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The next influenza pandemic is a case of when, rather than if. In the last influenza pandemic in 2009, 201,200 people died worldwide.
The UK is leading the world in preparation for such outbreaks, thanks to an innovative network of health research studies maintained in 'hibernation', ready to be activated from the onset of the epidemic.
This approach is a more effective alternative to previous practice in the UK. It was necessary to wait for a pandemic to be declared before launching studies which then have difficulty getting in tune quickly enough.
The new approach is promising elsewhere in the world as well as for other health emergencies, including other infectious diseases and chemical, biological and radiological incidents.
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Pandemic flu preparedness
We describe the development and benefits of hibernate studies in an article published today.
This initiative was a follow-up to the UK's experience in the last influenza pandemic, the 2009 A / H1N1 strain, commonly known as "swine flu". At least 3,700 people died in the UK and 201,200 worldwide. It was a variant of the "Spanish flu" strain that killed more than 50 million people worldwide in 1918.
In 2009, the National Institute for Health Research (IRDH) quickly sponsored and activated studies to document clinical and public health responses to the epidemic. Even with accelerated processes, some have been completed too late to have a significant impact. Some studies have suffered from delays in the call for proposals and the evaluation, funding and implementation of subsequent projects, including the receipt of relevant ethical and regulatory approvals.
Search ready to leave when needed
Major research networks from other countries shared the experience. In 2012, the NHIR set up a series of studies to maintain activation for activation in the event of a new influenza pandemic. The eight studies focus on key aspects of a pandemic influenza related to care and public health, including surveillance, vaccination, triage and clinical management.
One study is to develop rapid influenza phone surveys to monitor the behavior of the general population and to identify ways to better communicate public health advice. Another is to advance the real-time modeling of influenza outbreaks and provide a tool to monitor and predict the progress of an ongoing pandemic.
The study I'm leading, the EAVE project, aims to create a reporting platform that will determine the effectiveness of new vaccines or antiviral drugs when a new influenza pandemic is underway.
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Foster collaboration
After seven years, these studies are now mature and, in our opinion, illustrate the importance of the potential for rapid research, as well as clinical response and public health, in a future influenza pandemic.
Hibernation has raised a number of issues, reflecting the need to maintain stakeholder engagement (including policy makers and research organizers) and to keep studies up-to-date in terms of regulatory compliance. research, scientific and social changes and technological progress.
The spirit of cooperation is one of the advantages of the network. Too often, researchers compete when they attempt to answer research questions in an emergency situation. The response of research to the 2014 Ebola outbreak in West Africa was late, then competitively inappropriate. This resulted in several underfed and unsuccessful studies. On the other hand, the British model makes it possible to advance the financing and the planning of complementary studies, to test the system and to develop a collaborative network of researchers.
The challenge ahead is that trade-financed studies do not compete for scarce resources and fit into this framework to ensure that the highest quality studies are conducted as quickly as possible. With this in mind, the time may have come to establish an international registry of studies on pandemics and emerging infections planned, along with collaborative arrangements.
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