Prioritizing post-COVID-19 health research in sub-Saharan Africa: A modified Delphi study for future pandemic.

Background: The COVID-19 pandemic exposed weaknesses in healthcare systems and disparities in healthcare access across sub-Saharan Africa (SSA). The insights of frontline healthcare professionals (HCPs), and healthcare researchers involved with the response to COVID in SSA are crucial to ensuring that health systems are optimally prepared for the next pandemic threat. Nonetheless, there is limited consensus as to what are the clinical and public health research priorities necessary to ensure that SSA is optimally prepared and responsive to future pandemics. The aim of this Delphi consensus process was to collate the insights of leading HCPs engaged in research and clinical practice across SSA and prioritize a set of post-COVID-19 pandemic research priorities and determine the investment agenda necessary to address those priorities. Methods: A modified Delphi process was designed to prioritize a shared agenda. A group of researchers from the African Forum for Research and Education in Health (AFREhealth) were asked to first list potential research topics. Then, members of the broader AFREhealth community were invited to rate the importance of each topic on a 4-point Likert scale, through two rounds of consensus-seeking. Consensus for inclusion was predefined as ≥70 % of respondents' rating. Results: Health professionals, academics, and scientists representing a variety of professions from twenty SSA countries responded to the survey rounds, delivered electronically. An initial subset of researchers suggested 11 initial topics; subsequently, 53 respondents completed round one, and 64 completed round two of the modified Delphi. A final list of 20 topics that met predetermined consensus was grouped into four technical domains: [1] Health workforce and health professions education research; [2] Epidemiology and surveillance; [3] Clinical and health systems research; and [4] and other cross-cutting topics. Across these four domains, the highest-ranking priorities included [1] leveraging digital tools to enhance the health workforce, [2] strengthening genomic surveillance, [3] assessing health system resiliency, and [4] conducting ethical research. Conclusions: Post-pandemic research priorities for pandemic preparedness and response included strategies to determine to leverage digital tools to enhance workforce training and impact, leveraging genomic surveillance capacity to close epidemiologic gaps, and developing strategies to enhance health system resiliency. The priorities outlined in this analysis underscore the need for capacity-building and context-specific research in sub-Saharan Africa to ensure an effective and equitable response to future pandemics.