The WHO Investigations and Studies Initiative, commonly known as the Unity Studies serves as a global and regional mechanism to strengthen preparedness and readiness for future pandemics.
The Initiative complements routine surveillance systems by enabling targeted, standardized epidemiological investigations that address priority questions on transmission dynamics, disease severity, population susceptibility, and the effectiveness of public health and social measures.
These investigations are particularly valuable during the early stages of an epidemic or pandemic, and can also be applied on an ongoing, periodic, or alert driven‑driven basis, such as in response to the emergence of a new respiratory virus subtype, variant, or lineage.
Through the use of standardized protocols and a coordinated network of global and regional implementation sites, the Initiative enhances the generation of evidence for public health action, supports international comparability of epidemiological findings, and strengthens operational research as part of collaborative surveillance. It also contributes to national efforts to implement and adapt public health and social measures based on timely, high quality‑quality data.
To address early surveillance needs in a timely and effective manner, several preconditions must be in place. These include ethically approved study protocols for defined populations, clearly identified resources, and well established‑established roles and responsibilities to carry out study activities. Robust data governance arrangements (covering data sharing, analysis, and reporting) are also essential at the country level. Together, these elements ensure that countries and regions are equipped to rapidly implement targeted investigations and generate high quality scientific evidence to guide public health ‑quality scientific evidence to guide public health decision making at national, regional, and global levels during epidemics and pandemics.
The Global Influenza Programme (GIP) at WHO headquarters coordinates the Unity Studies Sites Network globally. In close collaboration with headquarters, the WHO South‑East Asia Region (SEAR) initiated the establishment of the regional chapter of the Unity Studies Sites Network in early 2024.
The SEAR Unity Studies Sites Network is coordinated by the Pandemic and Epidemic Management (PEM) unit (formerly Infectious Hazards Management Unit-IHM) of the WHO Health Emergencies Programme at the WHO Regional Office for South‑East Asia (SEARO).
Virtual meeting to introduce the concept and Terms of Reference (ToR)
In early 2024, the WHO Regional Office for South‑East Asia (SEARO) initiated preparatory consultations to establish the South‑East Asia Regional (SEAR) chapter of the Unity Studies Network. This followed initial communication from WHO Headquarters and the release of the global Terms of Reference (ToR) for the WHO Unity Studies Sites Network. The ToR outlined the purpose and scope of the network, defined the roles and responsibilities of participating institutions, described the benefits of participation, and specified the criteria for selection of implementation sites
On 3 July 2024, WHO SEARO convened a preliminary regional meeting (virtual) with institutions eligible to serve as network sites, WHO Country Offices (WCOs), and WHO Headquarters. The eligible SEAR sites were identified based on their previous implementation of Unity Studies during the COVID‑19 pandemic and their demonstrated capacities to conduct investigations and studies in line with the Terms of Reference. The meeting introduced the Unity Studies concept, outlined its operational framework and Terms of Reference, and provided an overview of available study protocols as well as key technical considerations for research readiness activities.
Participants of the WHO SEAR preliminary meeting on Unity Studies (Credit: IHM/WHE/ SEARO)
As an outcome of the meeting, institutions were requested to review the proposed Terms of Reference (ToR) and provide feedback by mid‑2024 to support its regional adaptation. WHO Headquarters committed to finalizing the ToR and sharing updates with SEARO. SEARO was tasked with initiating formal communication through WHO Country Offices to interested institutions, inviting them to join the network and acknowledge the ToR. The meeting also emphasized the importance of establishing a community of practice to foster collaboration and exchange of ideas, even ahead of the formal endorsement of the regional network.
Regional adaptation of the ToR and its Acknowledgement
Following the preliminary meeting, focal points from the eligible study sites and the relevant WHO Country Offices in the South‑East Asia Region reviewed and provided feedback on the global ToR. This review included several elements unique to the SEAR context. In consultation and agreement with WHO Headquarters, the ToR were subsequently adapted and finalized to align with South-East Asia regional needs and implementation priorities, with the SEAR‑specific version completed in November 2024.
The SEAR‑adapted ToR is available here.
Global Launch of the Unity Studies Network
WHO formally launched the network of sites of the WHO Global Influenza Surveillance and Response System (GISRS) Unity Studies, through a virtual meeting held from 28 May to 5 June 2025. The meeting brought together more than 60 participants from all six WHO regions, including representatives from current and prospective network sites, WHO Headquarters, WHO regional and country offices, and global technical partners. From the South‑East Asia Region, representatives from six sites across five Member States, along with relevant WHO Country Offices and the Regional Office, participated in the virtual meeting. Table 1 below lists the SEAR sites that joined the global launch.
The launch established a coordinated global network to strengthen preparedness for pandemics caused by influenza and other emerging respiratory viruses with epidemic or pandemic potential. It emphasized the use of harmonized protocols, the implementation of standardized and high‑quality studies, and the promotion of collaborative surveillance across regions. These efforts directly support Output 2 of the Pandemic Influenza Preparedness Framework Partnership Contribution High‑Level Implementation Plan III (2024–2030).
This milestone marked the transition of Unity Studies from an emergency‑adapted initiative during the COVID‑19 pandemic to a sustained, globally integrated research network within GISRS for epidemic and pandemic preparedness. The initiative expanded its scope beyond influenza and strengthened the platform for the equitable generation of rapid, comparable data to inform global risk assessments and support the timely launch of effective pandemic responses.
SEAR Unity Studies Network Sites
By mid‑2025, six sites across five countries in the South‑East Asia Region formally acknowledged the terms of reference, confirming their institutional commitment to the Unity Studies Network. Participating sites designated national focal points or principal investigators to coordinate activities with WHO. Table 1 below lists the Unity Studies sites in SEAR that formally acknowledged and joined the network by the end of 2025.
Table 1: Unity Studies Sites in SEAR with the focal points
| Member States | Name of Unity Studies Sites | Principal Investigators/Focal points |
|---|---|---|
| Bangladesh | Institute of Epidemiology Disease Control and Research (IEDCR), Dhaka | Prof Dr Tahmina Shirin Director, IEDCR Email: tahmina.shirin14@gmail.com |
| India | All India Institute of Medical Sciences (AIIMS), New Delhi | Dr Puneet Misra, Professor, Center for Community Medicine Email: doctormisra@gmail.com |
| Hamdard Institute of Medical Sciences & Research (HIMSR), New Delhi | Dr Farzana Islam, Professor & Head, Dept. of Community Medicine, HIMSR Email: drfarzanaislam@gmail.com | |
| Nepal | National Public Health Laboratory (NPHL), Teku, Kathmandu | Dr Ranjan Raj Bhatta, Director NPHL Email: director@nphl.gov.np Ms Lilee Shrestha, Chief Medical Technologist, NPHL Email: shresthalilee@gmail.com |
| Sri Lanka | University of Sri Jayewardenepura (USJ), Gangodawila, Nugegoda | Dr Neelika Malavige, Senior Professor, Department of Immunology and Molecular Medicine, USJ Email:neelika@sjp.ac.lk;neelikamalavige@gmail.com |
| Thailand | Prince of Songkla University (PSU), Songkhla | Prof. Dr. Tippawan Liabsuetrakul, Department of Epidemiology, Faculty of Medicine, PSU Email: ltippawa@hotmail.com |
Note: This list excludes one study site from Indonesia that was previously part of the SEAR Unity Studies Network. Following the reassignment of Indonesia to the WHO Western Pacific Region, the site transitioned from SEAR to the global network.
Following the global launch, WHO SEARO provided catalytic funding to each site through PIP PC supplementary resources to initiate implementation of the network’s Terms of Reference. Supported activities included orientation on Unity Studies protocols, research preparedness and capacity‑building efforts, and the adaptation of Unity Studies protocols to national contexts.
Country and Regional Level Activities and Progress (2024–2025)
Recent and ongoing unity studies activities at the regional and country level are as follows:
- Bangladesh
- IEDCR, Bangladesh is adapting the protocol for the Investigation of Non‑Seasonal Influenza and Other Emerging Acute Respiratory Diseases and is progressing with the required ethical and institutional clearances, in close coordination with the WHO Country Office
- India
- All India Institute of Medical Sciences (AIIMS) conducted a two‑day virtual training programme on WHO Unity Protocols for Influenza and Other Respiratory Pathogens of Pandemic Potential. The training was delivered in two batches and targeted both new and existing research sites established during the COVID‑19 sero‑epidemiological studies.
- Hamdard Institute of Medical Sciences & Research (HIMSR) adapted WHO’s Household Transmission Investigation (HHTI) and Associated Risk Factors for Influenza A, Influenza B, and Respiratory Syncytial Virus (RSV) Infection protocol for implementation among residents of Delhi, India. The experience was documented and shared as a best practice global unity studies webinar conducted in October 2025.
- Nepal
- National Public Health Laboratory (NPHL), Nepal is reviewing the available Unity Studies protocols in close coordination with the WHO Country Office. The laboratory plans to adapt suitable study protocols to the national context by 2026.
- Sri Lanka
- University of Sri Jayewardenepura (USJ), Sri Lanka is in discussion with the National Influenza Centre and the Epidemiology Unit of the Ministry of Health to plan the implementation of ToR‑related activities under the Unity Studies Network in 2025.
- During the Annual Regional Meeting on PIP PC and WHO’s Preparedness and Resilience for Emerging Threats (PRET) Implementation in SEAR, held on 27–30 October 2025 in Colombo, the USJ principal investigator also shared Sri Lanka’s experiences and lessons learned from conducting Unity Studies during the COVID‑19 pandemic, contributing to regional knowledge exchange and capacity strengthening.
- Thailand
- Prince of Songkla University, Thailand is working to establish an integrated surveillance framework for respiratory epidemic diseases by developing standardized clinical criteria and pan‑family diagnostic protocols. These efforts aim to strengthen the early detection of multiple respiratory viruses with epidemic and pandemic potential, as well as enhance national response capacity.
In addition to providing coordination, technical guidance, and resource mobilization to advance the implementation of Unity Studies, the Regional Office also undertook a range of activities to strengthen the network. These engagements supported technical exchanges, facilitated field visits, and enabled high‑level discussions, contributing to greater collaboration and capacity across participating sites.
One such example was the Global Public Health Summit 2025 in Colombo (13–16 July 2025), During these engagements, Member States, academic institutions, and WHO partners showcased progress in implementing Unity Studies, shared lessons learned from the COVID‑19 pandemic, and strengthened efforts to reinforce and institutionalize country‑led early investigation capacities.
Panelists of the Unity Studies plenary included experts from the Ministry of Health, academia, and WHO. (Photo credit: College of Community Physicians of Sri Lanka)
Collectively, these efforts played an important role in supporting the adaptation of standardized protocols, strengthening research capacity during health emergencies, and enhancing technical collaboration and coordination across research institutions in the Region. They have contributed to improved preparedness of Member States and strengthened their ability to detect, investigate, and respond to future epidemics and pandemics.
Looking Ahead to 2026
During the 2024–2025 biennium, the Unity Studies Network advanced rapidly from concept to global launch and early implementation in the WHO South‑East Asia Region (SEAR). Key achievements included the regional adaptation of the Terms of Reference (ToR) and the formal establishment of the SEAR chapter of the network, comprising six sites across five countries.
Notably, under the PIP PC HLIP III Monitoring and Evaluation Framework, The regional target of five sites formally joining the network by 2029 was achieved in 2025 (four years ahead of schedule) marking a significant milestone for the Region. In addition, most participating sites have already initiated country‑level activities, leveraging catalytic PIP PC funds alongside other available funding sources.
Looking ahead to 2026, regional priorities will focus on supporting Member States to incorporate Unity Studies protocols into national preparedness and response frameworks, strengthening long‑term capacity‑building and sustainability, and deepening collaboration through the community of practice and regional knowledge‑sharing platforms. Unity Studies represent a critical investment in pandemic preparedness, enabling countries to rapidly generate high‑quality, comparable evidence during future respiratory pathogen pandemics, grounded in the principles of equity, capacity strengthening, and regional and global solidarity. The WHO Regional Office for South‑East Asia will continue to provide strategic and technical support to participating sites to advance these objectives, in close collaboration with global experts.