The remaining unknowns: A mixed methods study of the current and global health research priorities for COVID-19
Norton A., De La Horra Gozalo A., de Colombi NF., Alobo M., Asego JM., Al-Rawni Z., Antonio E., Parker J., Mwangi W., Adhiambo C., Marsh K., Bayona MT., Piot P., Lang T.
Introduction In March 2020 the World Health Organisation (WHO) released a Global Research Roadmap in an effort to coordinate and accelerate the global research response to combat COVID-19 based on deliberations of 400 experts across the world. Three months on, the disease and our understanding have both evolved significantly. As we now tackle a pandemic in very different contexts and with increased knowledge, we sought to build on the work of the WHO to gain a more current and global perspective on these initial priorities. Methods We undertook a mixed methods study seeking the views of the global research community to i) assess which of the early WHO roadmap priorities are still most pressing; ii) understand whether they are still valid in different settings, regions or countries; and iii) identify any new emerging priorities. Results Thematic analysis of the significant body of combined data shows the WHO roadmap is globally relevant, however, new important priorities have emerged, in particular, pertinent to low and lower-middle income countries (less resourced countries), where health systems are under significant competing pressures. We also found a shift from prioritising vaccine and therapeutic development towards a focus on assessing the effectiveness, risks, benefits and trust in the variety of public health interventions and measures. Our findings also provide insight into temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future. Conclusion We hope these findings will help guide decision making across the broad research system including the multi-lateral partners, research funders, public health practitioners, clinicians and civil society. Summary box What is already known? The WHO produced a roadmap that set out the research priorities following a meeting in February, just before COVID-19 was declared a Pandemic. Now, at this point in the evolution of this novel disease across the world, and almost 6 months later, it is important to assess whether these priorities remain and if research teams in all countries across the globe agree that these are the most important question that need to be tackled within their health care setting and communities, both to mitigate this outbreak and to learn for next time. What are the new findings? Over 3,000 healthcare workers and researchers contributed to this research and their data tells us that across the globe there has been a shift in priorities and new questions have emerged, particularly from low-resourced settings. For example, there is a strong call for evidence on the relative effectiveness and optimal implementation of public health interventions in varied global settings, for social science studies to guide how to gain public trust and mitigate myths, to understand the impact on already present diseases within communities, and to explore the ethics of research within a pandemic. What do the new findings imply? The WHO roadmap is globally relevant, however, our findings also provide insight into the temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future.