Background:Cost, availability and accessibility can influence the patterns of antibiotic use, adherence to prescriptions and the development of antimicrobial resistance. Aim:To assess the cost, availability and affordability of antibiotics in Islamic Republic of Iran using the WHO access, watch and reserve classification. Methods:We analysed secondary data for March 2023 to March 2024 on cost, availability and affordability of antibiotics in Islamic Republic of Iran, using the WHO access, watch and reserve classification. Cost and affordability were compared between the access, watch and reserve antibiotic groups using the Kruskal-Wallis and Mann-Whitney U tests. P ≤ 0.05 was considered statistically significant. Results:Most injectable antibiotics were unaffordable while most oral formulations were affordable. Among the injectables, streptomycin was the cheapest (15 000 IRR/defined daily dose), followed by procaine-benzylpenicillin (82 325 IRR/defined daily dose), while temocillin was the most expensive (25 828 000 IRR/defined daily dose). However, streptomycin and temocillin were not in the essential medicines list. Among the orals, nitrofurantoin was the cheapest (12 370 IRR/defined daily dose) while linezolid was the most expensive (1 030 558 IRR/defined daily dose). There were statistically significant differences in prices (P = 0.007) and affordability (P = 0.035) between the access, watch and reserve groups. Affordability was significantly lower for the reserve group of antibiotics (P = 0.04). Conclusion:Our findings show that although access antibiotics remain largely affordable, watch group antibiotics were used excessively. Targeted policies are needed on the pricing, production, distribution, and prescription of antibiotics in Islamic Republic of Iran to promote rational use and curb antimicrobial resistance.

Objectives Enabling the reuse of participant-level health data is central to advancing public health and clinical practice. Measuring knowledge, attitudes and practices (KAP) related to data sharing is essential for understanding how stakeholders perceive data reuse and where further investment is needed. We conducted a measurement systematic review to identify and describe the development, scope and measurement properties of quantitative surveys assessing data-sharing-related KAP in biomedical research.Design Systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) approach.Data sources Ovid (MEDLINE), EMBASE, CINAHL, PsycINFO and HaPI were searched for relevant surveys from 1 January 2000 to 7 April 2021. The Ovid (MEDLINE) search was updated on 30 May 2022 and 15 April 2024.Eligibility criteria Quantitative surveys measuring knowledge, attitudes, behaviours or practices related to sharing or reusing participant-level health data were included.Data extraction and synthesis Two independent reviewers screened studies, extracted data and, where possible, applied the COSMIN Risk of Bias checklist to assess survey measurement properties. We summarised survey scope, target populations, data types, development and measurement properties narratively. Due to substantial heterogeneity, survey findings were not compared across studies.Results We screened 3684 title-abstracts, reviewed 104 full texts and extracted data from 72 publications representing 60 independent surveys. Most surveys originated from high-income countries and were used only once. Fewer than one-third reported pilot testing. Only six surveys provided sufficient information to apply COSMIN, and only three reported measurement properties, indicating low certainty in the available evidence.Conclusions This is the first systematic comparison of the development and measurement properties of quantitative survey instruments assessing data-reuse KAP. Most surveys lacked rigorous development and reporting, limiting their utility for comparing KAP related to data sharing across stakeholders and settings. The review findings will inform the creation of a cross-country, cross-disciplinary question bank to support future tool development.PROSPERO registration number CRD42021243926.

Knowledge Translation (KT) research investigates methods to promote the uptake of research by practitioners, managers and policy-makers. Rooted in decades of interdisciplinary scholarship showing that evidence use is shaped by social sense‑making, institutions and politics, KT has moved beyond a linear “research to policy” model. Yet, persistent gaps between evidence and decision‑making, as well as uneven institutional capacity and fragmented KT research motivated the development of WHO’s Global Research Agenda: to prioritize rigorous, context‑sensitive KT research that addresses systemic, governance and practical barriers to sustained evidence‑informed policy-making (EIP). From October 2023 to March 2025, a structured five-step approach was undertaken, starting with synthesizing existing evidence on KT strategies and priorities, and complemented by primary data from a global survey. These inputs were used to develop a conceptual framework to organize KT research priority areas. This framework guided a global consultative process, which engaged diverse interest-holders through online consultations and Delphi surveys to jointly identify research gaps, opportunities and priority areas for inclusion in the final research agenda. The initial step of evidence synthesis identified 120 research areas. Through the global consultative process, these were refined to 19 priority research areas organized into three domains: (1) research on KT/EIP interventions, (2) research on barriers, facilitators and opportunities for KT/EIP and (3) research on KT/EIP methods, standards, measurement, theories and frameworks. Specific research areas include strategies to institutionalize KT, contextual factors influencing evidence uptake and exploring innovative technologies such as Artificial Intelligence. This study proposes a prioritized research agenda to guide future KT/EIP research and inform funding decisions. The agenda requires sustained engagement with interest-holders to maximize its impact. Future research should validate and refine the priorities, and ensure relevance, utility and effective implementation across diverse settings. The GRA is more than a technical checklist; it is a strategic roadmap for navigating the political and institutional dimensions of evidence use, enabling a shift beyond supply-side fixes toward a relational, politically aware KT/EIP approach. This shift is essential to embed evidence use in routine decision-making, strengthen system resilience and advance health equity through sustained institutional reform.

Background:There is a lack of national data on antibiotic consumption by teaching hospitals in Islamic Republic of Iran based on the WHO access, watch and reserve categorisation. Aim:To quantify antibiotic consumption by teaching hospitals in Islamic Republic of Iran. Methods:We analysed antibiotic consumption data for March 2023 to March 2024 across all 248 teaching hospitals in the 10 regions of Islamic Republic of Iran, using the WHO-defined daily dose methodology and the access, watch and reserve categorisation. Results:Median antibiotic consumption was 299 defined daily dose per 100 admissions per day. Hospitals in Region 10 had the highest overall consumption (24.3% of total consumption), while Region 7 showed the highest use of reserve group antibiotics. Across all hospitals and regions, watch antibiotics were the most used (61%), followed by access (37%) and reserve (2%). Ceftriaxone 1 g and cefazolin 1 g were the most frequently used (11% of total consumption each), followed by meropenem 1 g injection (8.8%) and vancomycin 0.5 g (7%). Conclusion:Our findings show high reliance on watch antibiotics, extensive cephalosporin use and prevalent parenteral formulations. There is a need to assess the appropriateness of antibiotic use in Iranian teaching hospitals in order to strengthen antibiotic stewardship.

Background The coronavirus disease 2019 (COVID-19) has caused substantial morbidity and mortality on a global scale. A strong correlation has been found between COVID-19 treatment outcomes and noncommunicable diseases such as cancers. However, there is limited information on the outcomes of cancer patients who were hospitalised for COVID-19. Methods We conducted an analysis on data collected in a large prospective cohort study set-up by the World Health Organisation (WHO) International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). All patients with laboratory-confirmed or clinically-diagnosed SARS-CoV-2 infection were included. Cancer was defined as having a current solid organ or haematological malignancy. The following outcomes were assessed; The hazard ratio of 30-day in-hospital mortality, intensive care unit (ICU) admission, length of hospitalization and receipt of higher-level care. Results Of the 560,547 hospitalised individuals who were analysed, 27,243 (4.9%) had cancer. Overall, cancer patients were older and had more comorbidities than non-cancer patients. Patients with cancer had a higher hazard ratio of 30-day in-hospital mortality than non-cancer patients (29.1.3% vs 18.0%) and longer hospital stays (median of 12 days vs 8 days). However, patients with cancer were admitted less often to intensive care units than non-cancer patients (12.6% vs 17.1%) and received less invasive mechanical ventilation than non-cancer patients (4.5% vs 7.6%). The hazard ratio of dying from cancer, adjusted for age, sex and country income level was 1.18 (95%CI: 1.15-1.2). Conclusions This study’s findings underscore the heightened vulnerability of hospitalized COVID-19 patients with cancer, revealing a higher mortality rate, longer hospital stays, and an unstructured pattern of care that reflects the complexity of managing severely ill patients during a public health crisis like the COVID-19 pandemic.

Objective:To explore the global research funding landscape for traditional, complementary and integrative medicine. Methods:We conducted a three-part study to assess the global research funding landscape. First, we searched the Dimensions database and online sources using Microsoft Copilot and Google between 12 November 2024 and 22 January 2025 for relevant grants. Second, we analysed national research infrastructure using World Health Organization (WHO) data, verified by regional contacts (14 January-28 February 2025). Third, we appraised selected funders across WHO regions, evaluating funding schemes for innovation, capacity-building and alignment with traditional medicine paradigms. Findings:We identified 39 927 grants in the Dimensions database, with funding data available for 27 019 grants totalling 24.5 billion United States dollars (US$) for the years 1960 to 2024. Most grants (42.6%; 11 548) were valued under US$ 100 000, and half had a duration of 2-4 years. Cancer and cardiovascular diseases accounted for over half (8385/15 273) of topic-categorized grants, receiving US$ 5.8 billion and US$ 2.2 billion, respectively. Funders were concentrated in the Region of the Americas, and European and Western Pacific Regions. Only seven countries had schemes explicitly funding research for traditional, complementary and integrative medicine. Case study analysis of 40 schemes across 12 countries revealed limited support for traditional medicine paradigms, with few schemes meeting criteria for innovation, capacity-building or sensitivity to traditional knowledge systems. Conclusion:Funding for traditional medicine research remains disproportionately low relative to its global use. Strengthening support from research funding agencies is essential to achieving the goals of the WHO Global traditional medicine strategy 2025-2034.

Background:The coronavirus disease 2019 (COVID-19) has caused substantial morbidity and mortality on a global scale. A strong correlation has been found between COVID-19 treatment outcomes and noncommunicable diseases such as cancers. However, there is limited information on the outcomes of cancer patients who were hospitalised for COVID-19. Methods:We conducted an analysis on data collected in a large prospective cohort study set-up by the World Health Organisation (WHO) International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). All patients with laboratory-confirmed or clinically-diagnosed SARS-CoV-2 infection were included. Cancer was defined as having a current solid organ or haematological malignancy. The following outcomes were assessed; The hazard ratio of 30-day in-hospital mortality, intensive care unit (ICU) admission, length of hospitalization and receipt of higher-level care. Results:Of the 560,547 hospitalised individuals who were analysed, 27,243 (4.9%) had cancer. Overall, cancer patients were older and had more comorbidities than non-cancer patients. Patients with cancer had a higher hazard ratio of 30-day in-hospital mortality than non-cancer patients (29.1.3% vs 18.0%) and longer hospital stays (median of 12 days vs 8 days). However, patients with cancer were admitted less often to intensive care units than non-cancer patients (12.6% vs 17.1%) and received less invasive mechanical ventilation than non-cancer patients (4.5% vs 7.6%). The hazard ratio of dying from cancer, adjusted for age, sex and country income level was 1.18 (95%CI: 1.15-1.2). Conclusions:This study's findings underscore the heightened vulnerability of hospitalized COVID-19 patients with cancer, revealing a higher mortality rate, longer hospital stays, and an unstructured pattern of care that reflects the complexity of managing severely ill patients during a public health crisis like the COVID-19 pandemic.

Background The effective translation of evidence into policy requires strategic engagement among interest-holders to identify current knowledge gaps, align funding, and minimize research duplication. This study outlines the methods and results of a multi-stage process to develop WHO’s first Global Research Agenda (GRA) on Knowledge Translation and Evidence-informed Policy-making (KT/EIP), aimed at improving research efficiency, guiding funding, increasing evidence use, fostering collaboration, and raising awareness of KT research. Methods From October 2023 to March 2025, a structured five-step approach was undertaken, starting with synthesizing existing evidence on KT strategies and priorities and complemented by primary data from a global survey. These inputs were used to develop a conceptual framework to organize research priority areas. This framework guided a global consultative process, which engaged diverse interest-holders through online consultations and Delphi surveys to jointly identify research gaps, opportunities, and priority areas for inclusion in the final research agenda. Results The initial step of evidence synthesis identified 120 research areas. Through the global consultative process, these were refined to 19 priority research areas organized into three domains: 1) Research on KT/EIP interventions, 2) Research on barriers, facilitators, and opportunities for KT/EIP, and 3) Research on KT/EIP methods, standards, measurement, theories, and frameworks. Specific research areas include strategies to institutionalize KT, targeted approaches for public health emergencies, contextual factors influencing KT/EIP uptake, and the exploration of innovative technologies like Artificial Intelligence. Conclusions This study proposes a prioritized research agenda to guide future KT/EIP research and inform funding decisions. This resource for researchers, policy-makers, and funders requires sustained engagement with interest-holders to maximize its impact. Future research should validate and refine this agenda, and ensure relevance, utility, and effective implementation across diverse settings.

Objective Synthesise the published literature and national regulations on infrastructure, capabilities and capacities required to manage and quality assure clinical research. Introduction The World Health Assembly (WHA) resolution 75.8 (2022) called “for a strengthened global architecture for coordinated and high-quality clinical trials”. For this remit, infrastructure, capabilities, and capacities needed to design and deliver high-quality clinical trials must be understood and advanced. This rapid scoping review aims to identify the breadth of requirements and recommendations for effective management of clinical trials in regulations, national legislation and the published literature. The findings will be summarised into themes. It will inform a framework for the assessment and development of units undertaking observational studies and interventional clinical trials. Inclusion criteria Peer-reviewed literature, grey literature, and national legislation that recommends infrastructure, capabilities, and/or capacities needed to manage and quality assure clinical trials. Publications authored by those who design, manage, fund, sponsor, regulate or oversee clinical trials. Methods Peer-reviewed and grey literature will be identified through Medline, Embase, PsycINFO, and Global Health via Ovid; SCOPUS; the Web of Science Core Collection; and the WHO Global Index Medicus using specific field codes to increase the specificity of the search strings. No date, language, or geographic limits will be applied. Deduplicated titles and abstracts will be screened by two blinded reviewers with discrepancies resolved by a third reviewer. Grey literature may be identified through the peer reviewed literature, supplemented with structured searches of Google and DynaMed. National regulations will be sourced online and from available summaries. Full text literature and regulations will be screened by a single reviewer, with proportionate verification by a second reviewer. Data will be extracted and coded for patterns in NVivo software. All items and codes will be summarised using a thematic framework analysis and identify core constructs within each theme.

Data sharing is central to the rapid translation of research into advances in clinical medicine and public health practice. In the context of COVID-19, there has been a rush to share data marked by an explosion of population-specific and discipline-specific resources for collecting, curating, and disseminating participant-level data. We conducted a scoping review and cross-sectional survey to identify and describe COVID-19-related platforms and registries that harmonise and share participant-level clinical, omics (eg, genomic and metabolomic data), imaging data, and metadata. We assess how these initiatives map to the best practices for the ethical and equitable management of data and the findable, accessible, interoperable, and reusable (FAIR) principles for data resources. We review gaps and redundancies in COVID-19 data-sharing efforts and provide recommendations to build on existing synergies that align with frameworks for effective and equitable data reuse. We identified 44 COVID-19-related registries and 20 platforms from the scoping review. Data-sharing resources were concentrated in high-income countries and siloed by comorbidity, body system, and data type. Resources for harmonising and sharing clinical data were less likely to implement FAIR principles than those sharing omics or imaging data. Our findings are that more data sharing does not equate to better data sharing, and the semantic and technical interoperability of platforms and registries harmonising and sharing COVID-19-related participant-level data needs to improve to facilitate the global collaboration required to address the COVID-19 crisis.

Implementing infection prevention and control (IPC) programmes in line with the World Health Organization’s (WHO) eight core components has been challenging in Sierra Leone. In 2021, a baseline study found that IPC compliance in three tertiary hospitals was sub-optimal. We aimed to measure the change in IPC compliance and describe recommended actions at these hospitals in 2023. This was a ‘before and after’ observational study using two routine cross-sectional assessments of IPC compliance using the WHO IPC Assessment Framework tool. IPC compliance was graded as inadequate (0–200), basic (201–400), intermediate (401–600), and advanced (601–800). The overall compliance scores for each hospital showed an improvement from ‘Basic’ in 2021 to ‘Intermediate’ in 2023, with a percentage increase in scores of 16.9%, 18.7%, and 26.9% in these hospitals. There was improved compliance in all core components, with the majority in the ‘Intermediate’ level for each hospital IPC programme. Recommended actions including the training of healthcare workers and revision of IPC guidelines were undertaken, but a dedicated IPC budget and healthcare-associated infection surveillance remained as gaps in 2023. Operational research is valuable in monitoring and improving IPC programme implementation. To reach the ‘Advanced’ level, these hospitals should establish a dedicated IPC budget and develop long-term implementation plans.

Antimicrobial resistant (AMR) bacteria in effluents from seafood processing facilities can contribute to the spread of AMR in the natural environment. In this study conducted in Tema, Ghana, a total of 38 effluent samples from two seafood processing facilities were collected during 2021 and 2022, as part of a pilot surveillance project to ascertain the bacterial load, bacterial species and their resistance to 15 antibiotics belonging to the WHO AWaRe group of antibiotics. The bacterial load in the effluent samples ranged from 13–1800 most probable number (MPN)/100 mL. We identified the following bacterial species: E. coli in 31 (82%) samples, K. pneumoniae in 15 (39%) samples, Proteus spp. in 6 (16%) samples, P. aeruginosa in 2 (5%) samples and A. baumannii in 2 (5%) samples. The highest levels of antibiotic resistance (100%) were recorded for ampicillin and cefuroxime among Enterobacteriaceae. The WHO priority pathogens—E. coli (resistant to cefotaxime, ceftazidime and carbapenem) and K.pneumoniae (resistant to ceftriaxone)—were found in 5 (13%) effluent samples. These findings highlight the need for enhanced surveillance to identify the source of AMR and multi-drug resistant bacteria and an adoption of best practices to eliminate these bacteria in the ecosystem of the seafood processing facilities.

BACKGROUND: A growing body of evidence shows that sharing health research data with other researchers for secondary analyses can contribute to better health. This is especially important in the context of a public health emergency when stopping a pandemic depends on accelerating science. METHODS: We analysed the information on data sharing collected by the 18 clinical trial registries included in the WHO International Clinical Trials Registry Platform (ICTRP) to understand the reporting of data sharing plans and which studies were and were not planning to share data. Data on sponsor and funder organisations, country of recruitment, registry, and condition of study were standardised to compare the sharing of information and data across these facets. This represents the first ever comprehensive study of the complete data set contained in ICTRP. RESULTS: Across 132,545 studies registered between January 2019 and December 2020, 11.2% of studies stated that individual patient data (IPD) would be shared. Plans to share IPD varied across the 18 contributing registries– information on data sharing was missing in >95% of study records across 7/18 registries. In the 26,851 (20.3%) studies that were funded or sponsored by a commercial entity, intention to share IPD was similar to those that were not (11.5% vs 11.2%). Intention to share IPD was most common in studies recruiting across both high-income and low- or middle-income countries (21.4%) and in those recruiting in Sub-Saharan Africa (50.3%). Studies of COVID-19 had similar levels of data sharing to studies of other non-pandemic diseases in 2020 (13.7% vs 11.7%). CONCLUSIONS: Rates of planned IPD sharing vary between clinical trial registries and economic regions, and are similar whether commercial or non-commercial agencies are involved. Despite many calls to action, plans to share IPD have not increased significantly and remain below 14% for diseases causing public health emergencies.

The Infectious Diseases Data Observatory (IDDO, https://www.iddo.org) has launched a clinical data platform for the collation, curation, standardisation and reuse of individual participant data (IPD) on treatments for two of the most globally important neglected tropical diseases (NTDs), schistosomiasis (SCH) and soil-transmitted helminthiases (STHs). This initiative aims to harness the power of data-sharing by facilitating collaborative joint analyses of pooled datasets to generate robust evidence on the efficacy and safety of anthelminthic treatment regimens. A crucial component of this endeavour has been the development of a Research Agenda to promote engagement with the SCH and STH research and disease control communities by highlighting key questions that could be tackled using data shared through the IDDO platform. Here, we give a contextual overview of the priority research themes articulated in the Research Agenda—a ‘living’ document hosted on the IDDO website—and describe the three-stage consultation process behind its development. We also discuss the sustainability and future directions of the platform, emphasising throughout the power and promise of ethical and equitable sharing and reuse of clinical data to support the elimination of NTDs.

There is little published information on antimicrobial resistance (AMR) in animals in Ghana. We determined the prevalence and factors associated with AMR, multi-drug resistance (MDR-resistance to ≥3 antimicrobial classes) and colistin resistance in Enterobacteriaceae in healthy pigs in Accra, Ghana. Rectal swabs obtained from the pigs on 20 farms from January to March 2022, were examined for Escherichia coli, Enterobacter spp. and Klebsiella pneumoniae. AMR was determined using standard microbiological techniques and the mcr-1 gene detected through molecular analysis. Enterobacteriaceae were isolated from 197 of 200 pigs: these comprised 195 E. coli isolates, 38 Enterobacter spp. and 3 K. pneumoniae, either singly or combined. Over 60% of E. coli were resistant to tetracycline, with 27% and 34% being resistant to amoxicillin/clavulanic acid and ampicillin, respectively; 23% of E. coli and 5% of Enterobacter spp. exhibited MDR phenotypes. Phenotypic colistin resistance was found in 8% of E. coli and Enterobacter spp., with the mcr-1 gene detected in half. Our study findings should be incorporated into on-going AMR, MDR and colistin resistance surveillance programs in Ghana. We further advocate for tailored-specific education for pig farmers on animal antimicrobial use and for strengthened regulatory policy on antimicrobial usage and monitoring in the animal production industry.

Background: Monitoring of antibiotic prescription practices in hospitals is essential to assess and facilitate appropriate use. This is relevant to halt the progression of antimicrobial resistance. Methods: Assessment of antibiotic prescribing patterns and completeness of antibiotic prescriptions among out-patients in 2021 was conducted at the University Hospital of Kwame Nkrumah University of Science and Technology in the Ashanti region of Ghana. We reviewed electronic medical records (EMR) of 49,660 patients who had 110,280 encounters in the year. Results: The patient encounters yielded 350,149 prescriptions. Every month, 33–36% of patient encounters resulted in antibiotic prescription, higher than the World Health Organization’s (WHO) recommended optimum of 27%. Almost half of the antibiotics prescribed belonged to WHO’s Watch group. Amoxicillin–clavulanic acid (50%), azithromycin (29%), ciprofloxacin (28%), metronidazole (21%), and cefuroxime (20%) were the most prescribed antibiotics. Antibiotic prescribing parameters (indication, name of drug, duration, dose, route, and frequency) were documented in almost all prescriptions. Conclusions: Extending antimicrobial stewardship to the out-patient settings by developing standard treatment guidelines, an out-patient specific drug formulary, and antibiograms can promote rational antibiotic use at the hospital. The EMR system of the hospital is a valuable tool for monitoring prescriptions that can be leveraged for future audits.

Background: Monitoring of adverse drug reactions (ADRs) to antimicrobials is important, as they can cause life-threatening illness, permanent disabilities, and death. We assessed country-wide ADR reporting on antimicrobials and their outcomes. Methods: A cross-sectional study was conducted using individual case safety reports (ICSRs) entered into the national pharmacovigilance database (VigiFlow) during 2017–2021. Results: Of 566 ICSRs, inconsistent reporting was seen, with the highest reporting in 2017 and 2019 (mass drug campaigns for deworming), zero reporting in 2018 (reasons unknown), and only a handful in 2020 and 2021 (since COVID-19). Of 566 ICSRs, 90% were for antiparasitics (actively reported during mass campaigns), while the rest (passive reporting from health facilities) included 8% antibiotics, 7% antivirals, and 0.2% antifungals. In total, 90% of the reports took >30 days to be entered (median = 165; range 2–420 days), while 44% had <75% of all variables filled in (desired target = 100%). There were 10 serious ADRs, 18 drug withdrawals, and 60% of ADRs affected the gastrointestinal system. The patient outcomes (N-566) were: recovered (59.5%), recovering (35.5%), not recovered (1.4%), death (0.2%), and unknown (3.4%). There was no final ascertainment of ‘recovering’ outcomes. Conclusions: ADR reporting is inconsistent, with delays and incomplete data. This is a wake-up call for introducing active reporting and setting performance targets.

Data sharing is central to the rapid translation of research into advances in clinical medicine and public health practice. In the context of COVID-19, there has been a rush to share data, marked by an explosion of population- and discipline-specific resources for collecting, curating, and disseminating participant-level data. We present a comprehensive overview of COVID-19-related platforms and registries that harmonize and share participant-level clinical, OMICs, and imaging data and metadata, and describe how these initiatives map to best practice for ethical, equitable, and FAIR management of data resources. Data sharing resources were concentrated in high income countries and siloed by comorbidity, body system, and data type. Resources for sharing clinical data were less FAIR than those for sharing OMICs or imaging data. We review gaps and redundancies in COVID-19 data sharing efforts and outline recommendations to build on existing synergies and align with frameworks for effective and equitable data reuse.