An innovative and integrated model for global outbreak response and research - a case study of the UK Public Health Rapid Support Team (UK-PHRST)

Abstract

Background Despite considerable institutional experimentation at national and international levels in response to calls for global health security reform, there is little research on organisational models that address outbreak preparedness and response. Created in the aftermath of the 2013–16 West African Ebola epidemic, the United Kingdom’s Public Health Rapid Support Team (UK-PHRST) was designed to address critical gaps in outbreak response illuminated during the epidemic, while leveraging existing UK institutional strengths. The partnership between the government agency, Public Health England, and an academic consortium, led by the London School of Hygiene and Tropical Medicine, seeks to integrate outbreak response, operational research and capacity building. We explored the design, establishment and early experiences of the UK-PHRST as one of the first bodies of its kind globally, paying particular attention to governance decisions which enabled them to address their complex mission. Methods We conducted a qualitative case study using 19 in-depth interviews with individuals knowledgeable about the team’s design and implementation, review of organisational documents, and observations of meetings to analyse the UK-PHRST’s creation, establishment and initial 2 years of operations. Results According to key informants, adopting a triple mandate (response, research and capacity building) established the team as novel in the global epidemic response architecture. Key governance decisions recognised as vital to the model included: structuring the team as a government-academic collaboration which leveraged long-term and complementary UK investments in public health and the higher education sector; adopting a more complex, dual reporting and funding structure to maintain an ethos of institutional balance between lead organisations; supporting a multidisciplinary team of experts to respond early in outbreaks for optimal impact; prioritising and funding epidemic research to influence response policy and practice; and ensuring the team’s activities reinforced the existing global health architecture. Conclusion The UK-PHRST aims to enhance global outbreak response using an innovative and integrated model that capitalises on institutional strengths of the partnership. Insights suggest that despite adding complexity, integrating operational research through the government-academic collaboration contributed significant advantages. This promising model could be adopted and adapted by countries seeking to build similar outbreak response and research capacities.

A conceptual framework for analysing partnership and synergy in a global health alliance: case of the UK Public Health Rapid Support Team

“…, 2012 ; Parent and Harvey, 2009 ; Vangen and Huxham, 2013 ). Data from our case study supported this by illuminating the central role the mission played within the UK-PHRST ( Raftery et al. , 2021 ).…”

“…Both members of the team and external observers considered the team’s mission to be novel in the global epidemic response context as it aimed to combine outbreak response and capacity building with operational research in a triple mandate. Since it drew on complementary strengths of the partner organizations, this integrated mandate was considered key to its collaborative advantage ( Raftery et al. , 2021 ).…”

“…In addition, when operating overseas, the UK-PHRST could capitalize on pre-existing infrastructure, relationships and systems of the three universities’ (LSHTM, Oxford, KCL) well-established overseas research centres, a significant advantage of marrying the organizations ( Raftery et al. , 2021 ).…”

“…Partnerships depend on their relationships and interactions with the broader environment in the economic, political, social and cultural context, which includes external stakeholders, governmental policies and decisions, media and public interest ( Scott, 2007 ; Haugstad, 2011 ). The complex environment within which the UK-PHRST operated had a critical impact on driving its establishment and shaping its governance structures and continued to influence the partnership functioning and strategic direction as the partnership matured and evolved ( Raftery et al. , 2021 ).…”

Investigación e innovación biomédica ante la sindemia por COVID-19. Informe SESPAS 2022

“…A pesar de la considerable investigación internacional en respuesta a la reforma de la seguridad sanitaria mundial, hay poca investigación sobre modelos organizativos que aborden la preparación y la respuesta ante brotes 11 . En este sentido, cabe destacar el UK Public Health Rapid Support Team (UK-PHRST), que busca integrar la respuesta a los brotes, la investigación operativa y el desarrollo de capacidades 29 .…”