**4. Conclusions**

This perspective article defined the concept of real-time operational research. We selected four examples from the field of TB to show how this type of research can be implemented, with the findings in all four cases leading to important policy and practice changes. Important considerations about how to undertake and publish real-time operational research, build capacity and find the necessary funding are discussed. Disease control programmes, health services and health systems should include operational research as one of their core activities both to improve the delivery of established health interventions and to introduce and deploy new products and interventions as they become available. This is particularly important when health services are threatened by pandemics and epidemics.

**Author Contributions:** Conceptualization, A.D.H., P.T., A.M.V.K., S.S., S.D.B., I.D.R., M.K., R.Z.; methodology, A.D.H., P.T., R.Z.; resources, I.D.R.; writing—original draft preparation, A.D.H., P.T., R.Z.; writing—review and editing, A.D.H., P.T., I.M., J.M.C., H.T., K.C.T., A.M.V.K., S.S., S.D.B., I.D.R., M.K., R.Z.; funding acquisition, S.D.B., A.D.H.; All authors have read and agreed to the published version of the manuscript.

**Funding:** The writing and publication of this perspective article was funded by Bloomberg Philanthropies through a gran<sup>t</sup> (Grant Number 78941) from Vital Strategies and the Resolve to Save Lives Initiative, New York, NY, USA.

**Institutional Review Board Statement:** This was a perspective paper, and as such, no ethics review was required.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** Not applicable.

**Acknowledgments:** Not applicable.

**Conflicts of Interest:** The authors declare no conflict of interest. The funders had no role in the writing of this paper.

**Disclaimer:** The views expressed in this paper are those of the authors and may not necessarily reflect the views of their affiliated institutions.
