From Fragmented Response to Coordinated Action: A Governance Framework for Integrated Disease and Health Challenges

Health and disease challenges across animal health, human health, and broader determinants of wellbeing are frequently addressed through fragmented, reactive, and poorly aligned systems. Despite substantial advances in biomedical science, surveillance, and analytics, coordination failures persist across domains, particularly outside large-scale crises. This preprint introduces the Collaborative Outbreak Response Integrative Network (CORIN) as a governance framework designed to address these recurring coordination gaps. CORIN is not a regulatory authority and does not replace existing institutions. Instead, it functions as a coordination layer that enables structured cross-domain leadership, transparent priority-setting, shared situational awareness, and the translation of evidence into coordinated, pilot-scale action. The paper argues that many persistent failures in disease and health response are best understood as governance and coordination problems rather than scientific or technical deficits. While individual errors, institutional shortcomings, and instances of poor decision-making do occur, their persistence is framed as a consequence of deeper structural conditions that shape incentives, constrain behaviour, and limit coherent action across mandates and jurisdictions. Although initially framed around outbreak response, CORIN is intentionally designed to apply to a wide range of complex challenges, including endemic diseases, chronic conditions, and socio-economic determinants of health. The framework emphasizes alignment before optimization and coordination before scale, drawing on established principles from systems thinking, quality management, and public-sector governance. This Version 1 preprint is intended as a foundational governance artifact to support learning, discussion, and the development of coordinated pilot initiatives. Subsequent versions may incorporate feedback and applied case examples while preserving the core framework.