Dr Charu Kaushic, Chair of GloPID-R, and Dr Geneviève Boily-Larouche, CIHR Institute of Infection and Immunity, provide a perspective on pandemic preparedness and response, including lessons learned for global coordination among research funders
The COVID-19 pandemic has become a real-time experiment for global coordination, as national governments prepare, continue to respond, and plan for recovery from the different waves of the pandemic concurrently. Cohesive and coordinated multi-sectoral R&D efforts are needed to provide the timely evidence required to inform decision making and support the development of effective medical and social countermeasures that mitigate the health impacts and spread of COVID-19 locally, nationally, and globally. Research funding organisations provide the foundation upon which R&D pipelines and evidence-based decision making are built, and funding organisations are uniquely positioned to facilitate a cohesive response in times of emergencies, such as the current pandemic.
The response to COVID-19 has demonstrated how essential instruments of global coordination are to achieve a timely response and sustain the investments, relationships and infrastructures necessary to optimise research efforts during rapid calls to action. The Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) was created in 2013 under the recommendation of the Heads of International Research Organisations (HIROs) to be an instrument of global coordination among research funders.(1) GloPID- R brings together 29 key players from the global research funding architecture, including key philanthropic and national funders, and the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and the European & Developing Countries Clinical Trials Partnerships (EDCTP) as observers. The COVID-19 pandemic response has emphasised that alignment of priorities, real-time understanding of the funding landscape and remaining gaps, constant communication across stakeholders, policy alignment for data-sharing and timely exchange of knowledge between researchers are the pillars that support effective global coordination. Throughout the response to the COVID-19 pandemic, GloPID-R has driven a global effort to align funding and through this work, has drawn valuable lessons for improving global coordination processes.
1) Priority-settings: Involvement of national funders for rapid funding
In February, GloPID-R partnered with the WHO to identify research priorities and create the COVID-19 Coordinated Global Research Roadmap. Because global funders were meaningfully engaged in the priority- setting process, funding to support the different aspects of the roadmap was released at an unprecedented speed. Of the 29 GloPID-R members, 15 announced funding for rapid calls between February and June 2020, aligned with the Roadmap’s research priorities. Without the timely engagement of national funders, implementation of the Roadmap would be left to the few philanthropic funders that have the capability to rapidly release funds but may have a preference for funding specific priorities. National funders remain the majority of the funding bodies globally with a broad research agenda covering all nine priorities outlined in the Research Roadmap. Their early engagement in the priority-setting process has been essential to accelerate the broad implementation of the Roadmap as an instrument of global research alignment.
2) Understanding of the funding landscape: Timely tracking for course correction
In April 2020, GloPID-R and the UK Collaborative on Development Research (UKCDR) developed a tracker to understand the funding landscape. The Research Project Tracker provides an overview of funded research projects mapped against the WHO Roadmap’s priorities.
As of November 2nd, 2020, 5,026 research projects totalling more than $2.2 billion were listed in the tracker and mapped to the research priorities. This tracker was developed to support a more effective and coherent global research response by providing an opportunity for funders to course-correct investments and address gaps in funding. Understanding the landscape and ecosystem of funding is essential to balance research funding efforts and ensure that knowledge is created in all key research areas and synergised globally.
The mapping exercise also highlighted the gap in research taking place in low-resource countries. Because no one is safe until everyone is safe, the COVID Circle – COVID-19 Research Coordination and Learning partnership was developed with the UKCDR to strengthen research coordination and network connection and ensure that low-resource settings can partner and benefit from research.
3) Creating visibility of funded research: Fostering collaboration and giving traction to promising avenues
Alignment of research requires more than the funding of research; it needs a continuous exchange of data and insights between researchers. As the COVID-19 pandemic has progressed through its different phases, the evidence base and research needs have also evolved. To synergise research and accelerate the timely identification of evolving research gaps, GloPID- R hosted a series of meetings that created the visibility needed by the funded researchers to foster international connections. In July 2020, the Synergies meetings focused on Ending COVID-19 and preparing for the second wave: progress and gaps in research(2), and in December 2020, a Joint Research Forum, hosted in partnership with the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), focused on Long COVID(3). Both meetings created awareness, synergy and identified evolving research gaps and needs for researchers as well as funders.
While COVID-19 has demonstrated that we can accelerate the global research response through global coordination, challenges remain to achieve a more advanced state of coordination amongst funders. Decision-making for most of the national funders ultimately lies at the national level and by default, funders must respond to their domestic priorities first. In February, many of the GloPID-R members had simultaneously initiated their rapid response to COVID- 19 before the global research priorities were even identified. Although this allowed for rapid release of research funding, speed was achieved at the expense of a strategic approach that would have ensured maximum impact. This pandemic has illustrated how unilateral research initiatives can contribute to a fragmented research landscape. Duplication, loss in efficiency and ill-powered studies that cannot produce the quality of evidence needed for effective guidance for policy actions, are the cost of this lack of coordination. A robust mechanism for joint funding based on a single delivery mechanism will be a way forward to reduce fragmentation and accelerate the timely release of funding to support research.
Coordination takes time, efforts, and resources, and the more global this process is – as was needed for COVID- 19 – the more time and effort it requires to engage, negotiate and address the needs of all stakeholders. Effective coordination of research response builds on strong leadership, effective and inclusive priority- settings, evidence-informed decision-making, and timely impact evaluation. Trust between key stakeholders is crucial, and this can only exist through nurtured relationships. A focus on building and sustaining collaborative mechanisms, maintaining and improving stakeholder relationships, raising and maintaining awareness of the importance of increased pandemic preparedness, strengthening preparedness research and a One-Health approach, building partnerships with industry, and expanding investment into planning of research and infrastructure during peacetime will continue to pay dividends to see the end of this pandemic, and be better prepared for the next one.