Table 1.
Survey results: top three research priorities from the WHO roadmap categories showing less-resourced countries as a subset of the global responses
| Priority | Immediate | Longer term | |||
| Global (n=1528) | Less-resourced countries (n=694) | Global (n=1528) | Less-resourced countries (n=694) | ||
| Virus natural history, transmission and diagnostics | 1 | Support work to develop cheaper, faster easier to use in field antigen tests (for virus detection) | Support development of diagnostics products to improve clinical processes | ||
| 2 | Support development of diagnostics products to improve clinical processes | Development of cheaper, faster easier to use in field antigen tests (for virus detection) | |||
| 3 | Support work to develop cheaper, faster, easier-to-use in field antibody tests (for determining exposure) | Characterise immunity (naturally acquired, population and vaccine-induced, including mucosal immunity) | Support work to develop cheaper, faster easier to use in field antibody test tests (for determining exposure) | ||
| Animal and environmental research on the virus origin, and management measures at the human–animal interface | 1 | Improve understanding of socioeconomic and behavioural risk factors for spillover and transmission between animals and humans | Identify animal source and route of transmission (hosts, any evidence of continued spillover to humans and transmission between animals and humans) | ||
| 2 | Identify animal source and route of transmission (hosts, any evidence of continued spillover to humans and transmission between animals and humans) | Improve understanding of socioeconomic and behavioural risk factors for spillover and transmission between animals and humans | |||
| 3 | Design and test suitable risk reduction strategies at the human–animal–environment interface | ||||
| Epidemiological studies | 1 | Describe transmission dynamics of COVID-19 and understand spread of disease nationally, regionally and globally | |||
| 2 | Describe disease severity and susceptibility to facilitate effective clinical and public health response to COVID-19— identify groups at high risk of severe infection | Establish suitable cohorts and prospectively collect longitudinal laboratory and outcome data | |||
| 3 | Perform rapid population cross-sectional surveys to establish extent of virus transmission using standardised sampling framework | Describe disease severity and susceptibility to facilitate effective clinical and public health response to COVID-19—identify groups at high risk of severe infection | Perform rapid population cross-sectional surveys to establish extent of virus transmission using standardised sampling framework | ||
| Clinical management | 1 | Determine interventions that improve the clinical outcome of COVID-19-infected patients | Define the natural history of COVID-19 infection through careful standardised and comprehensive clinical and laboratory description of cases | ||
| 2 | Determine optimal clinical practice strategies to improve the processes of care (eg, develop criteria for early diagnosis, when to discharge, when to use adjuvant therapies for patients and contacts) | Determine interventions that improve the clinical outcome of COVID-19-infected patients | |||
| 3 | Develop protocols for management of severe disease in the absence of intensive care facilities | Define the natural history of COVID-19 infection through careful standardised and comprehensive clinical and laboratory description of cases | Determine optimal clinical practice strategies to improve the processes of care (eg, develop criteria for early diagnosis, when to discharge, when to use adjuvant therapies for patients and contacts) | ||
| Infection prevention and control, including healthcare workers’ protection | 1 | Understand the effectiveness of movement control strategies to prevent secondary transmission in healthcare and community settings | |||
| 2 | Optimise the effectiveness of PPE and its use in reducing the risk of transmission in healthcare and community settings | Research to support health systems strengthening and building of resilience post the outbreak | Optimise the effectiveness of PPE and its use in reducing the risk of transmission in healthcare and community settings | ||
| 3 | Develop new PPE approaches using local materials and manufacturing processes | Optimise the effectiveness of PPE and its use in reducing the risk of transmission in healthcare and community settings | Develop new PPE approaches using local materials and manufacturing processes | ||
| Candidate therapeutics R&D | 1 | Develop mechanisms to support coordinated collaboration to implement clinical trials for evaluation of safety/efficacy of therapeutics. | Identification of existing candidates for clinical evaluation in addition to the ones already prioritised | Develop mechanisms to support coordinated collaboration to implement clinical trials for evaluation of safety/efficacy of therapeutics. | Support basic science to identify new drug targets |
| 2 | Support basic science to identify new drug targets | Identification of existing candidates for clinical evaluation in addition to the ones already prioritised | |||
| 3 | Identification of existing candidates for clinical evaluation in addition to the ones already prioritised | Develop mechanisms to support coordinated collaboration to implement clinical trials for evaluation of safety/efficacy of therapeutics | Support basic science to identify new drug targets | Develop mechanisms to support coordinated collaboration to implement clinical trials for evaluation of safety/efficacy of therapeutics | |
| Candidate vaccines R&D | 1 | Develop a multicountry Master Protocol for phase IIb/phase 3 vaccine evaluation to determine whether candidate vaccines are safe and effective before widespread distribution | Capacity development for basic science and preclinical development of new vaccines | ||
| 2 | Capacity development for basic science and preclinical development of new vaccines | Develop a multicountry Master Protocol for phase IIb/phase III vaccine evaluation to determine whether candidate vaccines are safe and effective before widespread distribution | |||
| 3 | Identification of candidates for clinical evaluation in addition to the ones already prioritised. | ||||
| Ethics considerations for research | 1 | Identify key knowledge gaps and research priorities in relation to ethical issues arising out of proposed restrictive public health measures (eg, quarantine, isolation, cordon sanitaire) | |||
| 2 | Define a research governance framework that enables effective and ethical collaboration between multiple stakeholders, including WHO, the global research community, subject matter experts, public health officials, funders and ethicists | ||||
| 3 | Establish processes for speeding up ethical review of COVID-19-related research proposals | Sustained education, access and capacity building to facilitate effective cross-working and collaboration across the research thematic areas | |||
| Social sciences in the outbreak response | 1 | Investigate ways of ensuring transparency of information flow and mitigating false information spread by various mechanisms | Ensure that knowledge is produced according to local, national and regional needs | ||
| 2 | Ensure that knowledge is produced according to local, national and regional needs | Promote the prioritisation of knowledge needs according to epidemic dynamics | |||
| 3 | Examine optimal ways of communicating about potential interventions in high-density low socioeconomic status urban settings | ||||
PPE, personal protective equipment.