Table 2 Outline of lessons for HRSs from the pandemic, organized using the WHO framework for HRSs
HRS functions/components | Lessons related to each HRS component, comprehensive strategies and negative impact |
|---|---|
Governance | Governance |
1. Coordination | 1. Existing or rapidly established coordination was often the key, especially for clinical research, to effective responses and reduced risk of wasted resources |
2. Priority-setting | 2. Effective priority-setting was important in: rapidly testing new therapies, reducing waste of resources, considering the needs of diverse communities |
3. Ethical approval | 3. The ability to accelerate ethics and protocol approvals and to enhance data access and sharing increased the speed and efficiency of research production |
4. Evaluation | 4. The substantial and immediate benefits from rapid (but expensive) research progress provide enhanced opportunities and need for impact assessment |
Financing | Financing |
5. Securing finance | 5. Unprecedented (but uneven) funding; public, for many pandemic topics; private, for development of vaccines and therapies; collaborative, to help achieve major successes; but widespread concerns about wasted resources |
Capacity | Capacity |
6. Capacity-building | 6. Important contributions came from: mobilization of capacity developed over years to conduct primary and secondary research, enhanced interdisciplinary cooperation and clinical research integrated in healthcare systems |
Production and use | Production and use of research knowledge |
7. Knowledge production | 7. Accelerating research production (new vaccine platforms, mobilized capacity, adaptive platform trials) produced results—but problems for policy research; rapid publication of findings became essential but led to dangers |
8. Promote use in new products | 8. Translation of research into new products to reduce mortality and morbidity often occurred at unprecedented speed and often reflected unprecedented levels of both public funding and public/private collaboration tackling the crisis |
9. Translate to inform policies, practice and opinion | 9. The considerable divergence in the use of evidence to inform NPI policies, etc., and to promote equity in policies, partly reflected established structures and cultures; collaborative living guidelines and good communications mattered |
Comprehensive strategies for health research | 10. Pre-existing comprehensive health research strategies and vision enhanced the effectiveness of specific steps and opportunities for producing research to improve policies, practice and health, but did not ensure informed action |
Negative impacts on HRSs | 11. The pandemic damaged aspects of HRSs: reduced resources/opportunities especially for non-COVID-19, early-career, female and minority researchers; problems completing projects in lockdowns; reductions in public involvement |