CERCLE- Coalition for Equitable Research in Low-Resource Settings is an interdisciplinary coalition of scientists, physicians, policymakers and funders championing a global research response to infectious disease-related threats, driven by the needs of people in low-resource settings.
The Coalition along with its members aims to:
- Leverage global expertise and promote partnerships to support impactful research.
- Promote open sharing of research knowledge and data, and remove obstacles to timely research.
- Champion equitable and affordable access to vaccines, diagnostics and treatments
- Advocate and address key priorities for equitable research funding
The COVID-19 Clinical Research Coalition, now CERCLE, was born out of concern that the needs of people and health systems in low-resource settings needed to be addressed during the COVID-19 pandemic. The adverse impact of COVID-19 on fragile healthcare systems had proven to be devastating for all healthcare delivery. These challenges are ongoing as we face future infectious diseases threats and the Coalition continually works towards addressing them.
The research response to the COVID-19 pandemic had been vigorous, and significant new funding is emerging almost daily as there is a transition to pandemic preparedness. Resource-limited settings, particularly vulnerable populations, must be part of global plans to evaluate the safety and effectiveness of new diagnostic tools, drugs, vaccines, and non-medical interventions, and specific research is needed to address their future needs and priorities. Otherwise millions could be denied equitable access to proven and affordable interventions as future epidemics and pandemics emerge.
Conducting biomedical research involves many complex processes that normally take time, including clinical protocol development and approval by ethical review boards, engagement of regulatory agencies, approval and procurement of medications and materials for clinical sites, data management and analysis, and the sharing of data and outcomes. in the context of a public health emergency of international concern, all of these processes must be accelerated without compromising or absorbing healthcare capacity that is required to manage an emerging pandemic.
By working together and with government agencies, CERCLE members can develop, share, or harmonize systems, processes, and standards to ensure that during a global health emergency:
- research gets started quickly,
- clinical sites have the materials they need,
- key data are standardized,
- research results can be analysed and shared rapidly,
- research efforts can quickly change gears to evaluate other interventions if
- those tested do not have the expected efficacy.
This should help to ensure that any interventions proven to be effective are quickly scaled up or, where new health products are involved, approved to reach patients and health systems. Working in coalition will also provide greater leverage to ensure affordable pricing and equitable access.
Many CERCLE members already have active clinical trial sites that meet international standards, including Good Clinical and Laboratory Practices. They may use CERCLE to find partners to extend or adapt these trials to other countries in the same or other regions. Other members can support by providing technical expertise, funding, materials, and other support to ensure that priority research supporting an effective response in low-resource settings is facilitated as quickly as possible.
CERCLE members will work closely with their own and other governments to ensure research is adapted to national priorities. The research will also be adapted according to the epidemic situation in specific countries – all of which may vary, necessitating tailored diagnostic and treatment strategies.
The idea for the coalition came from Professor Nick White (Mahidol Oxford Tropical Medicine Research Unit [MORU], University of Oxford) Professor Philippe Guerin (Infectious Diseases Data Observatory [IDDO], University of Oxford), and Dr Nathalie Strub Wourgaft (Director of Neglected Tropical Diseases at the Drugs for Neglected Diseases initiative [DNDi]) in mid-March. They recognized that there were many capable and willing organizations across the world and anticipated that many questions would quickly come, specific to COVID-19 prevention, diagnosis, and treatment in different settings, which would require rapid research. Since then, the Coalition, now known as CERCLE has been responding to the changing needs of researchers which has resulted in expanding to a broader scope to encompass infectious diseases related threats and antimicrobial resistance.
CERCLE is now being formed with biomedical public and private research institutions, universities, non-profit organizations, regional research coalitions, health ministries, and funders from across Africa, Latin America, and South and South-East Asia, and their research allies and funders in Europe, Australia, East Asia, and North America. Among the participants of this coalition are many public-sector research institutes from LMICs. A full list of coalition members can be found here.
The need for collaborative mechanisms to support global clinical research is clear. At its creation, more than 70 institutions had joined from over 30 countries.
There is no single organization leading the Coalition, and therefore has no institutional bias. The primary governance body for the Coalition is the Steering Committee.
Organizations or individuals ready to contribute existing capacity to facilitate clinical trials on infectious diseases-related threats and antimicrobial resistance in resource-limited settings are invited to join the coalition, kindly apply via this form.