Clario Middle East Response

Dear Client,

In light of the evolving situation in the Middle East, we would like to share an update on Clario’s current operational status and considerations for studies in the region. Clario has established a dedicated Response Team to actively monitor developments, assess potential impacts, and support study continuity as conditions continue to change.

In parallel, we encourage you to remain in close contact with your Clario Project Manager to discuss study specific considerations and mitigation strategies.

This communication provides an overview of the current state of Clario’s logistics and supply chain operations, with a focus on impacted countries and neighboring regions. Additional context is included regarding trade compliance considerations and trial continuity, where relevant.

Logistics

Clario continues to actively monitor supply chain continuity across directly impacted and neighboring countries. Import and export capabilities vary by location and remain subject to change as regulatory requirements, carrier availability, and infrastructure conditions evolve.

Directly impacted countries:

• Israel
• Qatar
• Bahrain
• UAE
• Kuwait
• Iraq
• Iran
• Saudi Arabia

Neighbouring countries:

• Turkey 
• Armenia 
• Azerbaijan 
• Georgia 
• Kazakhstan 
• Turkmenistan 
• Libya 

Shipments

Across the Middle East, the current airspace status is impacting logistics and shipment operations in several ways:  

Closed Airspace  

• Bahrain, Kuwait, Iraq, and Iran have fully closed their airspace, restricting all flights in and out of these countries

Partially Open Airspace

• Qatar’s airspace remains partially open, but only a limited number of flights are operating  
• Israel also has partially open airspace, with restricted operations and fewer flights available  

Open Airspace with Limitations  

• The United Arab Emirates (UAE) has open airspace; however, flight options are more limited than usual and may change depending on regional developments  
• Saudi Arabia, Jordan, and Oman have open airspace, allowing regular operations  
• Lebanon’s airspace is open but currently sees only limited flight activity  

General Impact on Cargo Operations  

All couriers working in the region have reported that cargo options are limited overall. Even in countries where airspace is open, shipment delays are likely due to restricted flight schedules and operational challenges.   

Israel Logistics Update  

Shipments and Resupply orders can be processed again to Israel. However, delays are to be expected due to restricted flight schedules and limited operations within the country.  

Impact on Pass-Through-Costs for Middle East Region  

The ongoing situation in the Middle East has directly affected pass-through-costs associated with logistics and shipments. Couriers operating in the region have reported that their rates are subject to war-risk surcharges and increased operational costs and fuel charges, particularly along lanes where risks and capacity constraints are heightened.  

As a result, there has been a significant surge in shipping costs. Although it is challenging to provide a precise figure for the increase, current observations indicate that rates have risen by approximately 100-200% per kilogram.

Clients are encouraged to work directly with their Clario Project Manager to review trial supply needs and to determine actions to be taken considering the limitations and potential pass-through increase. We are in daily contact with our partners and will keep you informed of any changes to logistics services and fees as such information becomes available.

Return shipments

Return shipments from impacted regions remain challenging at this time. Clario will endeavor to manage returns where possible. Where studies are approaching closure or timelines are constrained, early engagement with your Project Manager is recommended to assess limitations, develop mitigation plans, and identify required actions.

Trial continuity

Given the current logistics constraints within directly affected countries, some sponsors may need to pause enrollment or anticipate startup delays. In such cases, sponsors may consider rebalancing enrollment across existing active countries or, where appropriate, opening additional countries. Clario can support these activities through established change management processes. We encourage early communication with Clario Project Management regarding any potential strategies so that we can proactively advise on options and share relevant operational experience across active trials.

Cybersecurity 

Clario’s Cybersecurity Operations team continues to review and align with guidance from Health Information Sharing and Analysis Center (H-ISAC), the U.S. Cybersecurity and Infrastructure Security Agency (CISA), and other partners. These measures remain in effect and no heightened concerns relating to these events have been identified at this time.

Next steps:  

Our Project Management teams understand which active studies are impacted by current events and will continue to coordinate with you on recommended actions. We encourage close collaboration to ensure alignment on patient management and study continuity.

This situation remains dynamic and we sympathize with all colleagues, peers and patients impacted. Our response team is here to support you and will continue to monitor developments and provide updates as appropriate. Should you have any questions, please contact your Clario Project Manager.

Kind Regards, 
Clario Executive Leadership