15.1 In Practice: Leveraging an Integrated National Health System for Research Response—The UK National Institute for Health Research Respiratory Translational Research Collaboration

This chapter describes the efforts and strategies that allowed the United Kingdom (UK) to lead the world in coronavirus disease 2019 (COVID-19) research, inform government policy, and provide its National Health Service (NHS) and social care systems with tools needed to prevent and treat COVID-19. The UK National Institute for Health Research (NIHR) minimized fragmentation of research efforts between countries in the UK, guided the prioritization of resources across the system in the UK, and focused efforts on therapeutics most likely to be effective against severe acute respiratory system coronavirus 2 (SARS-CoV-2), which causes COVID-19. The Urgent Public Health (UPH) process treated research as a crucial, prioritized component of the COVID-19 response from the start of the pandemic and assembled a portfolio of platform trials spanning first-in-human (Phase I) through Phase III safety and efficacy trials on medical countermeasures (MCMs). The impartial, scientifically driven UK Covid Therapeutics Advisory Panel (UK-CTAP) was established to identify, prioritize, and recommend drugs to be tested through national trial platforms while avoiding duplication of effort. Treatment recommendations were made through an open submission system approach based on three layers of scrutiny to guard against conscious and subconscious bias. A Therapeutics Taskforce coordinated government efforts and ensured that high-quality research was delivered at pace, providing patients with timely access to safe and effective COVID-19 treatments. These successes have helped save the lives of millions around the world, and NIHR continues to support critical research that enables treatments and vaccines for all.