Clinical research in the context of rapidly emerging public health threats

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A key lesson from a series of recent outbreaks of emerging pathogens of global public health importance including SARS-CoV, highly pathogenic avian influenza A (H5N1) virus, Nipah virus and the 2009 H1N1 virus pandemic was that mounting clinical research in response to a rapidly emerging infectious disease is extremely challenging and often delayed. During these events, important pathogenesis and clinical management data came mostly from sites that were already undertaking related clinical studies including those on inter-pandemic influenza (e.g., SEAICRN, Institute Pasteur Networks, Chinese University of Hong Kong, and University of Hong Kong) or from established national or regional research networks such as the Canadian and Australia/New Zealand Critical Care Trials Group.