Global coalition to accelerate COVID-19 clinical research in resource-limited settings * Download PDF [359 KB] (https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930798-4) * COVID-19 Clinical Research [log in to unmask] 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) 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. • View related content for this article (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) Posted by Sam Lanfranco Access CANCHID archives at: https://listserv.yorku.ca/archives/canchid.html . CANCHID is a constituency service to the Global Health Community and is managed by Prof. Emeritus Sam Lanfranco <[log in to unmask]>