On Sept. 30, 2020, the National Institutes of Health (NIH) announced that it had awarded nearly $234 million to improve COVID-19 testing for underserved and vulnerable populations. A part of the Rapid Acceleration of Diagnostics (RADx) initiative, the RADx Underserved Populations (RADx-UP) program will support 32 institutions across the U.S. and will focus on populations disproportionately affected by the pandemic. These groups include African Americans, American Indians/Alaskan Natives, Latinos/Latinas, Native Hawaiians, older adults, pregnant women and those who are homeless or incarcerated.

The program aims to understand COVID-19 testing patterns better among underserved and vulnerable populations; strengthen the data on disparities in infection rates, disease progression and outcomes; and develop strategies to reduce these disparities in COVID-19 testing. To accomplish these goals in rapid fashion, the RADx-UP program is supporting projects with established community partnerships that can use their existing research infrastructures to swiftly implement strategies and interventions to increase access and uptake of COVID-19 testing among underserved and vulnerable populations.

The RADx-UP program has three primary components supported by these NIH grants to increase availability, accessibility and acceptance of testing among underserved and vulnerable populations:

1. A collaborative clinical research network of existing large-scale programs that have adequate capacity, infrastructure and relationships with underserved communities. These are the first set of awards; NIH expects to issue a second group of awards later this year, pending availability of funds, to programs with established community engagement components, which will also form part of the collaborative network. Together these programs will develop and implement interventions to increase access and uptake of COVID-19 testing.
2. Research on the social, ethical and behavioral implications of these health disparities to inform the development and evaluation of testing programs. These projects will focus on assessing how ethical, historical, healthcare, social, economic and contextual factors, as well as cultural beliefs and attitudes, expectations and preferences influence the ability and willingness to be tested.
3. A coordination and data collection center at Duke University, Durham, North Carolina, providing overarching support and guidance on administrative operations and logistics, facilitating effective use of COVID-19 testing technologies, supporting community and health system engagement and providing overall infrastructure for data collection, integration and sharing.

In the coming months, the RADx-UP program will award additional funding, pending availability of funds, to address the evolving needs of the pandemic response, integrate new scientific and/or technologic advances such as vaccines, novel therapeutics and new testing approaches, and expand the studies and/or populations being reached.