Background. The WHO Unity Studies initiative supports countries, especially low- and middle-income countries (LMICs), to conduct seroepidemiologic studies for rapidly informing responses to the COVID-19 pandemic. Ten generic study protocols were developed which standardized epidemiologic and laboratory methods. WHO provided technical support, serological assays, and funding for study implementation. An external evaluation was conducted to assess 1) the usefulness of study findings in guiding response strategies, 2) management and support to conduct studies, and 3) capacity built from engagement with the initiative.
Methods. The evaluation focused on the three most used protocols, first few cases, household transmission, and population-based serosurvey, 66% of 339 studies tracked by WHO. All 158 principal investigators (PIs) with contact information were surveyed online. Interviews were conducted with 15 PIs (randomly selected within WHO regions), 14 WHO Unity focal points at country, regional and global levels, 12 WHO global-level stakeholders, and eight external partners. Interviews were coded in MAXQDA™, synthesized into findings, and cross-verified by a second reviewer.
Results. Among 69 (44%) survey respondents, 61 (88%) were from LMICs. Ninety-five percent gave positive feedback on technical support, 87% reported findings contributed to COVID-19 understanding, 65% for guiding public health and social measures, and 58% for guiding vaccination policy. Survey and interview groups responses showed that the main technical barriers to using study findings were study quality, variations in study methods (challenge for meta-analysis), completeness of reporting study details, and clarity of communicating findings. Untimely study findings was another barrier, caused by delays in ethical clearance, receipt of serological assays, and approval to share findings. There was strong agreement that the initiative created equitable research opportunities, connected expertise, and facilitated study implementation. Around 90% of respondents agreed the initiative should continue in the future.
Conclusions. The Unity Studies initiative created a highly valued community of practice, contributed to study implementation and research equity, and serves as valuable framework for future pandemics. To strengthen this platform, WHO should establish emergency-mode procedures to facilitate timeliness and continue to build capacity to rapidly conduct high-quality studies and communicate findings in a format friendly to decision-makers.