Don't Let the Evidence Die: From Rapid to Living Reviews, Experiences From the Global South

Timely and contextually relevant evidence is essential for decision-making in policy domains, especially during crisis or outbreaks like the COVID-19 pandemic. While systematic reviews provide methodological rigor, their cost and duration limit their policy utility. Rapid reviews offer a pragmatic alternative but are typically static and quickly become outdated as new studies, grey literature, and local knowledge emerge, leading to duplication of effort and losing track of policy decisions and use of evidence. This paper presents a pragmatic framework for converting rapid reviews into living evidence synthesis (LES) systems within policy contexts, especially in low- and middle-income countries (LMICs). Drawing on the experience of eBASE Africa, the framework demonstrates how LES functions can be incrementally embedded within conventional rapid-review workflows. It integrates PRISMA-aligned methods with continuous evidence surveillance across academic literature, grey literature, and non-traditional evidence sources such as social media and Indigenous Ways of Knowing, treating these as structured and systematically incorporated evidence streams, supported by responsible use of artificial intelligence and digital tools with human oversight. The framework reconceptualizes rapid reviews as entry points to living evidence systems, offering a scalable pathway to improve efficiency, continuity, and policy relevance, particularly in LMIC settings.