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The EDCTP-funded 
consortia ALERRT and Pandora

Jean Marie Vianney Habarugira

Epidemic preparedness
Resetting the research agenda

On 11-12 February 2020, WHO and GloPID-R (the Global Research Collaboration for Infectious Disease Preparedness) organised one of the most important meetings that sought to address the novel virus: the ‘2019 novel Coronavirus Global Roadmap’ meeting in Geneva, Switzerland. The meeting, attended by representatives from research and funding organisations, discussed the most pressing questions related to the novel virus.

As a major funder of clinical research, including epidemics preparedness in sub-Saharan Africa, EDCTP was also represented together with the two epidemic preparedness consortia: Francine Ntoumi and Alimuddin Zumla for PANDORA-ID-NET, Peter Horby and John Amuasi for ALERRT, and Jean Marie Vianney Habarugira for EDCTP. The results of this meeting have paved the way for a careful research priority setting procedure, which also informed the EDCTP strategic research agenda for 2020.

In just a couple of months, the world has seen an emerging novel coronavirus spread from one city to the whole globe. In January 2020, the PANDORA-ID-NET and ALERRT consortia, with a presence in quite a few sub-Saharan African countries and strong South-North collaborations, convened emergency meetings to discuss how to respond to the viral threat later named COVID-19. The two consortia were in the middle of their research response to other (re-)emerging infectious diseases, such as the Ebola outbreak in the Democratic Republic of the Congo (DRC), Lassa fever in Nigeria, chikungunya in the Republic of the Congo and monkeypox in the Central African Republic. Doubtlessly, the threat posed by the COVID-19 pandemic led PANDORA-ID-NET and ALERRT to another level of alertness and response.

Emergency preparations in Africa

In the weeks following the worldwide spread of the outbreak, PANDORA-ID-NET members published several papers addressing urgent COVID-19 questions. An editorial in the International Journal of Infectious Diseases (01 April 2020), Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future, highlighted the crucial role played by PANDORA-ID-NET consortium members and partners in ensuring that the capacity to screen and test was available for response researchers. The editorial also pointed out that some countries, including DRC,  now turned the resources and skills built earlier in the fight against Ebola, successfully against Covid-19. As the virus spread further in sub-Saharan Africa, PANDORA-ID-NET and Africa CDC intensified their collaboration on preparedness activities. A key activity was a joint workshop held on 11-13 March 2020 in Lusaka, Zambia, which was hosted by Zambia-based PANDORA-ID-NET members. The workshop with 33 participants from 20 countries covered topics such as laboratory diagnostic skills, clinical case management and risk assessment at points of entry.

In February, ALERRT decided to revise its FISSA (Febrile Illness in Sub-Saharan Africa) study protocol to include a research response component in the event of a public health emergency declaration by national or international health authorities in one or more countries participating in the FISSA study. Specifically, ALERRT has invited public health services and other care services responding to COVID-19 to join the consortium through an accelerated procedure. FISSA study procedures now incorporate care of individual patients and the collection of data relevant to COVID-19. Sample collection, testing and case management follow the standardised procedures recommended by WHO.

Jean-Marie Habarugira, Prof. Francine Ntoumi and Prof Alimuddin Zumla at the meeting in Geneva, Switzerland.

The Institut Pasteur of Dakar in Senegal a member of ALERRT - hosted on 6-8 February 2020 one of the early COVID-19-specific laboratory training courses in sub-Saharan Africa. The strong partnership and synergy with ISARIC (the International Severe Acute Respiratory and Emerging Infections Consortium), enabled ALERRT to quickly embark on COVID-19 clinical characterisation, following standardised procedures recommended by WHO. Moreover, ALERRT has now secured funding from the Wellcome Trust and the UK Department for International Development (DFID) for the COVID-19 Clinical Characterisation Protocol. The implementation of the study will involve close collaboration with the WHO Regional Office for Africa, Africa CDC, other similar networks and structures across Africa and globally to ensure the protocol is appropriately adapted for implementation in Africa.