Global funders of health-related research discuss epidemic and pandemic preparedness guidelines

The Ninth General Assembly of the Global Research Collaboration for Infectious Disease Preparedness, representing funding agencies, research institutions and government bodies from around the world, was held at FAPESP in São Paulo, Brazil, on October 24-25.

By José Tadeu Arantes  |  Agência FAPESP – The Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) brings together funding organizations that invest in research relating to new or re-emerging infectious diseases with the aim of increasing preparedness and speeding up the research response to outbreaks with pandemic potential. Its members are national science funding agencies, academic research institutions and philanthropic organizations. The World Health Organization (WHO) is one of several public health institutions and international initiatives that participate as observers. The Brazilian members of GloPID-R are Butantan Institute in São Paulo, Oswaldo Cruz Foundation (Fiocruz) in Rio de Janeiro, and FAPESP, which hosted the ninth General Assembly of GlopPID-R on October 24-25.

The meeting was opened by Charu Kaushic, Scientific Director of the Institute of Infection and Immunity at the Canadian Institutes of Health Research (CIHR) and Chair of GloPID-R; Esper Kallás, Director of Butantan Institute; Marco Aurélio Krieger, Vice President of Fiocruz; and Niels Olsen Saraiva Câmara, a science advisor to FAPESP, representing Scientific Director Marcio de Castro.

Kaushic noted that investment in funding for research to combat COVID-19 surpassed USD 5 billion in 2020, when more than 15,000 grants were awarded. However, this huge amount of funding stayed almost entirely in the Global North, mainly benefiting the most developed countries. The flow of funds widened to include the Global South in 2021, the second year of the pandemic. “It was in this context that our first regional hub came into existence, with the aim of improving the effectiveness of the response in low- and middle-income Asia-Pacific countries,” she said. 

GloPID-R currently has two regional hubs, one for the Asia-Pacific and the other for Africa. These hubs help connect funders with government institutions and society with the aim of assuring readiness and effective responses to outbreaks of diseases with epidemic or pandemic potential. One of the meeting’s most significant advances was a strong recommendation to establish a Latin American hub. “We’ve begun a discussion to set up this hub in partnership with Adolfo Lutz Institute, and we’ll also bring in other regional and national organizations,” said Reinaldo Salomão, a professor at the Federal University of São Paulo (UNIFESP) and a key organizer of the event, at which he represented FAPESP.

The Adolfo Lutz Institute is the reference laboratory for epidemiological surveillance in São Paulo state.

This was the first GloPID-R general assembly to include sessions open to the public, enabling its members to interact with heads of regional institutions, researchers, and graduate students.

The first open session, entitled “Beyond COVID: How to address future endemic and emerging infectious disease outbreaks?”, was chaired by Kaushic and Mariângela Simão, former WHO Assistant Director-General for Drug Access, Vaccines and Pharmaceuticals, and now President of Instituto Todos pela Saúde (ITpS), a nonprofit organization focusing on epidemic and pandemic preparedness in support of the Brazilian health system. The speakers were Patricia Garcia, a professor at Cayetano Heredia University (UPCH) in Lima, Peru; Michael Makanga, Executive Director of the European and Developing Countries Clinical Trials Partnership (EDCTP); Ester Sabino, a professor at the University of São Paulo (USP); Ana Maria Henao-Restrepo, a scientist at WHO; Butantan Institute’s Kallás; and Manoel Barral Netto, a researcher at Oswaldo Cruz Foundation’s Bahia state unit (Fiocruz Bahia).

Garcia noted that only 5.5% of research funding went to low- and middle-income countries during the COVID-19 pandemic. “That means Africa, part of Asia, and Latin America except Brazil,” she said, emphasizing the need for “targeted impactful research that supports local policymaking, strategy formulation and access to innovation in future pandemics.” 

Makanga stressed the acute vulnerability of African countries, calling on the World Health Assembly, WHO’s top decision-making body, to adopt a “ten-year global strategy to build research and development capacity and vaccine production capacity in all regions of the world, including low-income countries”.

Sabino focused on initiatives to prepare for imminent outbreaks, mentioning positive examples such as Brazil’s Collaborative Genetic Sequencing Network (Rede SEQV Br), and noting that most Brazilian states have installed capacity in research. “Real-time genome sequencing needs to be integrated with epidemiological, clinical and serological data if we want to glean a comprehensive understanding of viral pathogens,” she said.

Participating remotely via a video link, Henao-Restrepo addressed the issue of resilience against outbreaks and pandemics, outlined WHO’s research and development activities, and noted that WHO is mediating intergovernmental negotiations on a global agreement to prevent pandemics.

Complementing the presentations in the first session, Kallás provided an overview of Butantan Institute’s activities and Barral Netto described the Pandemic-Potential Outbreak Early Warning System developed by Fiocruz Bahia.

The second public session was entitled “Launch of the GloPID-R Funders Living Roadmap for Clinical Trial Coordination”. A living roadmap is a dynamic plan that is continuously evolving and updated in response to new information and insights. The session was chaired by John Amuasi, a member of the executive committee of the African Coalition for Epidemic Research, Response and Training (ALERRT) and Co-Chair of the GloPID-R Clinical Trial Networks and Funders Working Group; and Alexandre Biasi, Director of Education and Research at the Heart Hospital (HCor) in São Paulo.

Alice Norton, Head of the GloPID-R Research and Policy team, explained how the roadmap was developed and said that its aims are to “support epidemic-ready clinical trial networks and platforms; facilitate an agile, effective clinical trial response; and promote an equitable research environment”. Isabel Foster, GloPID-R Research and Policy Officer, spoke about implementation of the roadmap.

Vasee Moorthy, a senior advisor at WHO, noted that in May 2022 the World Health Assembly adopted Resolution 75.8 on “Strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination”, and spoke about WHO’s guidelines on best practices in clinical trials.

Katherine Littler, Co-Lead of WHO’s Global Health Ethics and Governance Unit, addressed the organization’s guiding principles for ethical research priorities: “promote social and clinical value, act efficiently, respect ethical constrains, and follow fair procedures”. Short presentations on clinical trial implementation in different regions were delivered by Biasi (Brazil), Amuasi (Ghana) and Srinivas Murthy (Canada).

Salomão (FAPESP), Elisabeth Higgs (National Institutes of Health, United States), Evelyn Depoortere (European Commission) and Yazdan Yazdanpanah (National Agency for Research on AIDS and Viral Hepatitis, ANRS, France) spoke about the positions of the respective funder members of GloPID-R.

GloPID-R was launched in February 2013 in Brussels, Belgium, on the recommendation of the Heads of International Research Organizations (HIROs), a group of government and philanthropic biomedical research funding institutions. The COVID-19 pandemic was a major test, to which it responded positively by setting up the first regional hubs for greater inclusion of the Global South. Under its current governance framework, the General Assembly elects the Chair and Executive Board from among its members for a two-year term. Kaushic’s term is now ending and a new board will be elected by January 2024.

Salomão found the 2023 General Assembly fruitful. “It reviewed the lessons learned during the pandemic and discussed the challenges we must surmount in order to be well-prepared for future public health emergencies,” he said. “FAPESP was honored to host the meeting and used the opportunity to raise awareness among Brazilian researchers and institutions in the public sessions, which showcased their strengths and potential. The most daunting challenge of all is the need to build a regional hub, and the discussions held at this meeting will have laid a sound basis for this endeavor. I’m quite sure that cooperating and learning from each other is the best way to prepare for an appropriate and efficient response to future infectious disease emergencies.”

A recording of the open sessions of the Ninth GloPID-R General Assembly is at: www.youtube.com/watch?v=GKnNg3n4Udk.