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BackgroundInfluenza pandemics occur when a novel influenza strain, to which humans are immunologically naïve, emerges to cause infection and illness on a global scale. Differences in the viral properties of pandemic strains, relative to seasonal ones, can alter the effectiveness of interventions typically implemented to control seasonal influenza burden. As a result, annual control activities may not be sufficient to contain an influenza pandemic.PurposeThis study seeks to inform pandemic policy and planning initiatives by reviewing the effectiveness of previous interventions to reduce pandemic influenza transmission and infection. Results will inform the planning and design of more focused in-depth systematic reviews for specific types of interventions, thus providing the most comprehensive and current understanding of the potential for alternative interventions to mitigate the burden of pandemic influenza.MethodsA systematic review and narrative synthesis of existing systematic reviews and meta-analyses examining intervention effectiveness in containing pandemic influenza transmission was conducted using information collected from five databases (PubMed, Medline, Cochrane, Embase, and Cinahl/EBSCO). Two independent reviewers conducted study screening and quality assessment, extracting data related to intervention impact and effectiveness.Results and DiscussionMost included reviews were of moderate to high quality. Although the degree of statistical heterogeneity precluded meta-analysis, the present systematic review examines the wide variety of interventions that can impact influenza transmission in different ways. While it appears that pandemic influenza vaccination provides significant protection against infection, there was insufficient evidence to conclude that antiviral prophylaxis, seasonal influenza cross-protection, or a range of non-pharmaceutical strategies would provide appreciable protection when implemented in isolation. It is likely that an optimal intervention strategy will employ a combination of interventions in a layered approach, though more research is needed to substantiate this proposition.Trial RegistrationPROSPERO 42016039803

Traditional social sector and international development organizations have prioritized measuring the impacts of their work for decades. Understanding the ways in which they are bringing about change or helping people and communities has long been part of the traditional social sector ethos. And, accountable to taxpayers, funders, and a diligent global community, these organizations have long felt the pressure for demonstrating tangible results. Consequently, most international development and social sector organizations-whether government agencies, philanthropic, multilateral, or nongovernmental organizations-have embraced a practice of robust measurement and evaluation and invested in the processes, systems, tools, capacity building, and partnerships necessary for assessing the progress and outcomes of their work. Beginning around 2007, the world began to witness the proliferation of new players into the social impact scene. The emergence of new actors dedicated to using market forces and capital markets for social good-such as impact investors, for example-has dramatically increased the pool of funding available to solve complex social problems. Current estimates of assets under management for impact investing range from US$ 114 billion dollars (Global Impact Investing Network, 2017) to upward of a trillion dollars (Paynter, 2017). The types of impact investments similarly vary-ranging from direct investments into social enterprises by fund managers representing high net worth individuals to socially responsible and sustainable investing by large institutional investors. The announcement of the Ford Foundation to invest one billion dollars in mission-related investments over the next decade represents the single largest investment to date. With a dual focus of generating good at the same time as financial returns, market actors, specifically impact investors, have fundamentally disrupted the old way of doing business.

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