year globally yet has been referred to as a “forgotten pandemic.” New viral respiratory pathogens are emerging with increasing frequency and have demonstrated their potential for devastating global public health, socio-economic and political impacts. Within two decades, the world has faced an influenza A(H1N1) pdm09 pandemic and the emergence of three highly pathogenic and deadly human coronaviruses, namely SARS-CoV, MERS-CoV and SARS-CoV-2, the last one causing a pandemic. As a result of the of recent pandemic, WHO has estimated the excess mortality due to COVID-19, disease caused by SARS-CoV-2, to be 13.3–16.6 million deaths in addition to colossal economic and social disruption. The WHO Eastern Mediterranean Region (EMR) is home to nearly 700 million people across 22 diverse countries and territories spread over South and West Asia, the Middle East and North Africa with its unique geographical, political and health system challenges. The 3rd Scientific Conference on Acute Respiratory Infections in the Eastern Mediterranean Region (EMARIS Conference) and the 6th Meeting of the EMARIS Network, brings together experts on acute respiratory infections (ARI), disease surveillance, preparedness and response to epidemics and pandemics. The conference is organized by the WHO Regional Office for the Eastern Mediterranean, in partnership with the Influenza Division of US Centers for Disease Control and Prevention and several other partner organizations and networks. This special issue of Influenza and Other Respiratory Viruses (IORV) reflects the scientific knowledge, practice experiences and discussions held at the EMARIS Conference. The issue covers conference submissions and relevant knowledge from within the EMR and from across the globe. It includes studies and commentaries on diverse topics including influenza burden, genomics, seasonal vaccination, behavioral information, and the significance and surveillance of non-influenza respiratory viruses. There are several pertinent findings presented in this special issue. In the area of influenza burden, the paper by Salman et al. on seasonal influenza burden used sentinel sites in Pakistan to demonstrate how influenza accounts for a significant proportion of respiratory morbidity and hospitalization in the country. The authors argue that estimates from sentinel sites could serve as a first step toward accurate estimation of national influenza associated disease burden. A paper by Sadeghi et al. on SARS COV-2 strains during the COVID pandemic in Iran also highlights how genome sequencing, which is a key strategy in genomic surveillance systems, could help detect and monitor the prevalence of SARS-CoV-2 variants; foster monitoring of the viral evolution of SARS-CoV-2 and identification of new variants for disease prevention, control, and treatment; and help provide information for enhanced public health measures and policy actions. Moreover, according to a study by Attia et al. on seasonal influenza vaccine policies in the Eastern Mediterranean Region, about 64% countries reported having a national seasonal influenza vaccine policy, 44% countries recommended influenza vaccine for all SAGE recommended target groups, and approximately 69% of countries reported that COVID-19 had an impact on influenza vaccine supply in the country—where the majority (about 82%) reported an increase in procurement and supply of influenza vaccine. The study urges countries to develop a roadmap for increasing influenza vaccine uptake, including assessment of the economic barriers and those related to vaccine acceptance and utilization. Understanding factors that affect patient behaviors and health outcomes is important for reducing disease burden. A study by Merza et al. on the factors associated with poor outcomes of inpatients with severe acute respiratory infections among patients who met World Health Organization’s (WHO) SARI case definition at Salmaniya Medical Complex in Bahrain, found that age above 50 years, and pre-existing kidney, lung, or heart disease were associated with worse outcomes. Authors are of the view that expansion of vaccination strategies targeting all individuals at high risk, and early diagnosis and treatment, could help reduce the burden of SARI. The COVID-19 pandemic has brought much attention to respiratory infections across the world. Today, human coronaviruses (HCoVs) continuously circulate in the human population. A study by Karami et al. in this issue assesses the impact of the coronavirus disease 2019 (COVID-19) pandemic on the circulation of HCoVs. Their multi-center survey provides a deeper insight into the low circulation Received: 28 February 2023 Revised: 6 March 2023 Accepted: 7 March 2023