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A new collaboration between Oxford, Brazil and Pakistan has been funded by the Bill & Melinda Gates Foundation. The partnership will provide researchers with de-identified health data from two of the worlds global COVID-19 hotspots to increase understanding of COVID-19 in these communities and help accelerate the management of the disease.

Global covid map © SHUTTERSTOCK

The COVID-19 pandemic has placed an unprecedented burden on global healthcare systems, particularly in under-resourced communities. The COVID-19 death rate in Brazil made it the second worst hit country in the world in 2020, and South Asia, home to a quarter of the world's population, is a COVID-19 hotspot. South Asian ethnicity is associated with a high risk of severe COVID-19 and related mortality however, there has been little or no real-world COVID-19 data analysis from South Asia or Brazil to explain the risk factors.

New funding from the Bill & Melinda Gates Foundation (the foundation) brings together researchers from the University of Oxford, with CIDACS (the Brazilian centre for big health data) and the Shaukat Khanum Memorial Hospital and Research Centre (SKMCH&RC) in Pakistan. Each institute holds large numbers of health records from patients in Brazil and Pakistan and these databases will be used to analyse the natural history of COVID-19 and characterise the disease to help inform decision-making around the care of hospitalised patients.

The initiative is led by Dr Sara Khalid, Senior Research Fellow in Biomedical Data Science and Health Informatics, NDORMS who said: "The Brazil and Pakistan databases will be mapped to OHDSI (Observational Health Data Sciences and Informatics), an initiative that enables teams from across the world to routinely share collected data and collaborate on real-world COVID-19 research on different groups, communities, and ethnicities. This is the first data we have from Latin America and South Asia, and it will be a significant milestone in our understanding of the COVID-19 pandemic in these regions. We hope this collaboration will be the beginning of a move towards globally inspired yet locally co-designed health analytics ecosystems."

OHDSI is a global network that brings out the value of health data through large-scale analytics. It is engaged in translational research towards the timely management of COVID-19 in a rapid and transparent manner which has impacted regulatory guidelines. This relies on mapping data by regional partners to a common data model (CDM). OHDSI's data sources cover over 500 million people globally, from 16 databases in the US, Europe and Asia.

The integration of the Brazil and Pakistan databases into the CDM creates the potential for observational research of COVID-19 and findings will be shared with Pakistan and Brazil's national COVID-19 taskforces, the foundation, WHO and other international stakeholders.

Dr Haroon Hafeez of the SKMCH&RC in Pakistan said: "Our IT team at SKMCH&RC will map our data to the CDM, and with support from the Oxford team and colleagues from OHDSI we will share our aggregated results. We are excited about the potential of this data towards understanding COVID-19 and developing future guidelines based on evidence. We strongly feel that this study will lay the foundation of efforts towards building data ecosystems in this region."

Elzo Pereira Pinto Junior, Researcher at CIDACS/Fiocruz Bahia said: "The Oxford-Brazil-Pakistan partnership demonstrates the relevance of researchers using real-world data from the Global-South to face the COVID-19 pandemic. In the future, we plan to apply what we learned in this project to address other relevant topics in public health, like cancer and child mortality. In addition, this initiative can represent a new way to produce knowledge in real-time, based on an international network and strongly influenced by the open science principles."

Mauricio Barreto, Professor of Epidemiology and Cidacs Director said: "There are huge challenges in analyzing data produced in different countries. This initiative involving researchers and institutions from two large countries from the South is a unique experience that we hope can be shared and multiplied."

Daniel Prieto-Alhambra, Professor of Pharmaco- and Device Epidemiology at the University of Oxford said: "It is critical that management of COVID-19 is based on real-world evidence. To be able to analyse data from these countries in the global south for the first time, will be a huge step forward in national and regional COVID-19 public health strategies and guidelines in Pakistan and Brazil."

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