NIHR Global Health Research Unit on Respiratory Health (RESPIRE-2)

The aim of RESPIRE-2 is to deliver low-cost, scalable policy and clinical interventions to reduce respiratory morbidity and mortality across Asia. We will build on capacity development, foundational research and relationships from RESPIRE to catalyse efforts to improve global respiratory health. Our goals include: building research capacity in low- and middle-income countries (LMICs); ensuring research is driven by the needs/priorities of LMIC populations; building equitable/respectful partnerships; engaging stakeholders, including communities, at all stages; and strengthening capacity to translate research findings into impact. We are expanding from RESPIRE work in Bangladesh, India, Malaysia and Pakistan to add 3 additional LMICs - Bhutan, Indonesia and Sri Lanka, focusing on disadvantaged populations; and developing new research themes on TB and key risk factors [tobacco, air quality]. We will adopt the successful management model in RESPIRE - a Unit Management Committee (UMC) - responsible for overall governance, which will be advised by an International Steering Committee. Our 3 research programmes are on Infectious Diseases, Non-Communicable Diseases and Preventable Risk Factors. Our 4 cross-cutting translational platforms address stakeholder and community engagement and involvement; education and capacity building; open science, data and methodologies; and digital health and innovation. These will help promote good research design and practice, support innovation and promote sustainability of the work of RESPIRE-2. We will coordinate their activity and outputs to ensure that new knowledge from RESPIRE-2 results in translational activity and promotes sustainability. Our research programmes are based on our formal priority setting exercises and long-standing collaboration with Asian partners to identify local priorities. We seek to adapt existing or develop new interventions and evaluate these in diverse settings with a focus on vulnerable population, where possible in multi-country studies. Close collaboration with Ministries of Health, study communities and other key stakeholders is a key aspect at all stages of our research cycle. We have worked with patient and community groups to select and design projects. We will work with partners to disseminate new knowledge and effective new approaches widely throughout Asia. We have considered the context of COVID-19 and will collaborate with ISARIC (International Severe Respiratory Infection Consortium) to build capacity in preparedness for emerging respiratory infections. Our research proposals will be subject to external peer review managed by the UMC. These assessments will also offer opportunity for input from technical experts in the platforms to ensure appropriate study design, access to digital health expertise, and data management plan/wider data sharing support - 20 RESPIRE projects deposited data in UK HDR Gateway (BREATHE) and this will continue in RESPIRE-2. In summary, RESPIRE-2 will build on established practices and processes as it works to achieve a step-change in developing applied respiratory research capacity and capability in the context of responding to urgent respiratory priorities affecting the most vulnerable populations across Asia. We remain committed to partnership working with other Units and Groups to maximize the return on these important global health investments. We request an investment of £7M with 60% spent directly in LMIC institutions.