The Global EMergency CAre Research Network (GEM-CARN)

Harnessing collaborative inter-disciplinary research to improve emergency care in low and middle-income countries.



Globally, 80% of healthcare emergencies in children and working-age adults occur in low- and middle-income countries (LMICs). While prevention is ideal, not all emergencies can be prevented.

The World Bank Disease Control Priorities project estimates that over half of deaths in LMICs could be impacted by emergency care. For example, research has shown that people with similar injuries are nearly twice as likely to die in LMICs than in high-income countries.

A recent draft World Health Assembly Resolution aims to extend Universal Health Coverage to a further 1 billion people by 2023, but there is a lack of research evidence to suggest which emergency interventions and care systems should be prioritised for development.

Project aim

 We propose to address this by establishing a Global Network of Emergency care researchers

– bringing together researchers from many different disciplines and countries to establish the best way to improve Emergency Care in low resource settings.

We aim to improve awareness and understanding of the challenges of Emergency Care in LMICs by creating a website and academy, and by planning new emergency care research studies. Our research priorities will be based on evidence reviews, gap analyses and early data from WHO initiatives in Africa – using the WHO Emergency Care Toolkit. These will help us design large studies to evaluate which medicines, procedures and Emergency Care System elements will best reduce premature deaths in the poorest billion of the World’s population.

This proposal builds on established collaboration between ScHARR Investigators and the Universities of Cape Town (UCT), Ain Shams Cairo, Manmohan Memorial Institute of Health Sciences, Nepal, University of the West Indies, World Health Organisation Emergency Acute Care and Surgery Programme and draws upon the collaboration of WHO and UCT with the Universities of Makerere (Uganda) and Muhimbili (Tanzania).

The overarching theme is to develop a network of researchers with the capacity to conduct studies leading to improved Emergency Care for people in LMICs. The aim is to bring together researchers from several disciplines including Emergency Medicine, Pre-hospital Care, Health Services Research, Public Health, Disaster Management and Defence Emergency Care.

The proposal seeks to build on the National Institute of Health Fogarty Center’s strategic initiative for emergency care research in LMICs (“CLEER”) through a scientific forum of networked researchers addressing the following key questions:

  • What is the impact of recent emergency care initiatives on patient outcomes in LMICs?
  • Which are the most important research questions for improving emergency care in LMICS?
  • Which research designs will deliver reliable evidence to inform future emergency care initiatives?
  • Which study outcomes should evaluate initiatives such as the WHO Emergency Care Development Toolkit?

Project team

Division of Population Health, University of Sheffield


  • Professor Lee Wallis, University of Cape town (Emergency Medicine), Republic of South Africa
  • Professor Sujan Marahatta, Manmohan Memorial Institute of Health Sciences, Kathmandu (Epidemiology), Nepal
  • Dr Teri Reynolds, World Health Organisation (Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention (NVI)), Tanzania, Uganda
  • Professor Mohamed El-Shinawi, Ain Shams University, Cairo (General Surgery) Egypt
  • Dr Ishtar Govia, University of the West Indies Mona Campus (Caribbean Institute for Health Research), Jamaica


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