Global Effort on COVID-19 (GECO) Health Research - Call Specification

Research proposals addressing COVID-19 in low and middle income countries (LMICs) - supported by NIHR and UKRI

Global Effort on COVID-19 (GECO) Health Research is a new cross UK government funding call aiming to support applied health research that will address COVID-19 knowledge gaps. The focus is on understanding the pandemic and mitigating its health impacts in low and middle-income countries (LMIC) contexts. The call prioritises epidemiology, clinical management, infection control and health system responses.

The call is supported by:

The UK Department of Health and Social Care (DHSC) through the NIHR
The Medical Research Council (MRC), which is part of UK Research and Innovation (UKRI)

The funds form part of the UK's Official Development Assistance (ODA) commitment. Support will be available to address the impacts of COVID-19 in LMICs for research which has a direct and primary focus on improving health in LMIC countries. Applications will be accepted from eligible institutions based in the UK or in LMICs. Restrictions apply, please refer to Eligibility for full information.

This call builds on the NIHR and UKRI COVID-19 Rapid Response UK-focused rolling call to facilitate a coordinated research approach. The GECO Health Research call will be run as a series of calls, i.e. three consecutive rounds of the call will take place on a rolling basis.

Eligibility

Applications are particularly encouraged from LMIC PIs, as well as PIs based in the UK working in equitable partnerships with LMIC investigators. Applicants must have a relevant academic affiliation to an eligible institution in an LMIC or the UK.

Eligible UK institutions include UK Higher Education Institutions, Research Council institutes, and eligible Independent Research Organisations (IROs). Further detail can be found on the UKRI eligibility web page.

For researchers based in LMICs, eligible institutions include Higher Education Institutions and not-for-profit research institutions. Where the application is submitted by an LMIC organisation, the primary headquarters of that organisation must be in one of the LMIC countries where the research will take place. The institution must be legally registered in an LMIC or the UK and the Principal Investigator must be employed by the institution that is hosting the research.

PIs may not be from a commercial organisation or government ministry but may be included in the application as a project partner via service level agreement, making it clear what benefit is provided to the research programme.

Proposals must have a lead administering organisation eligible to accept and administer funds from NIHR and UKRI - either an eligible research organisation in a country on the OECD DAC recipient list or in the UK.

It is not permitted for the same person to be a Principal Investigator on more than one proposal at any one time. You may support others as co-investigator, as long as you have the capacity to do so without detriment to the project you lead.

China and India Institutions

Institutions based in China or India are not eligible to be the Principal Investigators for applications to this call but are welcomed as international co-investigators within proposals. This reflects that from 2020/21 partnerships with China and India funded through the Global Challenges Research Fund have a renewed focus: partnerships with co-investigators from China or India must have global or regional development impact as the primary objective, with local or national impacts within China or India as secondary objectives. It is expected that international co-investigators from China and India make a significant contribution to their own research costs, including covering their own overheads.

The application must have a direct and primary focus on improving health in an LMIC country or LMIC countries on the DAC list (see ODA eligibility).

Scope

The call specification is based on the WHO COVID-19 Global Research Roadmap priorities identified through a consultative process that involved experts from across the world. In addition, we have taken into consideration the African Academy of Sciences research priorities for COVID-19, and input from external experts, for example DHSC’s Global Health Research Independent Scientific Advisory Group and MRC’s Applied Global Health Research Board.

As well as projects addressing direct impacts of COVID-19, projects investigating the indirect consequences of the pandemic through other health issues such as (but not limited to): mental health, domestic violence, inter-personal violence, water and sanitation, maternal and neonatal health, nutrition, chronic conditions, and the wider impact on the health system or health service delivery, will be considered.

Implementation Science and operational research will be supported across the four Thematic Areas where appropriate to ensure a focus on practical application of findings.

Areas 3, 4, 5 and 9 from the WHO Roadmap are in scope:

Thematic Area 3. Epidemiological studies

1. Describe transmission dynamics of COVID-19 and understand spread of disease nationally, regionally and globally. This may include, for instance:

seroprevalence studies.
clarification of the importance of pre-symptomatic/asymptomatic transmission.

2. Describe disease severity and susceptibility to facilitate effective clinical and public health response to COVID-19. This may include:

identification of groups at/characteristics of increased risk of severe infection.
determination of the role of different age groups and household structures in transmission; for instance, consideration of the impact of demographic differences in LMIC settings, where the demographic pyramid of morbidity and mortality may mean COVID-19 has less impact in countries with a smaller elderly proportion of their population.
determination of susceptibility of children to COVID-19 and their role in transmission of the disease, whether infected asymptomatic, or infected symptomatic.

3. Evaluate impact of control and mitigation measures. This may include:

Determination and evaluation of the most effective measures to mitigate the health effects of the disease on the general population, and/or specific at-risk groups and/or specific settings such as health-care settings, schools or other work-places.
Determination and evaluation of the most effective measures to reduce the acute burden on healthcare providers and others delivering essential support and care, and to mitigate the health effects on health-care providers.
Estimation of the effects of social distancing measures and other interventions on transmissibility.
Comparative analysis/impact assessment for infection control intervention measures.

Thematic Area 4: Clinical management

Define the natural history of COVID-19 infection (e.g. Prognostic factors for severe disease, special populations, triage and clinical processes, sampling strategy).
Determine interventions that improve clinical outcomes for COVID-19 infected patients (including viral load, disease and transmissibility, markers of protection).
Determine optimal clinical practice strategies to improve the processes of care (including early diagnosis, discharge criteria, optimal adjuvant therapies for patients and contacts).
Consideration of how to manage outcomes when there are other co-existing conditions e.g. HIV, mental illness, diabetes, cancer.

Thematic Area 5: Infection prevention and control including health care workers’ protection

Understand the effectiveness of movement control strategies to prevent transmission in health-care and community settings (Effectiveness of restriction of movement of healthy exposed and infected persons to prevent secondary transmission - home, congregate settings, geographical restriction vs nothing).
Optimize the effectiveness of personal protective equipment (PPE), its adaptations in resource-poor/crowded environments and its use in reducing the risk of transmission in health care and community settings.
Assessment and mitigation of secondary health impacts of infection control strategies such as lockdowns. For instance, the impact on mental health issues, nutrition status, increased domestic/interpersonal violence, access to water and sanitation facilities.
Minimise the role of the environment in transmission of the COVID-19 virus e.g. transmission in informal settlements.
Understand societal, economic, organisational, behavioural and cultural influences on adherence to evidence-based Infection Prevention and Control (IPC) measures. This may include, for instance,

implementation research relating to use of diagnostic tests for containing the epidemic
determining how the test-trace-isolate approach can be adapted to be contextually appropriate and effective
context-sensitive implementation of public health handwashing and sanitation advice in low resource settings
context sensitive studies into vaccine preparedness and vaccine-related communications and engagement.

Thematic Area 9: Social Sciences and Humanities in the Outbreak Response

With a focus on health systems research relevant to the outbreak; wider impacts of the pandemic on the health system; and public health messaging.

Generate high-quality evidence to achieving the goals of the strategic public health response plan.
Promote the prioritisation of knowledge needs according to epidemic dynamics.
Promote that knowledge is produced according to local, national and regional needs.
Promote that knowledge outputs and methodological limitations are easily understood by non-social scientists.
Develop guidelines and Standard Operating Procedures (SOPs) to operationalise epidemic mitigation mechanisms.
Engage with communities to bring their voices to research and decision-making processes.
To understand cultural, long-term, and non-intended consequences of epidemic-control decisions.
Understand how decisions in the field may inadvertently undermine response goals.
Document how COVID-19 and the health system response affects the supply and access to other health care provision (such as maternal health, immunisation, routine surgeries, chronic disease care etc); and determining strategies to mitigate this.
Effective health systems responses to the epidemic: addressing issues such as health, wellbeing and effectiveness of the health workforce; supply chain management, financing, optimal implementation of clinical management and infection control measures.
Understanding and mitigating contextual vulnerability of health systems.

In parallel to this health-focused activity:

UK Research and Innovation has a route open for applications focused on the broader impacts of COVID-19 in LMICs for LMIC and UK applicants, for instance considering societal and economic impacts: UKRI GCRF/Newton Fund Agile Response call to address COVID-19;
NIHR and UKRI have a rolling call for proposals for research into COVID-19. The call is for UK-led groups (academics, small and medium enterprise (SME) and wider industry research) that will address a wide range of COVID-19 knowledge gaps/needs, and which will lead to a benefit to UK, and potentially international, public health within 12 months.

The application routes will be coordinated, and applications submitted to these calls may be redirected as appropriate, to ensure projects receive the most relevant and fastest review available.

Funding available

Proposals should normally be up to £1m per award.

The size of grants will vary according to the needs of each research project and will need to provide a robust case for value for money.

This call will cover 100% full economic costs (fEC) for Principal and Co-Investigators from LMICs. This applies to Investigators from Low and Middle Income Countries identified on the OECD DAC list of ODA recipients (refer to China and India Institutions for contribution). Normal fEC rules (80%) apply to UK based researchers. Funded projects will be subject to standard UKRI Terms and Conditions for fEC research grants.

A contribution towards the estates and indirect costs at the LMIC-based institution (calculated as up to 20% of the institution’s direct costs) can also be requested.

Applicants should provide costs of the proposal in GBP/£ as set out in the application form. In Section 1.5 please provide the total request against each category and provide a breakdown for 80% fEC and 100% costs; the overall (top line) total request should be the sum of staff costs, travel, consumables and other directly incurred costs, and indirect, directly allocated and estates costs. The total should be the amount being requested (i.e. the sum of 80% for UK HEIs, 100% for LMIC and 100% for non-LMIC, non-UK HIC if applicable) against each category. A brief description of the resources required, including estimated costs, in the different contributing environments and confidence in access to these will need to be provided in Section 3.6.

Duration

Proposals should normally be up to 18-month duration and applicants should be ready to start the research within 4 weeks of being notified of an award.

All proposals will need to be able to show how progress within the period of award could make a valuable contribution in addressing the impacts of the COVID-19 outbreak in LMICs, with data and tools/reagents generated under this call to be made widely available.

How to apply

Applicants must apply by completing the GECO Health Research application form, using the tab key to move between cells in the form, and submitting this as a pdf by the appropriate deadline:

12 midday BST, 22^nd June 2020- Now closed

12 midday BST 10^th August 2020 - Now closed

12 midday BST, 28^th September 2020 - Now closed

All proposals must use the provided form and be accompanied by:

The regulatory requirements annex (Annex 1) that forms part of the application form.
An optional but recommended document of supporting figures, GANTT chart and/or data tables (no more than 1xA4 page in total)
A CV for the Principal Investigator and all Co-Investigators. Each CV to provide relevant key publications/outputs and grants and other relevant information indicating their suitability to lead/support the research as described in the application (no more than 1xA4 page per CV).
For applicants from MRC Units, a core funding statement must be included as a letter of support. The statement needs to clearly explain the relationship between the proposed work and core support. It must be signed by the Unit Director or equivalent. Details can be found under ‘3.9 MRC Units and partnership institutes’ in the MRC grants guide.

Applications will require in the application form:

A plan for how research would be conducted under current restrictions (travel, social distancing) and need for front line health service provision and providers to be protected, and for local communities to be engaged and involved.
Demonstration of engagement with the relevant local or national bodies, such as Ministries of Health, in the country concerned to ensure that the work fits local or national plans and needs, and to facilitate knowledge transfer and use of research findings
Capacity strengthening plans to ensure future LMIC leadership on the research and research agenda
An outline of relationships with stakeholders, links or engagement with existing resources such as established longitudinal cohort studies or other in-country platforms or networks to demonstrate the likelihood of impact in the available timeframe.
Community engagement and involvement (CEI) plan. Active and participatory CEI that empowers communities and fosters co-production of research is actively encouraged. Patients and the general public within a given community, especially vulnerable groups who are at the greatest risk, will normally be the key group included in CEI activities. Other community stakeholders such as community leaders, opinion leaders, non-governmental organisations and civil society, service commissioners and providers, policy and lawmakers are examples of other stakeholders who can be involved. There is no standard model for CEI. Applicants should demonstrate that their CEI approach is appropriate and effective in the local context and for their study design. Applicants should demonstrate how they will engage and involve communities utilising the UNICEF Minimum Standards for Community Engagement.
Demonstration of an understanding of the relevant wider context (social, cultural, historical, economic, religious, etc) and the likely reception of public health interventions by the people and societies they are intended to benefit.
An ODA Compliance Statement
A Gender Equality Statement
References should be included in the character/word limit of the relevant section of the application form. They cannot be submitted as a separate document/attachment to the application form.

Applications must be collated into a single pdf in the following order - Form plus Annex, Document of supporting figures/GANTT chart and/or data tables, CVs - and submitted to geco@nihr.ac.uk.

To create a single file, please save your completed form, page of supporting information and CVs as individual PDFs and then merge into one file. Some pdf editors offer this function, or there are online tools to do this.

The office will not return applications due to missing data and/or components, with applicants bearing the risk of such missing data and/or components negatively impacting their proposal’s review.

Please note that successful applicants will be required to return their award acceptance within five working days of receipt. Failure to comply with these requirements could result in forfeiture of the award.

Award Start Date

Given that this opportunity is for timely proposals, grants are expected to start within four weeks of award notification.

Evaluation process

Proposals will be reviewed by members of a college of experts, chosen based on the subject matter of the proposal. These reviews will then be used by an Expert Panel, who will make recommendations on outcome to UKRI and DHSC. Applicants will not have an opportunity to respond to Panel comments in instances where feedback is provided, except where clarifications and/or changes are required as part of the award process.

Key assessment criteria for the submissions will include:

The potential for the proposal to have an impact and to provide a unique value-adding contribution relative to existing activity
Access to required resources
Applicant expertise and experience
Partnership: including strength and clarity of collaborations and opportunities provided
Design and feasibility of project plan
Value for money
ODA eligibility
Plans for community engagement and involvement and engagement with relevant local or national bodies and community groups
Alignment with the WHO COVID-19 Global Research Roadmap priorities

The decisions of the Panel will not be open to appeal and the funders reserve the right to amend the application process.

Official Development Assistance

The research supported through this call will contribute to the UK’s ODA commitment to LMICs as UK aid. Applications must demonstrate how the research will be of primary and direct benefit to the health of people living in LMICs.

Further guidance on ODA and demonstrating ODA compliance in applications for funding available via the UKRI: Global Challenges Research Fund webpage.

As part of the government’s commitment to ODA transparency and in line with DFID ODA reporting requirements, NIHR and UKRI are responsible for publishing information about ODA grants including project titles and summaries via the International Aid Transparency Initiative (IATI) registry and via DFID’s national statistics. The purpose of publishing information via the IATI registry is to make information about ODA easily accessible to governments, stakeholders and other relevant groups in beneficiary countries. All funded projects from this programme will be published in this way.

As part of the award process, applicants will be required to adhere to the points set out in the:

Funder Principles For Supporting Research In Low- And Middle-Income Countries For Epidemics & Pandemics (See Annex 2).

This includes a commitment to equitable partnerships informed by UKCDR’s Equitable Partnership Principles.

Contacts and guidance

For general and scientific queries relating to the call, including queries relating to the administrative process of applying, please contact geco@nihr.ac.uk

Key dates

Round	Closing date	Panel meeting
Round 1	12 midday BST*, 22^nd June 2020	22 July 2020
Round 2	12 midday BST, 10^th August 2020	7 September 2020
Round 3	12 midday BST, 28^th September 2020	30 November and 1-2 December 2020

*BST British Summer Time

Annex 2

Funder Principles for supporting research in low and middle income countries for epidemics and pandemics

The UKCDR Funder Principles were launched in The Lancet on 17 July 2020 "Strengthening the global effort on COVID-19 research through joint principles for funding global research in epidemics and pandemics".

Please read the announcement from UKCDR: "UKCDR & GloPID-R align research funders to seven principles for stronger research response to epidemics & pandemics".