A new international consortium launched by a group of leading medical research funders from the UK, the US, France, Hong Kong and Singapore aims to gear up the clinical research community worldwide for a swift response to any future pandemics, epidemics or other rapidly emerging public-health threats.

Conceived by the Wellcome Trust, the UK Medical Research Council, the Bill & Melinda Gates Foundation, Inserm (the French National Health and Medical Research Institute), the Li Ka Shing-University of Oxford Global Health Programme and the Singapore Ministry of Health, the International Severe Acute Respiratory Infection Consortium (ISARIC) is a global collaboration involving more than 20 hospital-based clinical research networks.

The aim is to ensure that clinical researchers have in place the necessary open-access protocols and data-sharing processes – and have considered the associated ethical issues –  for a rapid response to rapidly emerging diseases with epidemic or pandemic potential, such as the recent H1N1 influenza and SARS (severe acute respiratory syndrome) outbreaks.

The initial focus will be on clinical studies with hospitalised patients to understand the causes of severe acute respiratory diseases, discover how they develop and progress in patients, and identify the best ways to treat patients and prevent transmission.

Changing epidemic research

These studies will be undertaken both during the inter-pandemic period and in response to emerging threats.

What the ISARIC would like to do is not only conduct high-quality clinical research on a global scale but change the way this research is pursued in epidemic settings. It will also provide training and capacity-building capabilities while engaging with the wider public.  

The initial chair of the Consortium will be Professor Jeremy Farrar, director of the Wellcome Trust Vietnam Research Programme and of the Oxford University Clinical Research Unit Hospital for Tropical Diseases in Vietnam.

The ISARIC was launched at the annual meeting of the American Society for Tropical Medicine and Hygiene.

Slow to react

“The processes needed to initiate clinical studies and share data and samples effectively can take time to establish, but the faster we can react and the more trust we have built before the outbreak, the more effective will be our response and the more lives we can potentially save,” Professor Farrar commented.

As the Consortium points out, significant disease outbreaks occur with growing frequency around the world, and they are not just influenza-related – for example, dengue, nipah and viral haemorrhagic fevers or artemisinin-resistant malaria. In almost all of these cases, Professor Farrar says, the clinical research community has been slow to react.

ISARIC will develop and implement standardised protocols, metrics and data-sharing processes, operating with pre-approved, open-access protocols that can be implemented rapidly in response to novel threats. This will ensure that researchers from high- to low-income countries can either to work to or adapt the same protocols while sharing compatible data sets, it explains.

Over twenty networks spanning all six populated continents have already signed up to ISARIC. This will allow for rapid recruitment of patients across a range of income settings on a scale achievable only through this form of global collaboration, the Consortium notes.

ISARIC is also working closely with the newly formed InFACT Network, which includes 17 investigator-led intensive-care research groups from around the world.