Building global health research capacity to address research imperatives following the COVID-19 pandemic
Authors: Peter H. Kilmarx, Roger I. Glass
Journal: PLoS Medicine (2021)

Research and development of new tools and interventions are necessary to improve global health, as has been made apparent by the Coronavirus Disease 2019 (COVID-19) pandemic [1].As of mid-July 2021, there have been nearly 190 million cases reported worldwide and more than 4 million deaths; and yet, less than a year after the outbreak was first reported, in an unprecedented global effort, researchers had developed home rapid self-tests [2], established treatment protocols proven effective to improve survival [3], and discovered highly effective vaccines that are already being produced and administered at a large scale [4].The COVID-19 pandemic also illustrates the importance of having research capacity in place as a critical element of pandemic preparedness.China, with its robust research capacity, was able to rapidly sequence the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARSAU : PleasenotethatSARS À CoV À 2hasbeendefinedasSevereAcuteRespiratorySyndromeCorona -CoV-2) virus in January 2020 [5] and quickly share the results, thereby jumpstarting global development of diagnostic tests and vaccines.In contrast, when outbreaks have occurred in countries with less research capacity, the development of countermeasures-diagnostics, therapeutics, and vaccines-may be delayed.We examined the relationship between a country's preexisting research capacity and the output of scientific publications in PubMed by the country's scientists following an outbreak.In the first 2 years after the Ebola outbreak was recognized in Guinea, only 42 papers on Ebola were published with authors with a Guinean affiliation, and there were significant challenges in launching Ebola treatment and vaccine studies.From Brazil, with its strong research infrastructure, 312 publications about Zika were authored by scientists with a Brazilian affiliation in the 2 years after that outbreak was detected, and substantial progress was made in rapidly characterizing the newly recognized, diverse clinical manifestations.Finally, authors affiliated with a Chinese institution published 8,921 articles on COVID-19 since the current outbreak was recognized, with remarkable progress in developing medical countermeasures.Anticipating significant progress in controlling COVID-19 in 2021, what are the future priorities for global health research?A helpful guide is the 2019 report of the Global Burden of Diseases, Injuries, and Risk Factors Study [6].This comprehensive synthesis showed that the largest absolute increases in number of disability-adjusted life years between 1990 and 2019 mostly included noncommunicable diseases, i.e., ischemic heart disease, diabetes, stroke, chronic kidney disease, and lung cancer.These illnessesAU : Anabbreviationlisthasbeencompiledforthose have overlapping risk factors-hypertension, high fasting plasma glucose, high body mass index, tobacco use, and ambient air pollution-which are also highly prevalent and mostly increasing over time [7], further suggesting important areas for research.Notably, some of these diseases and risk factors are also predisposing factors for more severe COVID-19 and prolonged symptoms post-COVID-19.