HUMANITARIAN CRISES MONITORING

CORONAVIRUS IN DEVELOPING COUNTRIES: SECONDARY IMPACTS

Written Evidence Submitted by The UK Collaborative on Development Research (UKCDR)

Here the UK Collaborative on Development Research (UKCDR) provides evidence on the secondary impacts of coronavirus, and presents the scope and potential impacts of UK Official Development Assistance (ODA) funded research investments. Some aspects of the terms of reference are emerging fields of research and are therefore yet to be well funded. UK ODA research funding calls are still open and may therefore fund further research within this scope.

Key messages

1. Global researchers identified research on the secondary impacts of the COVID pandemic as priorities in January 2020 and in particular for low- and middle- income countries (LMICs) in July 2020.
2. UK ODA research funding has been targeted to improve understanding of identified priorities, and frequently updated details are available in the COVID-19 Research Project tracker by UKCDR and GLOPID-R.
3. The complexity of the health and social impacts of the coronavirus pandemic have highlighted the importance of interdisciplinary research to address the multifaceted consequences. For example, we are witnessing, and research is evidencing, the interlinked impacts of health and poverty, for example, those in economic poverty are much more vulnerable to morbidity and mortality from the disease.
4. The pandemic may exacerbate existing social and economic inequalities and vulnerabilities, causing potential secondary impacts of increased violence against women, a widening poverty gap and the diversion of funds away from greater human health challenges (measured by annual morbidity). Thereby risking reversing recent advances like reductions in child mortality and global development more generally.
5. The coronavirus pandemic has shown the importance and urgency that both health systems and health research systems must move from a disease specific to a disease sensitive approach. Long-term investment must develop the capacity to enable health systems and health research systems to be prepared to react to a pandemic, and its multilateral consequences, rather than to a specific disease.

About UKCDR and its work on COVID-19

UKCDR is a collaborative of government departments and research funders working in international development. Since 2007, we have brought UK research funders together to discuss priorities and coordinate efforts to garner maximum impact. Our mission is to amplify the value and impact of research for global development by promoting coherence, collaboration, and joint action among UK research funders. We are governed by the Strategic Coherence of ODA-funded Research (SCOR) Board. The SCOR Board is chaired by an independent member, Professor Peter Piot, and brings together the Chief Scientific Advisers and Directors of our core members to provide oversight of UKCDR’s work and to discuss international development research priorities across their own organisations and coordinate efforts to garner maximum impact.

The funding bodies that make up UKCDR’s core membership are:

-          Department for International Development (DFID)

-          Department for Business, Energy and Industrial Strategy (BEIS)

-          Department for Health and Social Care (DHSC)

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-          UK Research and Innovation (UKRI) (incorporating the seven UK Research Councils, Innovate UK and Research England)

-          Wellcome Trust

-          Independent non-affiliated experts

UKCDR also convenes impartial funder fora to discuss key themes, identified through our mapping and analysis work, where joint or complimentary research investment has the potential to increase impact for developing countries.

UKCDR is conducting significant activities relating to COVID-19 research, particularly collaborating on ODA-funded research, and research with a focus on LMICs or global impacts:

-          Convening the UKCDR Epidemics Preparedness and Response Group of UK research funders

-          Aligning research funders on common principles to strengthen epidemic preparedness and research response

-          Developing the publicly available global COVID-19 Research Project Tracker in collaboration with the Global Research Collaboration for Infectious Disease Preparedness (GloPID-R)

-          Collaborating with the African Academy of Sciences and The Global Health Network to undertake a global study on research priorities for COVID-19, with a particular focus on lower resourced settings

-          Launching the COVID-19 Research Coordination and Learning Initiative (COVID CIRCLE), also in collaboration with GloPID-R, to further coordination activities and ensure that lessons are learnt for future epidemics and pandemics, with a focus on low-resource settings.

-          Providing input for the Canadian Institutes of Health Research on their development of the UN Research Roadmap for the COVID 19 Recovery (to be released).

At UKCDR, we firmly believe that research across disciplines and in partnership with LMICs is essential to drive global development progress. The UK ODA funding landscape provides the opportunity to address the Global Goals through the generation of knowledge.

UK Coronavirus research funding contribution

The UK has a broad and strong research base for a response to global disease outbreaks and has provided world-leading and influencing research, with global impact, on modelling and predicting the nature and spread of the virus, vaccine development and therapeutic testing.

UK funders have contributed significant portions of coronavirus research funding including UKRI, FCDO and Wellcome, through rapid response funding calls, or repurposing existing grant funding.

Cross-government coordination (NIHR and UKRI) funding focused on understanding the pandemic and mitigating its health impacts in low- and middle-income countries and has funded studies into the secondary impacts of COVID-19 in LMICs.

The UKCDR/GloPID-R COVID-19 Research Projects Tracker

The UKCDR/GloPID-R COVID-19 Research Project Tracker is a live (non-exhaustive) database of research projects funded around the world in response to the COVID-19 pandemic. The tracker maps projects against priorities identified in the WHO Coordinated Global Research Roadmap.

Projects are also classified against the research priorities of less-resourced countries, which were identified in our May 2020 collaborative study. This study found the impacts of COVID-19 on vulnerable groups including children and pregnant women, and engaging communities to build trust in public health interventions are “existing WHO research priorities which required a greater research focus”. Notably, the new priorities identified included understanding COVID-19 in diverse contexts such as in civil wars, refugee and migrant populations. The scope of research projects in these categories are included in our Living Systematic Review of COVID-19 funded research projects.

At the time of submission, the tracker contained data from more than 60 funders totalling 3,508 research projects worth (at least) $993.5m.

1. Non-coronavirus health care; the communities trust and engagement in healthcare provision (especially in relation to other infectious diseases and immunisation) 

The coronavirus pandemic is overwhelming many healthcare systems across the world. In low-resource settings where health systems are often under-resourced it could result in a reduction of access to healthcare services, such as childcare immunisations or diagnosis and treatment of other important endemic diseases including malaria, TB and HIV/AIDS. This was the case during the West Africa Ebola Epidemic in 2014, including over 80% reductions in maternal delivery care in Ebola-affected areas, 40% national reductions in malaria admissions among children <5 years and substantial reductions in vaccination coverage.

Research into effective health communications and maintaining trust of communities is crucial to the success not only of coronavirus prevention and treatment, but also maintaining non-coronavirus health care such as child vaccination programmes. To understand the relationship, we must use diverse research disciplines including social sciences and community engagement to advance our understanding and minimise the secondary impacts of pandemics.

On the topic concerning ‘the communities trust and engagement in healthcare provision’, there are three WHO sub-priorities that may be considered relevant, outlined below:

2. Economy and food security; economic performance, development and level of ODA (implications for livelihoods and food security and nutrition) 

As a secondary impact, there is not currently much data on this topic, but it is a growing area of research that will additionally be highlighted by the UN COVID-19 Recovery Research Roadmap. However, it is possible that the societal and economic impacts of regional and national lockdowns, will be disparate across different levels of society in both high-income and low-income countries, where there is greater reliance on informal sectors as a source of employment. Greater research across disciplines (e.g. bringing together economists, social scientists, health researchers) is needed to understand this better and respond adequately.

To find relevant projects on the tracker, a search was conducted for those research projects tagged against ‘policy & economy’ and ‘food security’.

3. Treatment of women and children; levels domestic abuse, gender-based violence and exploitation of women and children, including child marriage

The COVID-19 pandemic threatens to offset decades of gains made in safeguarding the well-being of women and children. Poverty is a key determinant of health that amplifies existing vulnerabilities to violence and exploitation. It intersects with disrupted education following lockdowns and other strong social drivers to put millions of children at risk of early marriage. Research can help understand these interactions better and ensure more effective solutions.

To find relevant research projects, a search was conducted on those projects whose study population(s) were tagged against ‘victims of domestic violence’ and/or ‘children’.

Conclusion

An interdisciplinary approach is essential to solving these problems, as while we focus on coronavirus prevention and treatment, we risk ignoring swelling economic insecurity and growing domestic violence. Research is essential to help us tackle these problems, using collective expertise to find holistic, adaptive, and appropriate solutions. Secondary impacts, including topics highlighted by this inquiry, have been directly identified by LMICs as areas of concern and research priorities. UK ODA funded research is already starting to help us understand the issues and could continue to have significant impact and provide essential solutions.

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