Research enablers A funding scheme to generate new knowledge about interventions that promise to contribute to the improvement of health in LMICs that has built clinical trial capacity.
| UK Funders | MRC, FCDO, DHSC/NIHR, Wellcome |
| Funding programme | Two strands: Full trial awards and Development awards |
| Total UK investment | ~£200M |
| Project dates | 2009-present |
| Countries of focus | All LMICs, current trial sites located in 47 countries across Africa, South Asia, Northeast Asia, Caribbean, Latin America, Central America, Europe, Middle East and North Africa region. |
| Model/approaches to RCS | Embedded |
| Find out more | Joint global health trials – UKRI |
Background
The JGHT scheme was set up in 2009 to deliver key efficacy and effectiveness data for health interventions in LMICs. This robust evidence is required to support policy change and real-world implementation, which ultimately leads to health impact. Global health trial platforms are underrepresented in LMICs- LMICs host 90% of the global burden of disease but less than 20% of clinical trials are being conducted there. This is driven by barriers faced by LMIC researchers such as a lack of financial and human capacity, lack of research environment and operational barriers.
The establishment of JGHT has pooled resources to allow UK funders to support trials of larger scope and/or cost, whilst sharing any potential risks. JGHT-funded studies can be led by applicants from LMICs and/or the UK but must be conducted in an LMIC. Although not an explicit goal, JGHT-funded research has built clinical trials capacity through the studies it has funded in low-resource settings.
Impacts
An independent review of the scheme reported a range of RCS impacts:
Skills development and LMIC-led research
- 71% of co-investigators reported enhanced scientific knowledge which has been used for further work.
- The scheme provided substantial support to LMIC-led research institutes including 46 awards made direct to LMIC principal investigators.
- The establishment of the JGHT Development award scheme provided funds for pilot studies and has served as an entry point to global health research and trials for less experienced principal investigators including LMIC based investigators.
Improved trial capacity
There is evidence that the JGHT scheme has had a positive impact on clinical trial capacity in the LMIC institutions.
- Funded 82 late-phase clinical trials and 67 development awards. Funding of Development awards has prepared groundwork for future trials in areas not previously involved geographically or addressed in terms of heath needs.
- 65% of PIs from closed full-trials highlighted that the research had enhanced trial capacity at the trial site(s), including through training in trial methodology and data management.
Research and policy impact
- JGHT-funded research has generated new knowledge about interventions which in turn are starting to contribute to improving health in LMICs.
- Study results from trials have directly resulted in health policy impacts, for example updated WHO guidelines and recommendations.
- The scheme has strengthened capacity to successfully apply for further funding and strengthened relationships with policy makers, influencing the likelihood of research uptake and impact.
“The information gathered and the wealth of experience has made [our] organisation attractive for other research donors and partners and has strengthened the relationship with the Ministry of Education and Health”
Success factors and lessons learned
- Funding LMIC researchers directly has facilitated LMIC leadership and ownership of the research agenda.
- Funding trials through JGHT has helped to overcome barriers (e.g. financial and human capacity) and strengthen capacity for sites to conduct more trials in future.
Future vision
Global health trial funding will likely remain focused on delivering impact from the trial, but the funders are looking at ways to facilitate capacity strengthening, either embedded in the research grants, or as standalone activities.