The World Health Organization has initiated the SOLIDARITY project to expedite evaluation of four prospective therapies for COVID-19. Preliminary uncontrolled studies and anecdotal reports have demonstrated the possible beneficial effect of chloroquine and remdesivir but failure of a combination of lopinavir and ritonavir, used to treat HIV.  Unfortunately limitation on numbers of cases studied does not allow a definitive decision on efficacy at this time. 

In order to save time and concurrently allow for diverse geographic distribution and large numbers of patients the WHO SOLIDARITY approach was devised.  Physicians will recruit participants who will receive selected drugs on the basis of informed consent. Personal details and history and outcome will be entered into a WHO database.  The attending physician will select from four possible therapies depending on availability of drugs and will adhere to the local standards of care for COVID-19.  Physicians are responsible for recording whether the patient was cured or died, the duration of hospital stay and whether oxygen or ventilation was required.

In contrast to classic drug evaluation studies, the SOLIDARITY Program is not double-blinded, but this concession is considered necessary with the need to select an efficient agent from among the four alternative treatments comprising:-

• Remdesivir
• Chloroquine and hydroxychloroquine
• Lopinavir in combination with ritonavir
• Lopinavir and ritonavir in combination with interferon-beta

With an enthusiastic response from physicians worldwide, in the face of an ascending incidence rate, it should be possible to generate results that will indicate possible efficacy within weeks of initiation of the study.