A living mapping review for COVID-19 funded research projects: final (27 month) update

Background: The coronavirus disease 2019 (COVID-19) has resulted in an unprecedented research response, demonstrating exceptional examples of rapid research and collaboration. There has however been an ongoing need for greater coordination, with limited resources for research and the shifting global pandemic. Methods: The UK Collaborative on Development Research (UKCDR) and Global Research Collaboration for Infectious Disease Preparedness (GloPID-R), two funder coordination groups have collaborated to develop a live database of funded research projects across the world relating to COVID-19. Drawing data continually from their members and further global funding bodies, as of 15th October 2022 the database contains 20,006 projects, funded by 351 funders, taking place across 157 countries representing an investment of at least $7.4 billion. To our knowledge it is one of the most comprehensive databases. The database is aligned to the World Health Organisation and GloPID-R Global Research Roadmap: 2019 Novel Coronavirus and the UN Research Roadmap for the COVID-19 Recovery. It is being used by the WHO, governments and further policy makers, research funders and researchers. This living mapping review aims to supplement the database by providing an open, accessible, and frequently updated resource summarising the characteristics of the COVID-19 funded research portfolio. Both descriptive and thematic analyses are presented and updated frequently to aid interpretation of the global COVID-19 funded research portfolio. Results: In this final version ten analysis, we provide an updated detailed descriptive analysis of the database (on data from three months after version nine) and focus our thematic analysis on research gaps, research areas in need of coordination, study populations, and research locations (with a focus on resource-limited countries). Conclusions: As the global research response to COVID-19 plateaus, this living mapping review has helped both funders and researchers to prioritise resources and review investments.

In a joint effort to further coordinate and synergise the funding of research to address the WHO Roadmap identified priority areas, the UK Collaborative on Development Research (UKCDR) partnered with GloPID-R to launch the COVID-19 Research Project Tracker 3 (the tracker) on April 3, 2020.The tracker is a live database of funded research projects across the world related to the current COVID-19 pandemic.It includes both newly funded research projects and repurposed research projects across all disciplines and categorises them against the mid-to long-term research and development priorities and sub-priorities identified in the WHO Roadmap.Mapping of projects as soon as funding is announced allows visibility of the funded research portfolio well in advance of any outputs such as publications.To date, the database has been accessed over 41 thousand times and we have had active engagement (beyond data entry) with over 30 funders, the WHO (and associated COVID-19 research priority area groups), and research groups regarding its use and the living mapping review.The data is also being extracted by several other funding tracking tools (including Europe Pub Med Central).
The UKCDR Epidemics Preparedness and Response Funders Group 4 and GloPID-R Funders groups have each been meeting frequently during the pandemic to strengthen UK and global COVID-19 research funding coordination activities, respectively.Their work is informed by the data and analysis from the tracker.Several members of both organisations have launched calls for research on COVID-19 in low and middle-income country (LMIC) settings.There is a particular concern that, due to the resource limitations in LMICs, an uncoordinated approach could potentially lead to unaddressed local research needs, failure of research to inform policy, or unsustainable research capacity to respond to future outbreaks.The UKCDR and GloPID-R funders groups have further strengthened their response by agreeing to a set of Funder Principles for supporting high-quality research for the most pressing global needs in epidemics and pandemics 5 and with the formation of a jointly hosted initiative for COVID-19 Research Coordination and Learning (COVID CIRCLE), encompassing the tracker and with a particular focus on resource-limited settings 5 .
As part of the COVID CIRCLE initiative, this living mapping review was established to regularly update and incorporate newly funded research projects as they become available and review their alignment to the WHO Roadmap priorities.A living mapping review (LMR) is needed due to the rapidly expanding number of funded research projects and the importance of the review to inform funding decision making.Here, in version ten, we present the results of the ninth three-month update of all research projects within the tracker as of 15 th October 2022 and a descriptive and thematic analysis to aid interpretation of the global COVID-19 funded research portfolio.We have additionally now added a mapping of these same research projects against research priorities identified in the United Nations (UN) Research Roadmap for the COVID-19 Recovery 6 .We previously published a more detailed analysis on the African continent specific baseline data from this tracker in collaboration with the African Academy of Sciences 7 .This is the final version of this LMR, marking the end of the COVID CIRCLE programme of work, which will now evolve into the Pandemic Preparedness: Analytical Capacity and Funding Tracking Programme (Pandemic PACT).

Protocol for LMR
The LMR protocol outlined herein was prospectively designed.Due to the rapid need for this project to be conducted to inform research responses during the pandemic, data extraction commenced before the protocol could be formally registered with PROSPERO.The protocol is outlined in this paper.

Rationale for use of living method
Research funding bodies have responded rapidly to the COVID-19 pandemic through repurposing existing grants and rapidly funding projects with both rolling and one-off funding calls.This has resulted in new research projects being funded at short intervals necessitating a living review for this work.The regular update of this review will help coordinate ongoing researcher and funder responses.

Eligibility criteria
All research projects funded by any research funder around the world (including regional funding organisations, national research funders and non-profit/ philanthropic organisations), with a focus on COVID-19 were eligible for inclusion in this analysis.This includes data from all types of research activities and was not limited to biomedical and health research.Furthermore, this analysis includes grants identified by funders as having been repurposed to address COVID-19 research priorities.

Information sources and search strategy
The database and subsequent analysis make use of data from publicly-announced COVID-19 research grants and were obtained using one of two methods.Data was either obtained through direct communication with research funders by requesting the completion of a template spreadsheet (Extended data 1 8 ).These requests were made to UKCDR and GloPID-R funder groups members 9,10 on a regular basis (as part of funder coordination meetings) and to wider funder contacts beyond these groups.Alternatively, data were also obtained from online databases belonging to research funders using "COVID" and/or "coronavirus" and/or "nCOV" and/or "sars-cov-2" as search terms (see Extended Data 2 8 ).New funders were identified by their association with other funders when looking for newly published data from funders already on the tracker.This could have been through results of co-funding, being members of the same funders' networks, etc.This then formed the basis of a series of internet searches to check whether these new funders awarded any COVID-19 research and, if so, whether they published the results of these funding calls.The tracker remains open to the submission of new funding data relating to COVID-19 from any global funder at any time.Screening of submitted data occurs on a weekly basis.
As the database is updated, a regular review is conducted to identify duplicate entries.Where duplicates are removed from the tracker the entry with the most detailed information is retained.
Though the set of data fields varied between funders, the data fields presented in Table 1 were considered a priority for the purposes of the tracker and subsequent analyses: Update schedule All figures will be updated on a three-monthly basis; the discussion will also be revised to reflect any changes and trends over time.This living review was updated for the duration of the COVID CIRCLE initiative funding which ran from April 2020 to December 2022.

Manually coded data fields
Data entry of additional manually classified variables was completed by one reviewer with each variable cross-checked

Amount awarded
Total amount awarded by the responsible funder for the duration of the project (with currency stated)

Country(-ies) where studies are being conducted
All countries where research is being conducted

Funder(s)
The names of all funding organisations (including co-funding)

Lead institution
The name of the organisation that holds the grant and is leading the research

Local implementing partner(s)
The name of any partner institutions located in the country(-ies) where the study is being conducted

Principal investigator
Name of the awarded project's lead investigator based at the lead institution (primarily used for project de-duplication) Project ID/reference number Any unique reference number / project ID assigned by the funder organisation to this project (primarily used for project de-duplication)

Project title
Title of the research project

Start/end date
Start and end dates of the project by a second reviewer.Abstracts in languages other than English were coded by project team members fluent in those languages or translated using Google Translate.Projects were coded against the following classifications: 1. WHO medium-long term research priorities and sub-priorities Projects were assigned to one or more WHO priority areas of primary focus (Extended data 3 8 ).An assignment of 'N/A' was made where: information provided was insufficient for classification; funds were allocated for research administration; or where projects clearly fell outside the WHO broad priority areas.Subsequently, projects were assigned to appropriate WHO sub-priority area(s).The assignment of 'N/A' was made if insufficient information limited further sub-categorisation or the projects fell outside the WHO sub-priority areas.In addition, suitable secondary priority area(s) with corresponding sub-priority(ies) were determined for those projects that significantly addressed other priority areas.Hence, projects were assigned with multiple primary and/or secondary WHO priority and sub-priority areas of research focus.The priority list will be updated if future iterations of the WHO Roadmap are released.

Emergent categories for research falling outside the WHO priority classification
For those projects that were not considered as addressing any of the WHO Research Priorities, they were assigned 'N/A' and new sub-priorities were developed and assigned on an initial data set of 400 projects.An inductive approach was used to develop new codes that emerged from the funded research and themes were confirmed through an iterative process through the projects in the baseline assessment.2).Any study coded with both included and excluded priorities was included for further examination.
The remaining projects were then individually examined and, where appropriate, were assigned to one or more of the research priorities identified in the UN Research Roadmap (25 research priorities in total, across five pillars: health systems and services, social protection and basic services, economic response and recovery, macroeconomic policies and multilateral cooperation, and social cohesion and community resilience).
If projects significantly addressed more than one research priority, secondary sub-priorities were assigned.Where projects met the inclusion criteria, but insufficient information was available for further classification, "N/A" was assigned and a project description recorded.

Study population
A study population categorisation structure was proposed using an inductive approach on an initial data set of 400 projects and validated using the full data set (at the time of version 1), allowing the categories to be specific to the populations represented in the funded research.
For the purposes of this analysis, a hierarchical categorisation system was produced to examine the study populations of the research projects included in the tracker.At the highest levels, research projects are assessed on whether they involve animal populations, human populations, literature reviews, policy analysis or only focus on the virus itself.Research projects focused on human populations, were classified against three additional sub-categories.Table 3 outlines the categories, sub-categories and levels in full.

Synthesis of results
Descriptive and comparative analyses are used in this analysis to present a description of funded COVID-19 research included in the tracker database as of 15 th October 2022.
The data used for this analysis can be obtained from the COVID-19 Research Project Tracker page on UKCDR's website, as mentioned in the data availability statement.Data on the tracker (and subsequent analyses) will continue to be updated as more data becomes available and are obtained by the project team.
The charts and figures produced in this analysis were produced using Microsoft Office (Office 365 versions of Excel and PowerPoint).

Limitations of the data
Among the main challenges of the analysis is the varying completeness of data which led to less refined categorisation (assignment of projects to broad priority but not sub-priority areas) where the qualitative details of projects provided were insufficient.Therefore, the assigned priority areas may have failed to capture all aspects of the projects relevant to the WHO Roadmap.The same can be said for any value that was assigned to a given research project by the project team, including the study population and type of research activity.The data validation process by reviewers with expertise in global health research, policy, and funding outlined in the Project Selection section was used to address this and ensure that any assigned value was as accurate as possible, given the information provided.
Data on funding amounts was available from 175 of 351 funders (62.3% of all projects) and as a result this analysis is limited in providing a full financial profile of COVID-19 research funding investments.However, as the analysis makes use of all publicly available information, it can therefore be considered the most comprehensive characterisation possible.
At a higher level, the comprehensiveness of the tracker is limited to the funders that have either provided data for the tracker or had their data extracted from online sources (if available) and by the quality of that available data.In this respect, there were challenges in engaging with (and obtaining data from) health research funders beyond existing networks either due to a lack of contacts or capacity from funders to contribute to the project (especially for funders whose award information is not in English).Few funders have yet identified or made available details on grants repurposed towards COVID-19 to date although we continue to request this.

Risk of bias
This LMR of funded COVID-19 research projects uses descriptive and thematic analysis to summarise the scope of funded COVID-19 research projects.No attempts are made to assess the quality of individual studies or whether the studies meet their objectives.The potential sources of bias with project selection, quality of data reviewed, and data extraction and classification are addressed by robust fortnightly searches, template completion by funders and independent assessment and review during project classification respectively, as mentioned in the Information Sources and Search Strategy.
While the intention of the tracker and subsequent analyses are to provide as comprehensive a picture as possible of the COVID-19 research landscape, the data obtained for the tracker is more likely to be derived from funders of research that are members of UKCDR (all UK and broad disciplinary focus) and/or GloPID-R (global membership spanning high-income countries, or HICs, to low-income countries, or LICs, with a majority of national funders, and a biomedical focus).This would likely skew the results to show that more research being funded from these organisations and reflect trends in their respective portfolios (in terms of location, research focus and research activity type) than may necessarily be the case of the landscape more generally.In particular, more than half of all the projects included in the latest version of the tracker (50.7%) are from just 9 funders based in 5 high-income countries.

Project selection
In total, 21,551 projects were assessed against the eligibility criteria outlined in the methodology and 1,544 were excluded for being duplicate projects or failing to meet the eligibility criteria as they were not related to COVID-19 (PRISMA Flow Diagram provided in Figure 1).The remaining 20,006 projects were assigned to the manually-coded data fields by project team members before being validated by an independent reviewer not involved with the initial screening and assigning process.This represents an increase of 2,051 projects as a result of the update to the analysis.All reviewers have broad expertise in global health research, policy, and funding.

Project characteristics
Summaries of the characteristics of the 20,006 projects included in the latest version of the tracker are provided in the discussion of the results (below) which breaks down the projects by: • Funder; • Priority and sub-priority areas; • Location; • Activity type; • Study population.
A full list of the projects is provided as underlying data 13 .
Project funder.The 20,006 projects included in the latest version of the tracker comprises of data compiled from 351 research funders based in 60 different countries representing an investment of at least $7.4 billion (funding amounts only available for 62.3% of projects) (Figure 2).This represents   The funding patterns at the WHO priority-level are reflected at the sub-priority level.Notably, seven of the ten sub-priorities with the greatest number of research projects are from the three priority areas with the greatest number of projectsnamely 'Virus: natural history, transmission and diagnostics' (3 sub-priorities in the top 10), 'Clinical Characterization and Management' (2), and 'Social sciences in the outbreak response' (2).
Similarly, seven of the ten sub-priorities with the greatest investment totals are from priority areas ranked among the top four for funding amounts -namely 'Virus: natural history, transmission and diagnostics' (again with 3 sub-priorities in the top 10), 'Clinical Characterization and Management' (2), 'Candidate Vaccines R&D' (1), and 'Social Sciences in the Outbreak Response' (1).Additionally, the top four sub-priority areas with the largest average of known funding amounts are all from the 'Candidate Vaccines R&D' priority area.
At the other end of the spectrum, five of the bottom ten sub-priority areas, in terms of the number of projects, are from two priority areas, namely the 'Animal and environmental research on the virus origin, and management measures at the human-animal interface' (36 th and 41 st ) and 'Clinical characterization and management'(35 th , 42 nd , and 43 rd ) areas.
In particular, two of these sub-priority areas, 'socioeconomic and behavioural risk factors for spill-over' under the 'Animal and environmental research' priority area (17 projects worth $7.0m), and 'Develop core clinical outcomes to maximize usability of data across range of trials' under the 'Clinical characterization and management' priority area (9 projects worth $2.2m), also rank among the bottom five in terms of known funding amounts (40 th and last, respectively).

Classification of research projects which did not categorise against WHO Roadmap (emergent categories).
There are increasing instances (30.1% of projects on the latest version of the tracker compared to 28.6% previously) where projects can be classified against a priority area but were not deemed relevant to any of the corresponding WHO sub-priority areas.These projects are labelled 'N/A' under the relevant priority area and can be seen alongside the sub-priority areas in Figure 4.These projects generally constitute less than one-fifth of either of the overall number of projects and known funding amounts under each of the corresponding priority area.
There are, however, two notable exceptions to this observation.Firstly, under the 'Candidate Vaccines R&D' priority area, a substantial proportion of research projects cannot be allocated to any of the WHO sub-priorities.This is the result of the narrow definitions outlined by the WHO for the sub-priority areas under 'Candidate Vaccines R&D' which, for instance, do not offer sub-priorities for candidate vaccines not undergoing multi-country clinical trials (60 projects worth $1.0b), vaccine design and administration (42 projects worth $10.1m), or vaccine logistics and supply chains (27 projects worth $138.0m).
Secondly, Figure 4 shows that, under the 'Social Sciences in the Outbreak Response' priority area, more than two-thirds of research projects (67.8%) do not align to the WHO Roadmap sub-priorities.This is unsurprising given the tracker collates all research on COVID-19 beyond health, and led us to define the emergent themes in Figure 5.These highlight important emergent themes for COVID-19 research prioritised by, both researchers and funders.
'Mental health' is among the two most prominent emergent categories -which does clearly fall within a health remit, and it is notable both that this type of research is receiving much attention, but also that currently this is mostly limited to research from a social science perspective, rather than a clinical perspective (and the same can also be said of research addressing 'digital health').The further emergent social sciences related sub-priorities of 'policy and economy', 'education', 'logistics' and 'food security' and emergent priority of 'environmental impacts' are all focussed on the broader social and economic impacts of the COVID-19 recovery and reflect the broader COVID-19 research focus of the tracker and the research consideration of the knock-on effects (health and otherwise).

Characteristics of research projects in Low-and Middle-Income Countries (ODA-recipient countries).
Most research projects in low-and middle-income countries could be categorised against one or more WHO research priorities.In addition, several were also categorised against the context-specific research priorities identified by the UKCDR, African Academy of Sciences (AAS) and the Global Health Network (TGHN) and are shown in Figure 7 and Figure 8.
Figure 7 shows that some projects mapped to the context specific sub-priorities identified for LMICs under all the nine WHO priorities.4).Table 4 summarises the distribution of the cross-cutting themes against the WHO Priority Areas.
Looking at the number of projects under each cross-cutting theme (Table 4), the theme of 'innovation', is largely driven by the large presence of UKRI data which has a separate 'innovation' specific funding stream (1,157 projects accounting for 69.5% of these projects).
The vast majority of repurposed grants (66.7%) were funded by the National Institutes of Health (NIH) totalling $291.8m.The number of repurposed grants is expected to increase as funders continue to make this data available.

Study populations included in projects.
Just over half of the research projects included in the latest version of the tracker deal with human populations (51.7%) with a significant emphasis on populations that have tested positive for COVID-19 (19.4% of research projects studying human populations) as well as population groups defined as vulnerable within the project (17.2% of research projects studying human populations).Figure 10 summarises how the research projects are classified across all levels of the study population categorisation system outlined above.

UN Research Roadmap for the COVID-19 Recovery
The total number of included projects relevant to the UN Research Roadmap for the COVID-19 Recovery was 6,421, with a total known funding amount of $1.2 billion (previously 5,622 projects worth $1.0 billion).The 'Macroeconomic policies and multilateral collaboration' pillar has the least number of projects overall -with all five related research priorities among the seven lowest funded research areas (in terms of both the number of projects and known funding amounts).

Trends in Funding Over Time.
To understand the progression of funding for COVID-19 research over time, Figure 13 summarises the cumulative sum of projects and funding  amounts on the tracker according to either the date that the award was made or the publication date of award information by funders (as opposed to the date when the details of projects were added to the tracker as there may be a lag between the time that funders publish award information and the time that such information is located and subsequently added to the tracker).
All but one of the additional 2,051 projects that were added to the tracker since the 15th of July 2022 came from databases that were known to be published prior to July 15th 2022 and are therefore 'newly captured', but not newly funded (the remaining project did not have a date of release).More widely, Figure 13 shows a rapid expansion of projects funded over the summer of 2020 -particularly between June and September, with a slower pace of new funding emerging from October 2020 onwards.as well as starting to fill some of the previously less funded sub-priority areas, such as 'supply of therapeutics' and ethics 'education, access and capacity building'.The final iteration has continued to show a clear plateauing of the funding response, with none of the new funding captured being awarded within the most up-to-date three month window.
We are keen for researchers, funders and policy makers to engage with these data directly for their areas of specialism and interest, through extracting the relevant data from the tracker and undertaking their own analyses to aid decision making.Given the time demands on all parties in the pandemic, we hoped that the regular provision of these descriptive and thematic analyses provide broad insights to help inform the research community and improve the efficiency and effectiveness of the research response going forwards.
Going forward this COVID-19 data will be incorporated into a wider funding tracker for infectious diseases of pandemic potential under the new Pandemic Preparedness: Analytical Capacity and Funding Tracking Programme (Pandemic PACT) and new living reviews will be established during 2023 14 .

Alignment of the funded research portfolio to the 2020 WHO Roadmap
Importantly, here we have aligned the funded research to the mid-and long-term research and innovation priorities of   i. Research projects may be assigned with multiple cross-cutting themes and WHO priority areas ii.Highlighted cells indicate the WHO Priority Area with the greatest number of projects for each cross-cutting theme (excluding projects that were not assigned a priority area, marked N/A).

Number of Projects
iii.Funding figures available for 61.2% of projects included in the latest version of the tracker database as not all funders provided financial information.iv.Definitions of cross-cutting themes-

•
Capacity strengthening: Projects which involve a capacity strengthening component.Capacity strengthening at all levels-individual, institutional and national is included.
• Cohorts: Projects carried out in newly established cohorts or pivoted existing cohorts for COVID-19 research.
• Gender: Projects which incorporate a gendered lens in description of methods/ objectives and project outputs.
• Implementation: Grants for facilitating research administration.
• Indirect Health Impacts: Projects focusing on indirect health impacts of COVID-19, for example related to disruptions in healthcare services, neonatal, maternal and child health, non-communicable diseases, chronic disease conditions and mental health.
• Innovation: Projects involving novel inventions and interventions.
• Long COVID: Projects involving the long-term morbidity and enduring symptoms of COVID-19 beyond the initial infection.
• Modelling: Projects involving any form of modelling in the methodology.
• New Variants: Projects involving new variants of the coronavirus that cause COVID-19.
• Pandemic Preparedness: Projects with preparedness for future pandemics as an objective.
• Repurposed projects: Pre-COVID research grants (usually for MERS, SARS and other pathogens) where additional funding has been awarded for tailoring to COVID-19 research.the WHO Roadmap and disaggregated the data by locations and population to give a detailed picture of how the research landscape aligns to these global research priorities.
The majority of research funded aligns well to the WHO Roadmap at the priority level, however, low levels of funding in the global research funding portfolio persist, specifically related to the priority areas of 'Ethics considerations for research' and 'Animals and environmental,' and increasingly new areas going beyond the sub-priorities stated in the WHO Roadmap are being researched.Whilst it is not possible to tell from the funded portfolio alone what is the appropriate level of funding for any priority area, we believe that 'Animals and Environmental' does still represent important and real research gaps, towards which the research community should be shifting its attention and for which GloPID-R has now partnered with the STAR-IDAZ consortium to set up a One Health working group.It is also important to note the intention and detail of these and all priority areas within the WHO Roadmap, where there is variability in who is best positioned to address the research sub-priorities with some clearly needing external research activity and others indicating research activity that the WHO planned to undertake directly themselves.
The lack of alignment of funded research projects to the 'Ethics considerations for research' priority may be one such example, as it misses the direct activity that the WHO has undertaken to address this priority through direct research and provision of important guidance on ethical matters relating to COVID-19 15 , which align to the sub-priorities as well as the clear strength of ethical consideration across many research projects (which don't necessarily have a core focus on ethics).Despite these considerations, both researchers and research funders need to pay greater attention to the prominence placed on ethical considerations for research by the WHO and ensure that further research is undertaken on those aspects outlined under the roadmap priority area explicitly for standalone ethics research (which we note have continued to expand in this iteration).
For 'Animals and environmental research', again the WHO has undertaken direct activity in this regard (including their mission with China 16 ).and through a recent scientific publication on the origins of COVID-19 17 .However, except for a few notable projects in LMICs, the instigation of necessary broader research activity in this area, particularly looking towards gaining broader understanding of how such viruses emerge in the human population and proactive surveillance is certainly limited and needs to be expanded and longer term in nature.This research needs to be undertaken in locations where diseases are most likely to emerge, due to the nature of interactions between humans and animals 18 , many of which are LMICs and this could therefore play an increasingly important role in the research portfolios in these locations going forward.It is also important that this research activity for this priority expands beyond the remit of the WHO and through collaborations with the UN Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health (OIE) through a One Health framework 19 and the newly 'international expert panel to address the emergence and spread of zoonotic diseases' is a further step towards this 20 Beyond the clear gaps at the priority level, it is inherently difficult to conclude when a particular priority area has received sufficient research funding or research projects at the grant award stage, as this is only apparent when the outcomes are achieved and it is clear that the research question has been sufficiently answered.We do however further note that within some of the better funded WHO research priority areas, there are still certain sub-priorities that again present clear gaps.This is the case for 'Optimal endpoints for clinical trials' and 'Develop core clinical outcomes to maximize usability of data across range of trials' within the 'Clinical characterisation and management' priority area.This may well result from the fact that these activities will be implicit but not explicit in clinical research projects; however, this in itself may indicate a clear issue where both these sub-priorities are essential for collation of results across studies and should therefore be explicit, pointing to the generally observed lack of coordination beyond a few pre-established clinical trial networks as highlighted in discussions at the GloPID-R Synergies Meetings 21 .In contrast, the variability of research activity indicated within the 'Candidate therapeutics R&D' priority area appears to reflect the inter-dependencies of these sub-priorities rather than necessarily a gap needing immediate funding, with research into 'Supply of therapeutics' depending to some extent on the identification of particular safe and effective therapeutics.
For those sub-priorities where research investments have been focused there will continue to be benefits to enhanced coordination.A key strength of this tracker is its breadth and we have therefore undertaken some initial cross-cutting thematic analyses across it here to highlight additional variables that cross-cut disciplines with the inclusion of capacity strengthening, innovation, repurposed grants, modelling, cohorts, pandemic preparedness, implementation, indirect health impact, gender, long covid and new variants.The analyses on these themes are given greater focus in 'tracker highlight' analyses released on the tracker website 3 .

Conclusion
In conclusion, we have here provided a final detailed review and thematic analysis across the COVID-19 funded research available.We now encourage the research community to use this and the tracker tool to support informed decision making on further research prioritisation, based on the knowledge of what research is already initiated.We encourage research funders to continue to submit their data to the tracker to ensure it can be as effective as possible, as the data will be translated into the new Pandemic PACT tool referenced above which will cover a wider range of diseases and contribute to pandemic preparedness through visibility of funding an research activity at the outset of outbreaks.To ensure the research investments yield impact, there is now need for enhanced coordination and reprioritisation (taking stock of achievements and defining whether original priorities are still valid over two years on).This is particularly important now that the initial flourish of research funding for COVID-19 appears to be plateauing and research priorities evolving.
We have also demonstrated the power of tracking research funding at source in real-time, which is particularly important in the fast-moving research environment created by a pandemic, but may have benefits for other global collaborative research efforts going forward.The challenge of nationally funded projects that are underpowered and therefore unable to achieve their aims, demands that researchers and funders be much more strategic going forwards to efficiently and effectively advance knowledge within epidemics and pandemics.Tools such as this tracker can facilitate global collaboration and solidarity to maximise the efficiency and impact of research funding.

Limitations of findings and challenges
To the best of our knowledge we have compiled the most comprehensive database of funded COVID-19 research.We are however very mindful of its inherent limitations and the difficulties in gaining a fully comprehensive picture in what is a truly global research effort to a global pandemic.One main limitation is the absence of commercial research data making inferences on gaps in the vaccine and therapeutics portfolios difficult (this is lacking due to associated intellectual property restrictions).This tracker however has rich data on the early stage development research for those same priorities which is valuable for public funder coordination efforts and enables thematic analyses across disciplines.Another limitation is the fact that few funders to date have shared data on repurposed grants or grants for institutional funding which may have been used for COVID-19 related research.
We are also aware of several funders across wider geographies and disciplines, from whom we have not yet been able to incorporate data.We call here for further research funders (especially within LMICs) to continue to submit their data to make this tracker and associated analyses more accurate to improve the ongoing coordination and help focus limited resources.
The alignment of research in this tracker to the priorities outlined in the WHO Roadmap also has its challenges, given the Roadmap was produced at speed by drawing together findings from different working groups operating in different ways.The resulting priorities are unsurprisingly imbalanced with some covering much broader research areas than others and with not all sub-priorities intended to be addressed by newly funded research.We have tried to account for this in the discussion of the results here.Another limitation of these priorities and indeed any priorities in a pandemic is their limited temporal nature.The WHO Roadmap priorities that we have mapped here, although named mid-to long-term priorities, were identified by world experts in February 2020, at a time when the majority of cases of COVID-19 were still in China and a pandemic had not yet been declared.
Despite these limitations, this tracker and analyses have contributed to improving coordination and effective decision making during the COVID-19 pandemic.We will incorporate the lessons learned from this process into our new Pandemic PACT initiative going forwards.

Sustainability and future work
This living mapping review has been updated on a quarterly basis for the duration of the COVID CIRCLE initiative.
Given the tracker contains a broad range of research relating to COVID-19 (beyond health research) and the evolution towards longer term thinking around research priorities, we have continued to code to the UN Research Roadmap for the COVID Recovery 6 in collaboration with the team who developed it.We will continue to expand on this work through the new Pandemic PACT programme 14 .

Peter Smith
MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK This assembly of the database on which this "systematic review" is based clearly represents a major effort.The database is likely to be most useful to funders, who will wish to avoid supporting research that is unnecessarily duplicative and it will also be of value to researchers seeking to identify others who are working in a similar area or to identify research areas that seem to have been relatively neglected.The authors have gathered data on research supported by 25 funders, mostly based in high income countries.How complete this is, even for these funders is difficult to judge, but based on the projects supported by each funder, there seems to be a strong bias towards UK funders.It is surprising, for example, to see the US NIH having supported less than 25% of the number supported by UKRI.A notable deficiency in the database, acknowledged by the authors, is the lack of data from China, where there has been substantial research on SARS-CoV-2, and LMICs in general (e.g.Brazil, India).However, it is understandable that there are challenges in accessing comprehensive information from these sources.Another challenge is that most, but not all, of the information presented relates to the number of projects supported rather than the magnitude of the support.The data base is also missing information from private companies, including pharma companies, where much research on vaccines, therapeutics and diagnostics is likely to be supported.It is also unclear whether the databases of registered clinical trials have been trawled to identify ongoing research.For these reasons, I am not convinced that it is appropriate to label the paper as a systematic review as it seems to be a review only of what has been accumulated in the database to date.
I recognize that the database is early in its life, but as an ongoing check on completeness it may be useful, in the future, to link published papers on SARS-CoV-2 to the database to see what is not being picked up in the database, acknowledging that it is not infrequently difficult to link a particular paper to a particular research grant.
In the review, projects in the database are linked to WHO Blueprint list of research priorities defined in February 2020.This helps identify areas where there are possible funding gaps.However, there are some limitation in using the data base for this purpose.For example, the authors note that there are clear gaps in support for 'optimal endpoints for clinical trials and core clinical outcomes' and on 'ethical considerations for research'.Both of these areas have had considerable attention, the former in the context of treatment and vaccine trials (the authors acknowledge the problems in identifying research that may be embedded in other research undertakings) and much of the ethical work that has been done has not required specific funding.
Despite some of the deficiencies identified above, the generation of the database has been a valuable undertaking, and as more funders come on board it will become even more useful.Similarly, the ongoing systematic review will give a useful summary of what is in the database and will help identifying trends in funding and areas where support has been lacking.

Are the rationale for, and objectives of, the Systematic Review clearly stated? Yes
Are sufficient details of the methods and analysis provided to allow replication by others?Yes Is the statistical analysis and its interpretation appropriate?Not applicable

Are the conclusions drawn adequately supported by the results presented in the review? Yes
Competing Interests: No competing interests were disclosed.
I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.
with the latest data in the tracker up to the 15 th October and have also taken that opportunity to address some of your comments within the new version of the paper.This continues (in our view) to be the most comprehensive data set on research funded on COVID-19 with now over five thousand projects from 72 funders (all categorised to the WHO R&D Blueprint).We have now provided further details relating to magnitude of funding commitment in addition to numbers of projects in the figures relating to funders and agree that this helps with interpretation.We have noted and agree with the limitations that you highlight regarding the challenges in accessing the full breadth of global research data in this field and we have already clearly acknowledged these limitations.We also agree that the 'systematic' terminology may not therefore be fully appropriate for this endeavour and have now instead re-categorised this as a living mapping review.We also agree with your points on the particular sub-priorities in the roadmap which may have received attention outside of newly funded or even repurposed grants, and we have further clarified our discussion of these.We are continuing to expand the global representation of funders in the database and are exploring connections with both clinical trial registrations and outputs (although neither of these are straightforward).We hope that you find this latest version of the paper of renewed interest and relevance.
R members.It is heavily UKRI biased.The US NIH, in particular, seems under-represented.Repurposed funded research may be missed.There is limited data from a number of governments (e.g.,China as noted by authors) and private sources (e.g., companies, private foundations such as the BMGF, and ethics think tanks).This publication may encourage more LMICs to participate in the accounting.
Is it possible to comment on measured or perceived impacts?Who uses?Is there documentation of times accessed?Is it timely information if the figures are updated only every three months?The group should conduct a survey at the end of the calendar year to see if funders changed direction based upon this effort.Has there been a reduction of duplication?Or, will this be a retrospective of what happened with little real-time impact on what was happening?Shifting of funding to LMICs is one positive example of impact.Again, we will need a later assessment to build upon this baseline review focusing on impact on the pandemic response.Has the scope been too broad?
Are the rationale for, and objectives of, the Systematic Review clearly stated?Yes

Are sufficient details of the methods and analysis provided to allow replication by others? Yes
Is the statistical analysis and its interpretation appropriate?Not applicable

Are the conclusions drawn adequately supported by the results presented in the review? Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Vaccine development.
I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.
responses or comments on the article can be found at the end of the article.DEFRA -Department for Environment, Food and Rural Affairs DFG -Deutsche Forschungsgemeinschaft (German Research Foundation) DFID -Department for International Development DIM-ELICIT -Donner de la puissance aux sciences de la vie avec les technologies innovantes -Empowering LIfe sCiences with Innovative Technologies DPI -Decanato de Pesquisa e Inovação (Dean of Research and Innovation) DRDO -Defence Research and Development Organisation

FAPESP
-Fundação de Amparo à Pesquisa do Estado de São Paulo (São Paulo Research Foundation) FAPESQ -Fundação de Apoio à Pesquisa do Estado da Paraíba (Paraíba Research Support Foundation) FCDO -(formerly DFID) -Foreign, Commonwealth and Development Office FCT -Fundação para a Ciência e Tecnologia (foundation for Science and Technology) FERCAP -Forum for Ethical Review Committees in Asia and the Western Pacific FFAR -Foundation for Food and Agriculture Research FFG -Österreichische Forschungsförderungsgesellschaft (Austrian Research Promotion Agency) FNRS -Fonds de la Recherche Scientifique (National Fund for Scientific Research) FORE -Foundation for Opioid Response Efforts FUNCAP -Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico (Cearense Foundation for Scientific and Technological Development Support) FUNDECT -Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (Support Foundation for the Development of Education, Science and Technology of the State of Mato Grosso do Sul) FWF -Fonds zur Förderung der wissenschaftlichen Forschung (Austrian Science Fund) FWO -Fonds voor Wetenschappelijk Onderzoek -Vlaanderen (Research Foundation Flanders) G²LM|LIC -Growth and Labour Markets in Low Income Countries Programme HRB -Health Research Board HRZZ -Hrvarske Zaklade za ananost (Croatian Science Foundation) ICGEB -International Centre for Genetic Engineering and Biotechnology ICMR -Indian Council of Medical Research IDA Ireland -Investment Promotion & Development Agency Ireland IDRC -International Development Research Centre IHCIETI -Instituto Hondureño de Ciencia y Tecnología (Honduran Institute of Science and Technology) IHU -Institut Hospitalo-Universitaire en Maladies Infectieuses de Marseille (Marseille University Hospital Institute for Infectious Diseases) INSERM -Institut national de la santé et de la recherche médicale (National Institute of Health and Medical Research) IRD -L'Institut de recherche pour le développement (Development Research Institute) IRSST -Institut de recherche Robert-Sauvé en santé et en sécurité du travail (Robert-Sauvé Research Institute in Occupational Health and Safety) ISCIII -Instituto de Salud Carlos III (Carlose III Health Institute) IZA -Forschungsinstitut zur Zukunft der Arbeit (Institute of Labor Economics) MBIE -New Zealand Ministry of Business, Innovation and Employment MEI -Montreal Economic Institute MINCTCI -Ministerio de Ciencia, Tecnología, Conocimiento e Innovación (Chilean Ministry of Science, Technology, Knowledge and Innovation) MINCYT Argentina -Ministerio de Ciencia, Tecnología e Innovación (Argentina Ministry of Science, Technology and Innovation) MinScience Colombia -Colombian Ministry of Science MIUR -Ministero dell'Istruzione, dell'Università e della Ricerca (Italian Ministry of Education, University and Research) NASA -National Aeronautics and Space Administration NBHRF -New Brunswick Health Research Foundation NCSEHE -National Centre for Student Equity in Higher Education NHMRC -National Health and Medical Research Council NIFA -National Institute of Food and Agriculture NIH -National Institutes of Health NIHR -National Institute for Health Research NMRC -National Medical Research Council (Singapore) NORCE -Norwegian Research Centre NSERC -Natural Sciences and Engineering Research Council NSF -National Science Foundation NSFC -National Natural Science Foundation NWO -Nederlandse Organisatie voor Wetenschappelijk Onderzoek (Dutch Research Council) NYU -New York University OFSP -Office fédéral de la santé publique (Federal Office of Public Health) OSAV -Office Fédéral de la securité alimentaire et des affaires vétérinaires (Federal Office for food safety and veterinary affairs) OUCRU -Oxford University Clinical Research Unit PCHRD -Philippine Council for Health Research and Development PCORI -Patient-Centered Outcomes Research Institute PEDL -Private Enterprise Development in Low-Income Countries PRACE -Partnership for Advanced Computing in Europe RBWH -Royal Brisbane and Women's Hospital REACTing -REsearch and ACTion Targeting Emerging Infectious Diseases RIKEN -Kokuritsu Kenkyū Kaihatsu Hōjin Rikagaku Kenkyūsho (Institute of Physical and Chemical Research) RSTMH -Royal Society of Tropical Medicine and Hygiene SENACYT Panama -Secretaría Nacional de Ciencia tecnología e Innovación (Panama National Secretariat for Science, Technology and Innovation) SEPAR -Sociedad Española de Neumología y Cirugía Torácica (Spanish Society of Pneumology and Thoracic Surgery) SERB India -Science and Engineering Research Board India SFI -Science Foundation Ireland SFOE -Swiss Federal Office of Energy SGC -Sino-German Center for Research Promotion SNF -Schweizerischer Nationalfonds zur Förderung der wissenschaftlichen Forschung (Swiss National Science Foundation) SNSF -Swiss National Science Foundation SSHRC -Social Sciences and Humanities Research Council STINT -Stiftelsen för internationalisering av högre utbildning och forskning (Swedish Foundation for International Cooperation in Research and Higher Education) SVRI -Sexual Violence Research Initiative TUBITAK -Türkiye Bilimsel ve Teknolojik Araştırma Kurumu (Scientific and Technological Research Council of Turkey) UBC -University of British Columbia UCB -Union Chimique Belge (Belgian Chemical Union) UCL -University College London UFRJ -Universidade Federal do Rio de Janeiro (Federal University of Rio de Janeiro) UFM -Uddannelses-og Forskningsministeriet (Danish Ministry of Higher Education and Science) UKRI -UK Research and Innovation UNICEF -United Nations Children's Fund USDA -United States Department of Agriculture WHO -World Health Organization WWTF Austria -Wiener Wissenschafts-, Forschungs-und Technologiefonds (Vienna Science and Technology Fund) ZonMw -Nederlandse organisatie voor gezondheidsonderzoek en zorginnovatie (Netherlands Organisation for Health Research and Development)

Figure 1 .
Figure 1.PRISMA flow diagram.The latest and previous versions of this figure are available as Extended data 8 .

Figure 4 .
Figure 4. Number of Research Projects Included Under Each Sub-Priority Outlined in WHO Coordinated Global Research Roadmap (known funding amounts indicated in brackets).

Figure 5 .
Figure 5. Number of research projects classified against emergent research priority and sub-priority areas not previously identified (known funding amounts indicated in brackets).

Figure 6 .
Figure 6.Location of coronavirus disease 2019 (COVID-19) research projects by country, WHO sub-region and Organisation for Economic Co-operation and Development's (OECD) Development Assistance Committee (DAC) list categories.

Figure 7 .
Figure 7. Research projects in LMICs categorised against their research priorities (LMIC Research Priorities).Shortened forms of the priorities used.

Figure 8 .
Figure 8. Research Projects in LMICs categorized against 'existing WHO Priorities requiring greater research emphasis'.

Figure 11 .
Figure 11.COVID-19 Research Projects Classified Against Pillars Identified in the UN Research Roadmap.

Figure 10 .
Figure 10.COVID-19 Research Projects Classified Using Study Population Categorisation System (number of projects indicated in brackets).Note: Individual research projects may be classified against multiple categories/sub-categories.

Figure 12 .
Figure 12.Number of Research Projects Included Under Research Priority Areas Outlined in UN Research Roadmap for the COVID-19 Recovery (known funding amounts indicated in brackets).

Figure 13 .
Figure 13.Cumulative number of projects and known funding amounts* by month of funder database release.
FAPERGS -Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (Research Support Foundation of the State of Rio Grande do Sul) FAPERJ -Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (Research Foundation of the State of Rio de Janeiro) FACEPE -Fundação de Amparo a Ciência e Tecnologia do Estado de Pernambuco (Foundation for the Support of Science and Technology of the State of Pernambuco) FAPDF -Fundação de Apoio à Pesquisa do Distrito Federal (Federal District Research Support Foundation) FAPEAL -Fundação de Amparo à Pesquisa do Estado de Alagoas (Research Support Foundation of the State of Alagoas) FAPEAM -Fundação de Amparo à Pesquisa do Estado do Amazonas (Amazonas State Research Support Foundation) FAPEAP -Fundação de Amparo à Pesquisa do Amapá (Amapá Research Support Foundation) FAPEG -Fundação de Amparo à Pesquisa do Estado de Goiás (Goiás State Research Support Foundation) FAPEMA -Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (Foundation for the Support of Research and Scientific and Technological Development of Maranhão) FAPEMIG -Fundação de Amparo à Pesquisa do Estado de Minas Gerais (Minas Gerais State Research Support Foundation) FAPEPI -Fundação de Amparo à Pesquisa do Estado do Piauí (Piauí State Research Support Foundation) FAPES -Fundação de Assistência e Previdência Social (Social Welfare and Assistance Foundation) FAPESB -Fundação de Amparo à Pesquisa do Estado da Bahia (Bahia Research Support Foundation) FAPESC -Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina (Santa Catarina State Research and Innovation Support Foundation)

Introduction
Researchers and research funders in global health have been preparing for a pandemic such as that caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for decades; however, the urgency and global scale of the research needs and response have been difficult to respond to and coordinate.Research funders have rapidly supported repurposing of existing studies and launched rapid funding calls to support research into the most pressing needs.Lessons in expediting research have been learnt from undertaking research in the recent Democratic Republic of Congo Ebola outbreaks and West Africa Ebola, Zika and SARS epidemics, however the truly global nature of the coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented needs and challenges for coordination.The World Health Organisation (WHO) triggered a rapid response, building on the R&D Blueprint 1 , and co-organised the Global Research and Innovation Forum: Towards a Research Roadmap for the 2019 Novel Coronavirus meeting with the Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) on February 11-12, 2020 at which over 400 global experts identified research priorities for COVID-19.In March 2020, the WHO released the WHO and GloPID-R Coordinated Global Research Roadmap: 2019 Novel Coronavirus (WHO Roadmap) 2 to coordinate and accelerate the global research response against the identified priorities.The WHO Roadmap is an unprecedented galvanizing document for global research collaboration.This project builds on this to help shepherd the global response.

Table 1 . Priority data fields for the UK Collaborative on Development Research (UKCDR) and Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) tracker and analysis. The
latest and previous versions of this table are available as Extended data 8 .

Table 3 .
Study population categorisation system.The latest and previous versions of this table are available as Extended data 8 .

19 Research Projects Classified Against Priorities Outlined in WHO Coordinated Global Research Roadmap. WHO Priority Areas.
8igure 3displays both the number of projects listed under each priority area and the known funding amounts (as not all funders provided financial information for their awarded research projects).The priority area under 'Candidate Vaccines R&D' ranks first among all nine priority areas with a known research funding amount of $2.2b (increasing by $173k since the update to the analysis)., while the other priority areas average 216.4 funders).The cross-cutting nature of ethics considerations for research, however, means that much work on this will occur within other research projects and many of the research projects coded to ethics here are not solely on ethical considerations and therefore jointly coded to other areas.Figure4shows how the 20,006 COVID-19 research projects included in the latest version of the tracker have been categorised against abbreviated versions of the 44 sub-priorities mentioned in the WHO Roadmap.The names of the sub-priorities are listed in full as Extended data8.
Following the inclusion of 2,051 additional projects to the tracker database, the two priority areas of 'Animal and environmental research on the virus origin, and management measures at the human-animal interface' (143 projects totalling $41.9m) and 'Ethics considerations for research' (302 projects totalling $60.0m) continue to receive comparatively little research attention from the fewest research funders (45 and 82, respectivelyWHO Sub-Priority Areas.
for which data has not yet been obtained.Among the 3,124 projects taking place exclusively in LMICs, 5.4% is being conducted across multiple countries.
6summarises the location where research projects are taking place.Research is being conducted in 157 countries with the greatest number of projects taking place in the United Kingdom (4,827 projects) followed by the United States (4,489) and Canada (2,519).3,124 projects (15.6%) are taking place exclusively in LMICs (previously 15.7%) -with Brazil being the country with the greatest number of projects among these (1,138), followed by India (350) and Argentina (200).This ordering of countries is largely a result of the present selection of data in the tracker from funders based in these LMICs.Though 99 projects on the latest version of the tracker are taking place in China, it is acknowledged that there is much more nationally funded research occurring ; new variants; pandemic preparedness; and repurposed grants (descriptions of the types of projects classified against these are provided in the notes for Table Cross-cutting themes.During the review and classification process projects were classified against eleven additional characteristics: capacity strengthening; cohorts; gender; implementation; indirect health impacts; innovation; long COVID; modelling
64,22ion of researchThe majority of the funded research projects in the tracker are located in HICs, reflecting national funding by some of the wealthiest research funders, with the truly global nature of the pandemic meaning that virus was circulating in these countries to enable relevant clinical research.A large amount of research has also been funded within China, although as explained in the limitations we have not managed to incorporate this.The global distribution of funding is now shifted slightly, with more funding calls and announcements related to LMICs and some domestic funding captured (e.g. in Brazil).There appears to have been growing recognition that context specific research is needed in LMICs12,22although the results presented here show only small proportional expansion of funding dedicated to context specific research priorities with an important focus on faster and easier diagnostic tools and identifying prognostic factors of severe COVID-19 infections.There remain clear research gaps relating to health systems, optimal personal protective equipment use, health care worker support, community engagement, disease severity studies and effective public health interventions in various settings.We published a separate detailed sub-analysis of the baseline tracker data relating to COVID-19 research in Africa, in collaboration with the African Academy of Sciences7.The emerging category of research on long COVID was not evident or anticipated as a research need at the time of development of the WHO Roadmap (although it should now inform the need for prioritisation of research including long-term follow up of cases for any newly emerging disease)24.These shifting priorities emphasise the need for 'living' research priority roadmaps, given the original roadmap was developed three years ago at the outset of the pandemic.We may also be observing the evolution of research priorities from response to recovery and expect to see further examples of this.The expansion of COVID-19 research beyond the original WHO Roadmap document illustrates the wide-reaching social, economic and cultural impacts of the pandemic.We have for the fifth time in this iteration mapped the funded research portfolio against the UN Research Roadmap for the COVID-19 Recovery6which identifies 25 research priorities across five pillars (health systems and services, social protection and basic services, economic response and recovery, macroeconomic policies and multilateral collaboration and social cohesion and community resilience).This has helped to categorise the many social sciences projects which fall outside the remit of the WHO roadmap and provides an initial assessment of the funded research portfolio against these UN identified priorities.The results indicate a large proportion of the funded research projects (32.1%) have relevance to the COVID-19 recovery agenda, however at the research priority level the notable absence of projects addressing 'macroeconomic policies and multilateral collaboration' may indicate an important gap.