A global coalition to accelerate COVID-19 clinical research in low income countries

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To accelerate COVID-19 related clinical research, especially in resource- limited settings, the Lancet has announced a global coalition of a number of scientists, doctors, policy makers, academia and  funders from over 70 institutions across 30 countries.  

The global pandemic getting out of hands is the biggest fear and horror that has overwhelmed the entire world. With death and suffering disrupting even the most advanced health care systems of developed countries, low and middle income nations like Africa, Latin America and Asia, where resources are already constrained, are all the more overburdened by the deteriorating and overwhelmed state of health care.

Therefore, to accelerate the COVID-19 related clinical research, especially in resource limited settings, the Lancet announced a global coalition of a number of scientists, doctors, policy makers, academia and  funders from over 70 institutions across 30 countries. Experts from as many as 70 institutions have joined including two from India — the Translational Health Science and technology Institute (THSTI) in Faridabad and Christian Medical College (CMC) Vellore are part of the coalition.

The press release from The Lancet highlights the need to implement this task so as to accelerate the research on the prevention and treatment of COVID-19 in the middle and low income countries.

Since there is no available vaccine yet and no drug has proven complete clinical efficacy against the coronavirus infection, the scale of challenge is too vast to be handled by any single institution or organisation. A well coordinated approach will be facilitated so that all the useful data and research material can be shared in real time, without delay.

Poor resource settings lack the availability of testing kits, personal protective equipment (PPE) and also, low number of trials are being planned in these areas. Besides, there is an issue of affordability in these countries.

Further, the release states that a number of barriers have to be overcome, including political and bureaucratic so that all the steps that are being taken are implemented on ground level. Like the SOLIDARITY trial conducted by WHO, which included 600 registered COVID-19 clinical trials had very few planned for poor-resource settings. Still, a large scale study needs to be conducted as there is no surety as to which therapeutic trial will actually prove beneficial. That is why open access to data is very important.

There are many issues, such as, shortcomings in basic care, front line worker welfare, regulatory clearance, access to Good Manufacturing Practice (GMP), etc., that needs to be dealt with in low and middle income countries. There is also a lack of infrastructure to actually support the clinical trials in these counties.

The release proposes the FAIR (Findability, Accessibility, Interoperability and Reusability) guidelines to be implemented so the open sharing of data is applied at all stages of COVID-19 research and which will accelerate progress. The coalition of multinational and multidisciplinary expertise will support in the ongoing research, and make sure that there is promotion of multicentre in resource limited areas and whatever effectiveness of interventions against COVID-19 should reach them as well.