ISARIC Regional Hubs

A standardised observational framework to characterise dengue clinical epidemiology and address critical knowledge gaps to improve patient outcomes.

Background

In 2020 ISARIC in collaboration with GOARN Research applied to Wellcome and FCDO UK for funds to support the pandemic response in low- and middle-income countries (LMICs) – ‘Enabling ISARIC Clinical Characterisation Protocol (CCP) roll out in LMICs’ [222048/Z/20/Z].

The approach taken was one of capacity building with a focus on starting to build out of ISARIC partners in Brazil, Ghana, Pakistan and the Philippines in the form of clinical research  Regional Hubs.

The International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) regional hub leads Dr John Amuasi (African Hub), Dr Fernando Bozza (South American Hub), Professor Madiha Hashmi (South Asian Hub), and Doctors Janice Caoili and  Muge Cevik (Southeast Asian Hub) coordinate all hub activities.

As part of the funding, each Regional Hub has been able to recruit a regional coordinator to implement and scale up activities around the ISARIC WHO CCP, strengthening their clinical and operational clinical research response.

The implementation of the standardised ISARIC WHO CCP in four different regions across the global south is a platform for timely data collection, analysis, with the capacity to generate data informing regional clinical and public health management. The infrastructure which has been invested in this platform, can further be mobilised to respond to future emerging pathogens. Through the operationalisation of the CCP, clinical research capacity and capability, have been strengthened in the regions.

Highlights of the Hub activities at the end of 2022 include:

  • > 120 research sites across the 12 countries of Brazil, Cameroon, DRC, Ghana, Guinea, India, Kenya, Nepal, Pakistan, Philippines, Senegal and Uganda
  • In the coming months further countries are due to come onboard to operationalise the CCP covering Bangladesh, CAR, Indonesia, Malaysia, Malawi and Thailand
  • Data collected and shared on nearly 24,000 COVID-19 patients

 

Supported by

Wellcome Trust logo      Foreign, Commonwealth and Development Office logo with transparent background

Read the case study examples below

Dr John Amuasi, Ghana (African Hub)

Trained as a medical doctor in Ghana, working as a medical officer at the 1,000-bed Komfo Anokye Teaching hospital in Kumasi, Ghana from 2004-2010. He also served as the Head of the Research and Development Unit of the Hospital from 2007-2010.

Dr Amuasi completed his post- graduate training at the University of Minnesota in the USA with a PhD in clinical research outcomes and has extensive experience in building trans-national research collaborations, dealing with national and international health authorities and reporting along a wide range of stakeholders.

He has served as a Steering Committee Member of the Ebola Data Sharing Platform (with other representatives from WHO, MSF, IMC, Wellcome Trust, Oxford University, WAHO).

In June 2017 Dr Amuasi also served as a member of the Strategic Review Group for the ISARIC.

He has been at the fore-front of global efforts towards addressing emerging and re-emerging infectious diseases and currently serve as an Executive Committee member of the African Coalition for Epidemic Research, Response and Training (ALERRT), where he co-leads Work-package 4 on Operational Readiness and resilience.

Learn more about the African Regional Hub case studies here.

Dr Fernando Bozza, Brazil (South American Hub)

Dr Bozza’s research activities involve clinical and translational research on severe emerging and reemerging infectious diseases, antimicrobial resistance, and the neuro-cognitive consequences of severe infections. He has also acted in the consolidation of collaborative clinical research initiatives in Brazil and Latin America, such as the Brazilian Intensive Care Research Network, where he was the founder and first president.

Dr Bozza’s research group has made significant contributions to managing emerging infectious diseases, including studies on dengue, Zika, Chikungunya, yellow fever, and COVID-19. Bozza has more than 250 peer reviewed papers, including publications in high-impact journals such as NEJM, JAMA, Nature, Lancet Infectious Diseases, Lancet Respiratory Medicine, Emerging infectious diseases, etc. Dr Bozza is a member of the ISARIC Board of Directors.

Dr Bozza coordinates the critical care and infectious disease research on the largest integrated hospital network in Latin America (IDOR-Rede D’Or São Luiz). The network is present in ten Brazilian States and comprises 63 hospitals.

Furthermore, Dr Bozza is grantee of the ICODA (International COVID-19 Data Alliance) Challenge, supported by Health Data Research UK (HDRUK) the and Bill & Melinda Gates foundation, being Principal Investigator of the EFFECT-Brazil project, which aims to evaluate the COVID-19 vaccine effectiveness in Brazil using statistical and machine learning models. His team comprises biomedical researchers, physicians, epidemiologists, engineers, and statisticians.

 

Learn more about the South American Regional Hub case studies here.

Professor Madiha Hashmi, Pakistan (South Asian Hub)

In 2017, Professor Hashmi established Pakistan Registry of Intensive CarE (PRICE), a real-time intensive care registry that was rolled out nationally and now has more than sixty collaborating intensive care units across Pakistan.

The cloud-based platform links routinely collected information to real-time dashboards, providing continuous granular healthcare information necessary to empower clinicians to drive setting-specific priorities for service improvement and research. PRICE is a co-founding member of ‘Critical Care Asia’- a Wellcome Trust and MORU project, the Collaboration for Research, Implementation and Training in Intensive CARE (CRITIcal CARE Asia) that seeks to improve the quality of critical care in the region.

The PRICE network was also recruited to international multicentre clinical trials regarding COVID-19 management, leveraging the registry platform data, namely REMAP-CAP and GenOMICC.

Professor Hashmi is also a member of the ISARIC Board of Directors, and is uniquely placed to spearhead projects in South Asia, aimed at generating clinical research evidence for severe acute respiratory and other emerging infections, in a region with challenged research capacity and infrastructure.

Learn more about the South Asian Regional Hub case studies here.

Dr Janice Caoili and Dr Muge Cevik, Philippines (Southeast Asian Hub)

Dr Janice Caoili is a senior infectious diseases specialist, Chief of the Infectious Diseases Section at Department of Medicine, Makati Medical Center and a Research Consultant at TDF. Her main interest focuses on TB, HIV, infection control, COVID-19 and emerging infections.

She has been engaged with research projects in South East Asia for over 15 years starting as coordinator for the US CDC Preserving Effective TB Treatment Study (PETTS) implemented in 9 countries including Thailand, Taiwan, South Korea and the Philippines and as the Deputy Program Manager for the HIV and AIDS Component, Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) Project.

She has collaborated with TB Alliance as the Principal Investifator (PI) for several Clinical Trials on novel anti TB drugs and new TB treatment regimen. These drugs are now part of drug resistant TB treatment regimens.

She is the PI of various clinical trials and projects at TDF and Makati Medical Center (MMC). She is the Co-investigator for MMC Site for the WHO Solidarity Trial for COVID-19 Treatment. This trial utilized an adaptive design and has enrolled 11,330 patients from 405 hospitals in 30 countries. The trial showed that some drugs used during the earlier part of the pandemic were not effective for COVID-19. Dr Caoili is one of the site leads for The WHO Solidarity Trial Vaccines that has enrolled almost 7,000 participants in the Philippines and still ongoing.

Dr Caoili is the Vice President and a Chair of the Philippine Society for Microbiology and Infectious Diseases (PSMID) and Board Member of the Philippine Coalition Against TB (PhilCAT) and involved in developing national guidelines and national strategy. She is also a member of the MMC Institutional Review Board involved in reviewing and monitoring of various research projects in the Philippines.

 

Since 2021, Dr Janice Caoili with Dr Muge Cevik coordinate the hub activities in Southeast Asia for the rollout of the WHO ISARIC CCP. Dr Muge Cevik is a physician and researcher in infectious diseases and medical virology, and provides advice on laboratory activities and interpretation of the results to inform public health response.

Learn more about the Southeast Asian Regional Hub case studies here.