Research and Innovation for Global Health Transformation - Call 4 Stage 1 Guidance for Applicants

The closing date for electronic submission of applications is Wednesday, 10 March 2021 at 1pm UK time

Introduction

In 2015, the NIHR Global Health Research Portfolio was established to support applied health research for the direct and primary benefit of people in low- and middle-income countries (LMICs) on the Development Assistance Committee (DAC) list, using Official Development Assistance (ODA).

The Global Health Research Portfolio is underpinned by three principles which guide development and delivery. These are:

• Meet eligibility criteria as Official Development Assistance (ODA), i.e. funded research directly and primarily benefits people in ODA-eligible countries on the DAC-list.
• Deliver high-quality applied health research, building on the Principles of the NIHR: Impact, Excellence, Effectiveness, Inclusion and Collaboration.
• Strengthen research capability and training through equitable partnerships.

The NIHR has established a substantial portfolio of applied global health research and training in areas that are underfunded or where there is an unmet need. The portfolio aims are delivered through a combination of; researcher-led and commissioned calls, funding initiatives to develop and advance global health research career pathways both in LMICs and in the UK, and through partnerships with other major global health research funders. Together these have positioned the NIHR as a key player in supporting high-quality global health research.

Background

NIHR Research and Innovation for Global Health Transformation (RIGHT) funds cutting-edge interdisciplinary applied health research in key areas in LMIC where a strategic and targeted investment can result in a transformative impact.

The active portfolio currently comprises five awards focusing on severe and stigmatising skin diseases, two on epilepsy and one on infection-related cancers under RIGHT Call 1, and six awards under RIGHT Call 2 focusing on global mental health. The application process for RIGHT Call 3 with a priority focus on multimorbidity is underway at the time of the launch of RIGHT Call 4. Find out more about the research funded by the RIGHT programme.

The NIHR is pleased to launch a fourth RIGHT call that will meet the aims and ambitions set out in the following call specification. This call supports targeted investments in the global burden of unintentional injuries and urgent and emergency care through high quality, interdisciplinary applied health research to improve outcomes for patients in LMICs. The NIHR has recognised this as an area of unmet need, making it an NIHR priority for a themed call in the UK, and globally through this RIGHT call.

Please note that this is the first time that a RIGHT call is also open to direct applications from LMIC Contracting Leads. Please see section 7.2 of this document for applicant eligibility.

Rationale

The NIHR recognises the significant global burden of mortality and morbidity due to injuries, accidents and conditions requiring urgent and emergency care, and has worked with the World Health Organization (WHO) to determine the scale of the burden and identify research gaps.

Injuries and accidents constitute a major global health challenge with significant social and economic consequences, causing over 5 million deaths per year or 16,000 deaths per day.

The worldwide burden of unintentional injuries – defined as any injury that is unplanned, not caused on purpose or not caused with intention to harm – is disproportionately concentrated and increasing in LMICs, comprising 91% of global deaths and 94% of disability-adjusted life-years lost, with a disproportionate impact on the young and vulnerable. Given current trends, the global burden of injuries is expected to continue to impede development and drain scarce resources. By 2030, road traffic injuries alone are predicted to be within the top 5 leading causes of death globally.

Overall, road traffic injuries are the largest contributor to deaths from unintentional injuries, accounting for 1.35 million deaths each year and is the leading cause of death among children and young adults aged between 5-29 years. Other leading causes of unintentional deaths include drowning (the leading cause of death for 1-4 year olds), falls and burns. However, the category of unintentional injuries is broad and encompasses other unintentional injuries such as snake and animal bites.

There is international recognition that injuries and accidents are an increasing global health burden. The Lancet’s Non-Communicable Disease and Injury (NCDI) Poverty Commission has committed to facilitating the prioritisation of evidence-based, country-level investments to reduce the burden of chronic conditions and unintentional injuries among the poorest billion individuals. At the seventy-second World Health Assembly in 2019, a resolution was adopted on emergency and trauma care aimed at assisting countries to ensure timely care for the acutely ill and injured. The Assembly called for near-term additional efforts globally to strengthen the provision of emergency care as part of Universal Health Coverage to ensure the timely and effective delivery of life-saving health care services to those in need, including the injured.

While considerable efforts have been made to address unintentional injuries and the response to them, the burden varies significantly across different geographical contexts and social groups. Therefore, the research, interventions for behavioural change and investment priorities for high income countries (HICs) are often not directly transferable to LMIC settings, despite most deaths and injuries occurring in LMICs.

Timely and effective care at the scene of an injury through to facility-based emergency care are essential components of any response to injuries and has the potential to improve outcomes. The lack of an organised emergency care system in many LMICs leads to wide discrepancies in health outcomes. There is a critical need for research assessing the role of emergency care services in reducing the global burden of unintentional injuries.

RIGHT Call 4 has been established by NIHR to address a lack of funding in the important public health issue of unintentional injuries in LMICs.

Aims of RIGHT Programme

Through the RIGHT programme, NIHR provides research funding to support cutting-edge interdisciplinary applied health research in key areas in ODA-eligible countries where a strategic and targeted investment can result in a transformative impact.

Building on the NIHR GHR principles above, the strategic aims across the RIGHT programme are to:

• Deliver applied health research for the direct and primary benefit to LMIC(s), typically through research in key thematic areas for the prevention of ill health and optimal disease management.
• Strengthen capacity for research and knowledge exchange through equitable partnerships between researchers involved in the research.
• Promote interdisciplinary approaches to working (including, but not limited to: clinical, health economics, statistics, qualitative and social sciences), to ensure that research objectives can be delivered.
• Generate new research knowledge and evidence on interventions to improve health outcomes of people in LMIC(s).

Priorities and focus of Call 4

In order to achieve the aims outlined above, the NIHR is seeking applications for RIGHT Call 4 that address applied health research in the following areas:

Prevention and management of unintentional injuries in LMICs

• Evaluation of interventions to prevent and/or to improve outcomes from unintentional injuries.
• Implementation research to assess effectiveness of intervention strategies in LMIC settings and context specific challenges.
• Applied research, leading to better understanding of cultural attitudes, environmental factors, practices and behaviours influencing risks and interventions for injury prevention.
• Context-specific research on integrated preventative strategies and their evaluation with the potential to influence policy process and ensure that interventions are based on evidence.
• Research to build evidence and comprehensive data to understand challenges to implementation of injury prevention and management measures and barriers to scale up interventions that have shown to be effective.
• Development and evaluation of interventions of ongoing management including rehabilitation, wounds and quality of life.
• Health economics research to assess impact of injuries and the cost effectiveness of injury prevention interventions.

Emergency care system strengthening in LMICs

research into health care system improvements for improved treatment and care for those affected by unintentional injuries in LMICs.

• Development and evaluation of interventions to improve immediate post-accident treatment at the scene.
• Implementation research to improve the response to and delivery of urgent and emergency care as a result of unintentional injuries in low resource settings.
• Health economics research to assess investment to strengthen emergency care systems in terms of sustainability and long-term uptake.

Budget and length of funding

Through this call, awards up to £5 million, typical range £1-5 million (maximum of £5 million) over 3-5 years are available for eligible research.

The amount requested and the length of the funding period should be fully justified according to the nature of the proposed research.

Eligible costs for NIHR RIGHT include:

• Direct Costs
  
  • Staff costs
  • Travel, Subsistence and Conference costs
  • Equipment
  • Consumables
  • Community Engagement and Involvement
  • Dissemination
  • Risk Management and Assurance
  • Training and Development Costs
  • External intervention costs
  • Monitoring, evaluation and learning
  • Other Direct Costs
• Indirect Costs / Overheads (guidance varies according to type of organisation)

Please see the NIHR Global Health Research Finance Guidance for detailed information.

Proposal and Partnership Development Award

Proposal and Partnership Development Awards (PPDA) were established to support partnership development and the preparation of a RIGHT Stage 2 application. Applicants that are successful at RIGHT Stage 1 and invited to submit a RIGHT Stage 2 application are eligible to apply for a PPDA. PPDA provides funding of up to £10,000 to

• Support applicants to work collaboratively with all study partners to develop stage 2 applications;
• Enhance/initiate partnerships and Community Engagement and Involvement (CEI) activities to strengthen the research proposal;
• Initiate preparation of study governance documentation (i.e. due diligence and finance assurance policies).

To be considered for a PPDA, applicants must complete a separate PPDA application. The PPDA application must be submitted at the same time as the RIGHT Stage 1 application in the Research Management System (RMS) by the deadline 10 March 2021 at 1pm UK time

PPDA applications will be reviewed for those applicants that are successful at Stage 1. Those applicants that are rejected at Stage 1 will not be eligible for PPDA. Those applicants that are successful at Stage 1 will be notified of the outcome of their PPDA application at the same time as the RIGHT Call 4 Stage 1 application.

Eligible costs for PPDA and the reimbursement process is described in full in the RIGHT Call 4 Finance guidance.

Please see separate Proposal and Partnership Development Award Guidance for completing the PPDA application and further examples of what a PPDA can support.

Scope

Key criteria for funding

NIHR RIGHT Call 4 will provide funding to support targeted investments in applied health research to address the global burden of unintentional injuries, for the direct and primary benefit of people in one or more LMICs, as listed on the DAC list of ODA-eligible countries.

The following key criteria for this call encompass the overarching NIHR principles and contribute towards the aims for the NIHR GHR portfolio as a whole. The key criteria for funding are incorporated within the Funding Committee selection criteria which will be used to assess applications at Stages 1 and 2.

Applications for RIGHT calls will be required to describe how they address the following key criteria for funding:

1. Relevance of the proposed research: Applications should demonstrate that the proposed research fulfils a significant gap, addresses unmet needs and priorities in ODA-eligible countries and aligns fully with the scope of this call. The proposed research plans should be based on a review of the local context/health system(s) and existing evidence.
2. Research excellence: Applicants should demonstrate that the planned research is context-specific, needs-driven and addresses unintentional injuries and urgent and emergency care in LMICs. The research plan should be clear and robust detailing clear research questions/objectives, sound design and detailed methodology to address the questions and meet the objectives; clear milestones, identification of possible risks and factoring in ethical considerations).
3. Strength of the research team: Applications should demonstrate the research team has a depth of relevant expertise and promotes interdisciplinary approaches to working by including expertise / activities associated with a broad range of disciplines such as clinical, health economics, statistics and social sciences. The proposed research plans should establish equitable partnerships within and across research teams.
4. Impact and Sustainability: There is a clear and implementable strategy for pathways to impact, including research uptake and dissemination, with the potential to improve practice, inform policy, and support implementation and scalability.
5. Capacity Strengthening: There are clear plans for research and research management capacity and capability strengthening at individual and institutional level.
6. Community Engagement and Involvement: Relevant and appropriate stakeholder and community engagement and involvement should be evident throughout all stages of the research, from research priority setting and design, to delivery, dissemination, and impact evaluation activities.
7. Equity of partnerships: Equity and collaboration should be demonstrated across all aspects of the research proposal, including; programme leadership, decision-making, capacity strengthening, governance, appropriate distribution of funds, ethics processes, data ownership, and dissemination of findings. Promotion of equality, diversity and inclusion are expected to be strongly reflected in all aspects of the planned research.
8. Value for money: Evidence of a clear, well-justified budget that represents good value for money is required. Applications must demonstrate that all planned expenditure is proportionate and appropriate against the planned activities outlined in the application and consider Economy, Efficiency, Effectiveness and Equity (please see the NIHR GHR Core Guidance for more information on value for money

In recognition that the COVID-19 outbreak is having a significant impact across global health systems, applicants should consider the context of COVID-19 where relevant to their research proposal, both in terms of project planning and the generalisability of outcomes.

In scope 

NIHR RIGHT Call 4 will support applications that:

• Propose applied health research programmes that primarily and directly address the challenges faced by LMICs in the area of unintentional injuries and/or urgent and emergency care.
• Include interdisciplinary applied research teams with demonstrable expertise and a track-record of ensuring research is transferred into benefits for patients in LMICs. This can include teams in LMICs as well as UK teams and researchers, who may want to build new research partnerships with colleagues in LMICs or apply their research expertise to global health.
• Seek to address issues of equity by incorporating research questions around gender, age, social barriers to health and economic impact.
• Demonstrate equity and collaboration in programme leadership, decision-making, capacity strengthening, governance, appropriate distribution of funds, ethics processes, data ownership, and dissemination of findings.
• Include relevant engagement with policy makers, patients and the public, civil society organisations and charities throughout the proposed programme.

Out of scope 

RIGHT Call 4 will not support applications that: 

• Do not meet the published call and eligibility criteria for RIGHT Call 4.
• Include intentional injuries, such as self-harm, suicide, interpersonal violence, homicide and injuries resulting from war.
• Address health care system improvements for conditions which are unrelated to unintentional injuries
• Consist solely of one of the following:
  • randomised clinical trials (RCTs) of interventions
  • epidemiological studies
  • evidence synthesis (e.g. systematic reviews)
  • evaluations of existing services, where the programme of work does not include evidence-based development and improvement of these services replicating research already undertaken in High-Income Countries – research proposals should be clearly relevant to the ODA-eligible LMIC in which the research is being undertaken
  • implementation science
  • dissemination
• Primarily focus on establishing new biobanks or bio-sample collections or data collection studies (samples or data from existing biobanks, patient registries may be used).
• Primarily focus on observational research, secondary research or health policy implementation.
• Focus on basic laboratory/discovery research or experimental medicine.
• Research on viral or infectious diseases as a result of animal/vector bite, such as malaria, viral haemorrhagic fevers, rabies etc.

Eligibility

ODA Eligibility

The NIHR Global Health Research programme supports high-quality applied health research for the direct and primary benefit of people in low and middle-income countries (LMICs) on the Development Assistance Committee (DAC) list, using Official Development Assistance (ODA) funding.

In order to be eligible to receive NIHR Global Health Research funding, applications must demonstrate how they meet ODA compliance criteria and outline:

• Which country or countries on the OECD DAC list of ODA-eligible countries will directly benefit?
• How the application is directly and primarily relevant to the development challenges of those countries?
• How the outcomes will promote the health and welfare of people in a country or countries on the DAC list of ODA-eligible countries?

Where some elements of the research is not undertaken in an ODA-eligible country during the course of the award (including where a country graduates from the DAC list during the lifetime of the award or there is a need for specialist expertise) the application must clearly state the reasons for this with due consideration to the benefit of the research to ODA-eligible countries.

Further information can be found at:

• NIHR ODA Guidance for Researchers
• OECD Factsheet: What is ODA?
• OECD DAC list of ODA eligible countries
• Official development Committee.

Who can apply

Applications MUST be led by either:

• A Principal Investigator (Lead Applicant) employed by an LMIC Higher Education Institution (HEI) or Research Institute.

Or

• A Principal Investigator employed by a UK HEI or Research Institute (UK Joint Lead Applicant) to jointly lead with a Principal Investigator employed by an LMIC HEI or Research Institute (LMIC Joint Lead Applicant).

The contracting institution must be a HEI or Research Institute. For RIGHT Call 4, an LMIC or UK Research Institute is considered to be a not-for-profit research organisation with a proven track record in, and sufficient research and financial capacity to manage and deliver research and training, in the field or discipline in which it is applying for funding.

For organisations that have not previously been funded by the RIGHT programme, additional eligibility and due diligence checks may be undertaken in addition to standard NIHR eligibility and due diligence checks prior to contracting.

Please note: Where the contracting organisation is a UK institution with a UK Joint Lead Applicant, it is mandatory for an LMIC Joint Lead Applicant to be included on the application, with the expectation that the joint leadership/partnership is equitable. Where the contracting organisation is an LMIC institution, a UK Joint Lead Applicant is not a mandatory requirement. LMIC Lead Applicants may propose joint leadership partnerships with a Principal Investigator from another eligible LMIC or UK institution, or lead the application without a Joint Lead Applicant.

Dependent on the nature of the partnership, there may be other affiliated Co-applicants (maximum of 15) and collaborators/project partners including service level providers.

Contracting and funding must take place via the lead administrating institution (i.e. the LMIC or UK Joint Lead Applicant’s official organisation, i.e. the organisation where the LMIC/UK Joint Lead Applicant is employed).

Commercial organisations or governmental agencies cannot be a Lead or Joint-Lead on an application as they do not fall under any of the eligible categories above. However, these organisations may be included in applications as Collaborator or via service level agreement, providing it is clear what benefit a commercial company would bring to the research programme. In addition, a company’s commercial model must be compatible with the conditions laid out in the NIHR research contract and NIHR’s policies/limitations around funding indirect costs, and the costs are clear in the budget. It is important that any Applicant organisation is aligned with NIHR’s principles including open access to research.

Non-health research institutions, e.g. an institute of engineering, can act as Co-Applicants or Collaborators, provided their expertise is relevant to the plans proposed.

Under this call, an individual cannot be named as Lead/Joint Lead Applicant on more than one application.

There are no restrictions on the number of applications an institution can submit under this call provided they are distinct in their objectives.

Existing NIHR Global Health Research award holders are eligible to apply to this call provided there is assurance they have sufficient plans in terms of time and resources available to them to deliver concurrent awards successfully.

Please refer to the Global Health Research Programmes Applications – Core Guidance for more information that may be useful to your application.

If you are unsure of eligibility, please contact ccf-globalhealth@nihr.ac.uk.

Selection Criteria for Stage 1

RIGHT Call 4 Stage 1 applications will be assessed against the following four key criteria:

• Relevance of the proposed research
• Research excellence
• Strength of the research team
• Impact and sustainability

Please refer to the key criteria in Section 6.1 for details of what is expected to be demonstrated in the application for each of these criteria.

At Stage 1, applicants are expected to consider, but not provide extensive detail for key criteria (e-h) in section 6.1. Applicants should however ensure these are embedded throughout proposal development.

At Stage 2, the Funding Committee will assess research proposals based on all key criteria listed in 6.1. Therefore, applicants who are successful at Stage 1 will be expected to further develop their proposal and provide a higher level of detail on the remaining criteria at Stage 2.

Selection process for RIGHT Stage 1

NIHR RIGHT Call 4 is a two-stage competition with a mandatory Intent to Submit form during stage 1. Stage 1 is a short-listing outline stage. Stage 2 is for successful applicants at Stage 1 to produce a full application.

All eligible applications at Stage 1 and Stage 2 will be considered by an independent international Funding Committee that will make recommendations to the Department of Health and Social Care on which applications should be supported.

If high numbers of applications are received, the NIHR may adopt a triage process where members of the Funding Committee will review and score access applications against published eligibility and selection criteria ahead of the Funding Committee meeting. Those proposals which are below the agreed threshold will be rejected at that point and will not receive feedback. High-scoring applications will proceed to the Funding Committee meeting.

Timetable

Step	Date
Call launch	11 November 2020
Deadline for intent to submit form	10 February 2021
Deadline for remit enquiries*	4 March 2021
Deadline for receipt of Stage 1 applications and PPDA applications	10 March 2021 at 1pm UK time
Funding Committee review	May 2021
Applicants notified of outcome of Stage 1 and PPDA	June 2021
Stage 2 opens for successful Stage 1 applicants	June 2021

*NIHR will not guarantee they will be able to answer queries about the remit or content of applications after this date. If you have other queries about RMS or the application process, please do contact us after this time.

Completing your application online

It is mandatory for applicants to submit a short intent to submit form prior to the full application submission. You must complete an online application via the Research Management System (RMS). The closing date for applications is Wednesday, 10 March 2021 at 1pm UK time.

• Applications will not be accepted if submitted after the exact closing date and time, the system will automatically prevent this from happening.
• It is the applicants’ responsibility to allow sufficient time to submit an application.
• Applicants must contact the NIHR RIGHT Global Health team by emailing ccf-globalhealth@nihr.ac.uk or calling +44 (0)20 8843 8080 immediately if they think there is a system problem, whilst attempting to continue with their submission.

Please see guidance on completing your application form.