Accelerating research on the prevention and treatment of COVID-19 in low- and middle-income countries

The unchartered coronavirus disease 2019 (COVID-19) crisis calls for universality and adherence to public health principles which include messaging, testing, isolation, treatment and access to a robust health system.  

In Low- and Middle-Income Countries (LMIC) the greatest challenges will be the lack of infrastructure and resources, whether those resources are natural, human constructed, or long-standing inequities. Such challenges will be magnified when resources are limited. It places even more need for effective prevention strategies.

A group of scientists, physicians, funders, and policy makers from over 70 institutions from over 30 countries have launched an international coalition to respond to coronavirus disease 2019 (COVID-19) in resource-poor settings.

According to the Drugs for Neglected Diseases initiative (DNDi), the COVID-19 Clinical Research Coalition aims to accelerate desperately needed COVID-19 research in those areas where the virus could wreak havoc on already-fragile health systems and cause the greatest health impact on vulnerable populations.

In a Comment published recently in The Lancet recently, the members of the coalition argue that international research collaboration and coordination is needed urgently to support African, Latin American, Eastern European, and certain Asian countries to respond effectively to the worsening pandemic and speed up research adapted to resource-limited settings.

The coalition brings together an unprecedented array of health experts, including public-sector research institutes, ministries of health, academia, not-for-profit research and development organisations, NGOs, international organisations, and funders all committed to finding COVID19 solutions for resource-poor settings.

One important research response to COVID-19 has been launched already, the World Health Organisation (WHO)-led SOLIDARITY trial, an unprecedented global effort. But theauthors found that out of almost 600 COVID-19 clinical trials registered, very few trials are planned in resource-poor settings. The authors commit to sharing their technical expertise and clinical trial capability to accelerate COVID-19 research in these settings.

The scale of the challenge is clearly beyond the scope of any single organisation. The coalition will facilitate a coordinated approach, so that all data from all regions can be collected in a similar fashion, pooled and shared in real-time. This will help countries and the WHO to make rapid evidence-based decisions on policies and practice.

"We welcome the launch of this coalition, which takes advantage of existing multinational and multidisciplinary expertise in running clinical trials in resource poor settings, and will help the World Health Organisation (WHO) in its coordinating role in the global response to COVID-19,"said Dr Soumya Swaminathan, Chief Scientist, World Health Organisation."Although the epicentre is today elsewhere, we must prepare now for the consequences of this pandemic in more resource-constrained settings or we stand to lose many more lives."

Members of the Coalition call for specific commitments to ensure access, so that effective new treatments are made available as soon as possible in resource-poor settings and are affordable and readily accessible.

So far more than 70 organisations have joined this coalition, with a call made to other organisations ready to contribute existing capacity to join. The International Centre for Diarrhoeal Disease Research, Bangladesh, currently known as icddr,b is the only signatory of the coalition from Bangladesh.  Information about the COVID-19 Clinical Research Coalition can be found at: covid19crc.org.