Patients from Africa are not represented in clinical research for unwell patients, COVID-19 related or otherwise, thus disenfranchising entire populations and stymying pandemic response. The underlying reasons are related to infrastructure, data availability, knowhow and opportunity. Our group and project partners with pandemic response expertise will address both this knowledge gap and the underlying operational (and opportunity) gap by three activities. 1.Implementing a setting-adapted registry for unwell patients with and without COVID-19, compliant with the ISARIC protocol in 35 critical care units in seven countries adopting methods used in a parallel Wellcome-supported nine country network. Registry output will include patient characteristics, quality of care processes and outcomes. We will also do a national critical care service evaluation. 2.Identifying stakeholder (clinician and community) research priorities to improve critical care processes and outcomes leveraging activity 1 output, especially for pregnant women and surgical patients. We will determine stakeholder priorities for improvement, pandemic response and further research by using the data to facilitate workshops for all, including the public. 3.We will recruit network sites to participate in all types of clinical research that will benefit population health and wellbeing, supported by the registry infrastructure, our group and project partners. The network will directly assist doctors and nurses participate in research through mentorship, registry enabled patient recruitment and study monitoring.

This aim will be achieved by 3 objectives;_x000D_ - To implement a setting-adapted WHO/ISARIC CCP compliant critical care registry_x000D_ - To identify stakeholder research priorities to optimise critical care processes and outcomes_x000D_ - To prepare the network for context-relevant registry-enabled clinical trials.