WHO convened a Global Research and Innovation Forum on COVID-19 this week, bringing together 1300 experts virtually including researchers, funders and developers, to discuss the state of the science and to take stock of the six-month old pandemic which has resulted in more than half a million deaths, infected upwards of 10 million people in more than 200 countries, and has devastated lives and livelihoods.

The forum was convened in order lay out the existing knowledge gaps, map emerging research priorities and decide on the critical research questions that need to be addressed going forward. The conference follows the first Global Research and Innovation Forum on the pandemic in February this year.

Today’s briefing by WHO was addressed by an impressive panel of the organization’s scientists and experts – mostly women – to inform the media of the deliberations of the research forum. The experts included Dr Soumya Swaminathan, WHO Chief Scientist, Dr Maria Van Kerkhove, Technical Lead on the Covid-19 pandemic, WHO, Dr Ana Maria Henao Restrepo, Medical Officer, R&D Blueprint, WHO, Professor  Benedetta Allegranzi, Coordinator, Quality of Care, WHO and Dr Vasee Moorthy, Coordinator for Research and R&D, WHO.

Led by Dr Swaminathan, the team explained the state of the science, research and development efforts around health products; technical updates on public health interventions; and taking stock of trials for vaccines and therapeutics among other areas.

Swaminathan said that the forum in February had helped define research priorities to tackle the pandemic, resulting in a research roadmap. “This has shaped the global research agenda to a large extent,” she said.

It had also resulted in the creation of nine working groups, some comprising of more than 100 experts, coordinated by a WHO staff member. The working groups are composed of experts globally to have volunteered to pool in their efforts and expertise on COVID-19 research.

She said that over the last six months, “we have learned a lot and decided that it was time to reconvene to take stock of what we have learned.”

“Its clear that research, innovation and science have played  a leading role in this pandemic. And the public, more than ever, has been closely following the science and this has had its advantages and some downsides”, Swaminathan, WHO’s Chief Scientist said.

The way science usually progresses is by scientists putting forward their findings, those being peer-reviewed, then getting accepted for publication. These findings are sometimes questioned by future publications and eventually a consensus is formed around a particular question. “In this case, everything has accelerated and it is moving really fast,” she said.

There has been a huge explosion of publications and knowledge, a lot of it in the pre-print stage – and WHO has had to review 500 or upto 1000 publications on a daily basis. “It has been very challenging to keep up with the science, but also to judge the quality…” she added.  

WHO also noted the willingness of scientists to collaborate. In addition, research funders have also been involved through GloPID-R – a consortium of infectious disease research funders (the Global Research Collaboration for Infectious Disease Preparedness). Swaminathan mentioned the involvement of the private sector and developers at the two-day forum.

She noted the role of social and behavioural science experts and experts on ethics in tackling some of the more difficult questions around clinical trials including human challenge studies, the ethics of using contact tracing apps, and the ethics on fair allocation of scarce resource, among others.

Some of the working groups include one on clinical characterisation pathways and management to examine ways to improve clinical care and reduce mortality; on epidemiology to examine the modes of transmission and public health measures; on animal and environmental research looking at viral origin, viral diversity, management of human-animal interface; on diagnostics including molecular diagnostics, antigen and antibody tests; on infection prevent and control; on ethics; on social sciences and behaviour change while engaging with communities. And on candidate therapeutics R&D and candidate vaccines R&D.

The forum saw deeper discussions on therapeutics and vaccines that took stock of on-going trials. On therapeutics, researchers shared data, enabling WHO to conduct pooled analyses to inform better patient management. Experts discussed the kinds of therapeutics agents that must now go into trials including anti-virals, immunomodulators, anti-thrombotics or the new monoclonal antibodies.

Experts also discussed vaccine trial designs based on protocols shared by developers working on  candidates in clinical human trials, she said. On-going efforts were analysed. The forum discussed ways of getting researchers, funders, sponsors and  developers of vaccines to conduct trials in a speedy but scientifically rigorous manner to establish efficacy and safety beyond doubt, Swaminathan said.  

The conference also found that bulk of the research was taking place in high income countries, Swaminathan said. There was recognition that research must be geared towards low and middle income countries, while also involving researchers and institutions from these countries.

Swaminathan also highlighted another “message” from the conference – on the need for interdisciplinary science to have more dialogues between the working groups. She cited as examples, more collaboration between biomedical working groups with social science and ethics; for vaccine efforts to include engagement with civil society and communities.

A number of questions were raised on the U.S. buying up Remdesivir supplies. Swaminathan pointed to on-going efforts to determine Remdesivir’s efficacy on clinical outcomes, citing one study that did not have an effect on mortality. She added that a meta-analysis of the data will be done from published and ongoing studies.

She emphasized, “Global solidarity is important. And not just for this drug but also for other drugs, and for vaccines that are likely to be developed over the coming months… This is a test, I think, for all of humanity.”

According to a statement by WHO, “The group reviewed the latest data from the WHO Solidarity Trial and other completed and ongoing trials for potential therapeutics: hydroxychloroquine, lopinavir/ritonavir, remdesivir and dexamethasone.”

On vaccines, Ana Maria Henao Restrepo informed journalists that “a healthy pipeline” of nearly 150 candidate vaccines for COVID-19 are moving forward with evaluation.

This post was updated subsequently to correct minor grammatical errors. This is regretted. More caution and oversight will be exercised in the future especially when a story is being posted at midnight!