Is global COVID-19 expertise accessible enough?

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had an unprecedented impact on people and economies across the globe. While the pharmaceutical and biotech communities have risen to the challenge by expediting research, repurposing medications and focusing on novel drug discovery and development, COVID-19 continues to spread and affect areas where experts and research are not as easily accessible.

In this article, Drug Target Review’s Hannah Balfour explores the obstacles for emerging countries with regards to the pandemic and highlights key points from a report that calls for democratised access to COVID-19 expertise.

Research is vital for effective health policies

Throughout the pandemic, countries have adopted a wide range of strategies to reduce the transmission of COVID-19. Lockdowns, curfews and periods of isolation for people with confirmed or suspected coronavirus have been some of the most common measures implemented. However, the exceptional nature of the pandemic has meant that policy makers have had to ‘feel’ their way through the pandemic, with decisions hinging upon the research and knowledge of experts they can access or assessments of how measures implemented by neighbouring countries are working.

This approach has not been limited to virus containment strategies; it has dictated the implementation of clinical best practices and impacted which pharmaceuticals are approved for COVID-19 indications.

The majority of institutions researching COVID-19 are based in China, Western Europe and the US (see map below), which has led to whole continents and many emerging countries having limited access to experts and research to advise these policies. China, Western Europe and the US are also running the largest numbers of clinical trials and are therefore at the cutting edge of clinical best practice.

A map of the number of cases of COVID-19. The main institutions (blue dots), who have worked on coronavirus as of 3 April 2020 [credit: techspert.io].

Unsurprisingly, in countries with restricted access to the latest research, the number of confirmed cases continue to rise. Conversely, several countries with many institutions researching COVID-19, including China, are perceived to have entered the recovery phase from the virus with cases expected to gradually decline aside from instances of sporadic infection.

Brazil, for instance, is reported to have the second highest number of active cases (over 1.6 million) and deaths (almost 65,500) globally, but only six institutions in South America are currently reported to be conducting research on COVID-19¹. Peru and Chile also appear within the top 10 countries with the most confirmed cases of COVID-19² (data correct as of 7 July 2020: S).

All African countries now have confirmed cases of COVID-19, with deaths beginning to be reported, and the World Health Organization (WHO) predicts the continent will experience 250 million cases in all; however, a recent report was only able to identify four research institutes outside of the Middle East conducting research on COVID-19.

Interestingly the US contradicts this trend, having one of the highest outputs of COVID-19 research and nearly three million confirmed cases as well as just over 130,000 deaths due to COVID-19, both the highest globally.

Examples of knowledge sharing

UNESCO webinar and the COVID-19 Universal REsource gateway (CURE)

In May 2020, UNESCO and its partners held a webinar for interested stakeholders in South Asia, Southeast Asia and Latin America showcasing the COVID-19 Universal REsource gateway (CURE), as an example of an Open Access initiative. Professor Devika Madalli of the Indian Statistical Institute stated: “The gateway will harvest verified openly licensed information on the whole life cycle of the pandemic from multiple sources and present them in one user-friendly site.” Several participants in the webinar highlighted the importance of the gateway and the need to adapt it to the requirements of subregions to reflect diverse language resources on the virus and ongoing local research efforts.

CURE is an artificial intelligence (AI) platform that automatically collects information from online sources about COVID-19. It is joint initiative between UNESCO, the Indian Statistical Institute and the Network of Scientific Journals from Latin America, Caribbean, Spain and Portugal (Redalyc). Eventually the platform, and other AI-based information collection systems, will be integrated into the Global Open Access Portal (GOAP) that provides a worldwide view on open access and highlights various initiatives, as well as advocating for successful policies, to promote open access to scientific information. 

The work of the World Health Organization (WHO)

The WHO is sharing information on COVID-19 management, health implications and research progress globally. It has also dispersed expert teams to help support the COVID-19 response in several emerging countries, including Belarus, Egypt, Azerbaijan and a virtual mission to Armenia, among others. Around 70 missions have been initiated in countries in the European Region to assist with responses to COVID-19 outbreaks, including a team of five public health experts and epidemiologists who arrived on 7 July in Turkmenistan.

The organisation continues to collect the latest research, international scientific findings and knowledge on COVID-19, presenting it in a searchable multilingual database. While not exhaustive, the database is updated daily with new research and is a comprehensive source of current literature. The Health System Response Monitor (HSRM) has also been designed and implemented in Europe to collect and organise up-to-date information on how countries are responding to the COVID-19 pandemic.

Another pool of information, the COVID-19 Technology Access Pool (C-TAP), will also compile pledges of commitment to share COVID-19 health technology related knowledge, intellectual property and data through the WHO’s ‘Solidarity Call To Action‘.

Conclusion

While there may be a disparity in which countries are currently suffering from the virus and those that are actively conducting COVID-19 research and clinical trials, information on the latest research, medical interventions, clinical practices and support with COVID-19 policies is available to all through bodies such as UNESCO and the WHO.

In the current age of digital technology, geographical distance should not be a barrier between policy makers and the experts and information they need. Several AI and other platforms are already under development and it is hoped that these can make research more accessible to those in need.