Global coalition to accelerate COVID-19 clinical research in
resource-limited settings
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Go Here for full article in Lancet: 
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext
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Published:April 02, 2020DOI:  https://doi.org/10.1016/S0140-6736(20)30798-4
(https://doi.org/10.1016/S0140-6736(20)30798-4)
       There is no available vaccine against severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) infections and no drug with proven
clinical efficacy, although there are several candidates that might be
effective in prevention or treatment. Encouragingly, the response from the
research community to the pandemic of coronavirus disease 2019 (COVID-19)
has been vigorous. A review of clinical trial registries, as of March 24,
2020, identified 536 relevant registered clinical trials.
 Of the 332 COVID-19 related clinical trials, 188 are open for recruitment
and 146 trials are preparing to recruit. 

 The distribution of these clinical trials is centred in the countries most
affected by COVID-19 in the past 2 months, particularly China and South
Korea, with high-income countries in Europe and North America planning most
of the forthcoming trials. Very few trials are planned in Africa, south and
southeast Asia, and central and South America.
The number of confirmed COVID-19 cases reported in resource-poor settings
is still relatively small, but the availability of testing is also low and
numbers of COVID-19 cases are expected to rise substantially in the coming
weeks. The capacity of weak health-care systems to manage a surge of severe
pneumonia is limited, and the low availability of appropriate personal
protective equipment (PPE) for front-line health-care staff means that
these key staff are likely to be disproportionately affected by COVID-19.
Disruption or complete breakdown of those health-care systems would result
in high direct and indirect mortality since care of all illness would be
affected.

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(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext#coronavirus-linkback-header)COVID-19
trials should be adequately powered to generate evidence. They need to be
large and well designed. Priority should be given to interventions that
reflect the specific needs of countries and are readily implementable. For
resource-poor settings, that means interventions need to be affordable and
available, and adaptable to the health-care systems and the populations
they serve. The adverse impacts of COVID-19 on health and welfare are
likely to be considerable in low-income or middle-income countries (LMICs).
Clinical trials, and evaluations of affordable and implementable
interventions of all types—behavioural, organisational, medical, and
supportive—are a priority.4
(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext#bib4)On
March 18, 2020, the Director-General of WHO announced the launch of the
SOLIDARITY trial, an international study of potential treatments for
COVID-19 to be conducted in Asia, South Africa, Europe, and the Americas.5
(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext#bib5)
WHO has an important convening role in setting COVID-19 research
priorities, facilitating trials, and coordinating efforts. The WHO COVID-19
research and development blueprint6
(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext#bib6)
and the R&D Blueprint Scientific Advisory Group will provide guidance and
ensure the necessary coordination and sharing of information. WHO will also
have a central role in reviewing the evidence generated by trials and in
producing guidelines. Yet despite these international efforts, there remain
substantial organisational and bureaucratic obstacles to a rapid research
response. Strong political support, effective collaboration, adequate
expertise and resources, and informed guidance will be needed to overcome
these barriers.
Go Here for full article in Lancet: 
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext
(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext)

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