Written Evidence Submitted by

Mr Michael Head, Senior Research Fellow in Global Health Clinical Informatics Research Unit, Faculty of Medicine at the University of Southampton

(C190067)

3. The flexibility and agility of institutions, Government departments and public bodies, and processes to respond appropriately during the crisis including:

the availability and responsiveness of funding;

There have been large quantities of research funding made available in the early months of this pandemic, both within the UK and globally. The Research Investments in Global Health study (RESIN) is based within the Clinical Informatics Research Unit at University of Southampton  (https://www.the-ciru.com/resin). RESIN analyses funding decisions and reviews the research landscape, to describe the direction of spending, and identify research strengths and knowledge gaps. RESIN has an established track record in this area and has been contributing data for research priority-setting over the last 11 years.

RESIN has been documenting public and philanthropic funding dedicated towards the COVID-19 pandemic response. As of July 2020 (thus covering approximately the first 6 months of the COVID-19 outbreak), we have documented >1000 global research awards totalling over £770 million ($1 billion; US dollars). This funding and research response has been unprecedented and allows for a huge amount of new knowledge to be rapidly described and disseminated.

For example, there have been well over £400 million ($0.5 billion) dedicated towards urgent vaccine development (with clearly much greater funding coming from the private sector), along with £77 million ($100 million) for each of therapeutics and diagnostics. There has also been >300 awards (£47 million ($61 million)) focused on behavioural and social sciences, reflecting the national and international need to understand public response and behaviour to different interventions and policy decisions. The UK is nationally the second greatest contributor to the research funding; 10% of the overall investment portfolio with further funding awarded to CEPI. The USA has contributed 29% of the total tracked global research funding.

Five key UK public and philanthropic funding organisations have provided investment for COVID-19 research: UKRI, NIHR/Department of Health, Wellcome Trust, CSO Scotland and the British Society for Antimicrobial Chemotherapy, totalling £83.5 million across 147 individual awards. Of this portfolio, 42% (£35 million) was focused on public health research and 29% (£24 million) on COVID-19 vaccine research. The UK has a large global health research portfolio and 20% (£16.5 million) of the funding for COVID-19 research was awarded to institutions outside of the UK, namely in: Canada, The Gambia, Ghana, Singapore, South Africa, Uganda and USA.

As we have seen, the UK and the world is unprepared for a pandemic. It should be noted that research funding decisions are essentially reactive to public health emergencies. The RESIN study has demonstrated that, here with coronavirus outbreaks (including SARS and MERS), and other infectious disease threats such as Zika and Ebola, there has historically been very little proactive ‘horizon-scanning’ of these threats. With coronavirus research funding, there has been more investment in the first 6 months of 2020 than across the entirety of 2000-2019. The global health community can do much better during the next inter-pandemic period.

However, the UK has learned from the 2009 swine flu pandemic, with proactive approaches to ensuring rapid set up of studies, such as the RECOVERY trial (https://www.recoverytrial.net/, which is a multi-funder collaboration), which has provided vital information around the effectiveness (or lack thereof) of therapeutics such as dexamethasone and hydroxychloroquine. Whatever the extent of any UK policy failings in other areas, the research response has arguably been excellent.

(July 2020)