OECD Survey on the STI policy responses to Covid-19

 

Italy


Updated on: 2020-03-29

Response
Q1A. What arrangements, if any, do you have in place to ensure scientific advice informs national policy and decision making in relation to Covid-19? The head of the Civil Protection Department, Angelo Borrelli, established a scientific technical committee to deal with the Covid-19 emergency (Ordinance n. 630 of February 3, 2020). The Committee is composed of:
- Coordinator of the Office for the Promotion and Integration of the National Civil Protection Department, who will act as the coordinator of the scientific technical committee;
- Secretary General of the Ministry of Health;
- Director General of Health Prevention (Ministry of Health);
- Director of the Office for the Coordination of Maritime, Air and Border Health Offices of the Ministry of Health;
- Scientific Director of the Lazzaro Spallanzani National Institute for Infectious Diseases;
- President of the National Institute of Health;
- a member designated by the President of the Conference of Regions and Autonomous Provinces.

The Committee advises the Head of the Civil Protection Department on the adoption of the most appropriate prevention measures necessary to deal with the spread of Covid-19 (see http://www.protezionecivile.gov.it/ammin...).

Q1B. In what ways, if any, are you coordinating on Covid-19 STI responses at international level? The complexity of the current Covid-19 pandemic crisis requires an exceptional effort by the international scientific community. On March 24, DG-RTD of the European Commission convened a meeting of the Research DGs of the 27 Member States for a first brainstorming on
(i) priorities for EU coordinated R&I action on Covid-19 in the short (6 months) and medium term (12 months) and beyond;
(ii) actions to be undertaken by Member States and the European Commission to best maximise funding (e.g. to complement and expand the already launched Covid-19 projects under Horizon2020); and
(iii) how to mobilise State long-term investors.

In this context, Italy proposes to establish a panel of high-level experts which could bridge and co-ordinate the scientific/public health domain with the wider societal domain (something similar to the ‘Mission Boards’), and would allow also scientific efforts and interactions with non-EU countries (e.g. USA, China, etc.) to be better co-ordinated. Furthermore, this ‘board’ could guarantee to have one strategy for COVID-19 (with standardized policies) across countries, also during the crucial post-quarantine phase, in order to ensure that the results obtained during the quarantine/isolation are not nullified.
Q2.Do you have dedicated arrangements in place for communicating science advice and for refuting misleading information to the public on Covid-19? The strategy implemented in Italy to tackle the Covid-19 emergency involves an information campaign by the Ministry of Health and the Presidency of the Council of Ministers, to make the measures adopted by the government clear to citizens. The daily press conference of the Civil Protection to update the national community on data about the pandemic is broadcast by all main TV networks. Furthermore, in order to reach the largest number of citizens, belonging to a range of different socio-demographic groups, the campaign is being promoted through the main social media networks (Facebook and Instagram), as well as on Italian television channels (private and public). In particular, citizens are warned against fake news. People are invited to rely upon official websites e.g. www.salute.gov.it/nuovocoronavirus.
Q3. What new STI policy measures, if any, is your country taking to respond specifically to the Covid-19 crisis? The Government has kicked off the “Innova per l’Italia: la tecnologia, la ricerca e l’innovazione in campo contro l’emergenza Covid” project (https://innovazione.gov.it/innova-per-l-...), jointly managed by three Ministries (Innovation, Economic Development, University & Research) targeted at companies, universities, public and private research institutions, who can provide contributions in the field of development and production of devices for the prevention, diagnosis and monitoring of SARS-CoV-2, to promote its containment. The project invites these actors to propose their contribution in three areas:
- the procurement, innovation or industrial re-conversion of their technologies and processes, to increase the availability of personal protective equipment (in particular surgical masks) and the production of complex respiratory systems for the treatment of respiratory syndromes (including individual components);
- the procurement of innovative kits or technologies to facilitate the diagnosis of Covid-19;
- technologies and tools for monitoring and prevention of Covid-19.
The proposals received will be evaluated and the Extraordinary Commissioner will activate the necessary steps to implement the approved projects.

The Italian Medicines Agency (Agenzia Italiana del Farmaco) has also set up a crisis unit for the Covid-19 emergency (www.aifa.gov.it). Its strategy is based on four main areas of action:
- promoting controlled clinical trials of off-label drugs;
- promoting R&D/access to experimental drugs;
- designing national guidelines for Covid-19 case management, in collaboration with the Civil Protection and Lazzaro Spallanzani Hospital;
- preventing shortage of drugs at the hospital level.

Italy strongly encourages exploitation of the ‘newborn’ European Open Science Cloud (EOSC) for sharing data and best practices according to an Open Science and Open Innovation approach. The GloPID-R project (https://cordis.europa.eu/project/id/8746...) could represent another platform with a similar purpose.
Q4A. At national level, what mechanisms are you developing or relying upon to bring together different STI actors (researchers, industry, government, health sector, foundations, etc.) to effectively collaborate on responses to Covid-19? See the response to question 3, where the “Innova per l’Italia: la tecnologia, la ricerca e l’innovazione in campo contro l’emergenza Covid” project (https://innovazione.gov.it/innova-per-l-...), jointly managed by three Ministries (Innovation, Economic Development, University & Research) is described.
Q4B. At international level, what mechanisms are you developing or relying upon to bring together different STI actors (researchers, industry, government, health sector, foundations, etc.) to effectively collaborate on responses to Covid-19? See the response to question 1.
Q5. What novel approaches, if any, is your country using to address the coronavirus crisis (e.g. use of machine learning, open science initiatives boosting access and sharing of data and research results, development and use of prediction models, etc.)? A new project, lead by Italian industries, universities and research infrastructures, has been promoted and funded by the European Commission. The EXSCALATE4CoV (E4CoV) project aims to exploit the most powerful computing resources currently based in Europe to empower smart in-silico drug design, while increasing the accuracy and predictability of Computer-Aided Drug Design (CADD). Advanced CADD, in combination with high-throughput biochemical and phenotypic screening, will allow the rapid evaluation of the results and reduce time for discovery of new drugs. E4CoV will select, through virtual screening protocols, the most promising drugs against SARS-Cov-2 from a pool of off-label drugs (> 10,000 drugs). At the same time, the Dompè Tangible Chemical Database (TCDb), comprising >500 billion molecules, will be screened to identify new potential drugs to be tested against Covid-19, thus enhancing the success rate of the virtual screening step. Other European participating institutions will contribute in the domains of bioinformatics (Swiss Institute of Bioinformatics, SIB), biochemical assays (Fraunhofer IME), phenotypic screenings (KU LEUVEN). Along with homology models, the International Institute of Molecular and Cell Biology (IIMCB) and Trieste Synchrotron will determine the crystal structure of the coronavirus functional proteins to further enhance the quality of the in-silico models and to evaluate the structural similarities with other viral proteins. The entire process will allow the rapid identification of active and safe molecules to be further tested in animal models and in clinical trials. The coupling of virtual screening with multiple high throughput biochemical and phenotypic screenings will allow the rapid identification of ‘safe in man’ off-label drugs for immediate treatment of the already infected population. Such massive virtual screening activities need a huge computational resource, therefore the activities will be supported and empowered by three of the most powerful computer centres in Europe, namely CINECA, BSC and JÜLICH. The supercomputing facilities have been extended to the other tier-0 systems in Europe, including the ENI Corporate HPC facility, and will be able to guarantee jointly the best combination of hardware architectures, the required knowledge, and the highest speed-up for the simulations. In addition, INFN (CERN Tier-1 centre) will make available their data sharing and high throughput infrastructure to facilitate products exploitation. The Lazzaro Spallanzani National Institute for Infectious Diseases is the eligible centre to test for the proof-of-concept in patients, and many others hospital and polyclinics in Italy and Europe confirmed their commitment to participate to this experimentation and project.
Q6A. What impact on the STI system do you anticipate in the short-, medium- and long-term, and what measures are you implementing to address those? In the short term, we need to reflect on how to improve our foresight activities. Most OECD countries invested in these activities in the past, and designed their STI medium-to-long term initiatives accordingly, but we should recognise that our ability to anticipate troubles looming on the horizon was, at best, inadequate.

Despite the scourge of SARS, MERS and EBOLA, just to mention the most recent viral disease outbreaks, in the last couple of decades we have been listening to a narrative that communicable diseases were as extinct as dinosaurs, but obviously they are not. Therefore, we should accordingly revise our vision and our priorities for investment.

To guarantee preparedness worldwide - because we know that there will be other epidemics, but we do not know where they can break out again in the future - we should encourage and incentivise seamless sharing data and best practices worldwide. Italy sees this as one of the priorities for the European Open Science Cloud which is now entering into operation.

Furthermore, we should make use of smart directionality, based on scientific evidence and, hence, on research, in orientating the evolution of our health systems. This evolution, in the recent past, has been characterised by a trend which led to a reduction of hospitalizations per inhabitant on one hand, and, on the other hand, to strengthening large care centres. This concentration process, providing greater quality, competence and cutting-edge technologies, should have been accompanied, in principle, by an enhancement of primary care, to ensure overall care services as close as possible to the citizen. In reality, especially in the case of complex care pathways, and the Covid-19 is a case in point, a significant communication and coordination gap remains between these two settings of care, which can cause, and indeed has caused in the current epidemic, a harmful delay in the early detection of cases, which is crucial for circumscribing a sprouting epidemic.

In this complex challenge of combining the need to guarantee proximity of the services to the patient and the excellence of the healthcare, a fundamental role can be played by new technologies, that can allow these two perspectives to be reconciled, to improve and simplify the processes of diagnosis and care and, in short, to bring excellence to the patients’ home.

Therefore, besides the ordinary instruments of the current and future R&I programmes, a step forward would be a ‘one stop shop’, to be co-funded by a multilateral initiative (see e.g. The Global Fund to Fight AIDS, Tuberculosis and Malaria), with an open-ended list of topics, among which a place should be reserved to the development of technologies aimed at supporting preparedness and resilience of our health systems and increasing social cohesion, through a strong person-centric, smart primary health care.
Q6B. Is support of the STI system part of planned stimulus packages aimed at supporting the economy? The “Cura Italia” Decree (Decree Law March 17, 2020, n. 18) regarding measures to strengthen the National Health Service and economic support for families, workers and businesses during the COVID-19 emergency, has made 400 million Euros available to the Ministry of Economic Development also to support companies to invest in R&D and innovation projects.
Q7. Is there anything else regarding the STI policy response to Covid-19 in your country you would like to mention? The Ministry of University and Research has launched on March 23 a mapping activity, addressed to universities and other public research institutions, to collect information about all ongoing research projects and also on planned projects on SARS-Cov-2 and Covid-19. The scope of the initiative is to reduce fragmentation and prevent unnecessary duplication. The deadline to collect data has been set for 27 March.