CITATION: Series | Clinical trials in global health | volume 9, issue 5, e711-e720, may 01, 2021
How COVID-19 has fundamentally changed clinical research in global health
Jay J H Park et al.
Open Access Published:May, 2021 DOI:https://doi.org/10.1016/S2214-109X(20)30542-8
COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response to the COVID-19 pandemic has prominently highlighted many fundamental issues that exist in clinical trial research under the current system and its incentive structures. The COVID-19 pandemic has not only re-emphasised the importance of well designed randomised clinical trials but also highlighted the need for large-scale clinical trials structured according to a master protocol in a coordinated and collaborative manner. There is also a need for structures and incentives to enable faster data sharing of anonymised datasets, and a need to provide similar opportunities to those in high-income countries for clinical trial research in low-resource regions where clinical trial research receives considerably less research funding.
We recognise the incredible pressure this pandemic has put on researchers, regulators, and policy makers, all of whom are doing their best to move quickly but safely in a time of tremendous uncertainty, but the readiness of the research community to bring about rapidly informed decisions on the basis of research evidence has been inadequate.
Investing in large-scale clinical trials that can facilitate international collaboration will be important to generate high-quality data efficiently that can inform policy and change clinical and public health practices.
I have not had a chance to read this paper in full, but a few additional comments:
1. There has been a huge shift of funding away from existing non-COVID research
2. There are special challenges with regards to conducting high quality research when health systems are under excessive pressure
3. Such research should include implementation research to explore how health systems can be made more resilient to provide essential health services during and between waves, and after the pandemic.