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Sep 03, 2013.
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Added on 03 Sep 2013
Authors: By Sungano Mharakurwa, PhD; Reviewed by Sophie Beauvais
Health scientists play a vital role in the health system and economy of nations. They contribute evidence for disease control and elimination; they participate in the creation of ethical and evidence-based policies, and they enhance national technical capacity. The evidence health scientists generate is utilized to improve health and health equity at all levels of the health system. The huge disease burden they prevent confers substantial economic gains through increased productivity from a healthy population and savings on national health expenditure.
Unfortunately, as many of us know firsthand, research capacity in disease-endemic countries remains one of the biggest unmet challenges. In sub-Saharan Africa for example, health research in most countries has an allocation of less than 0.5% of national health budgets (only Malawi, Uganda and South Africa spend more than 1% of their GDP on R&D). Worldwide, the Council on Health Research for Development estimates that 98% of health R&D expenditures are made in high income countries, and that only 25% of research on neglected diseases is done in developing countries. (WHO. 2004) (COHRED Global Forum for Health Research. 2012 Report). This discussion examines the current status, challenges and prospects of opportunities for endemic country scientists.
1. Suggested steps for increasing opportunities available to health scientists in DEC
- Researchers need to make the case to their governments that health research is an investment for national development, and should work and push for a national framework on health research that identifies research priorities for their countries and help to guide in relevant capacity building. It is also important for governments to realize that research is an ongoing activity, even in underfunded countries.
- High level regional meetings need to be organized by the scientific community with key national administrators to show the benefits of science.
- Donors can facilitate and require counterpart scientists to be present and take over programmes funded for long term action. The symposium of Nobel laureates, scientists, and others from around the world, hosted by Gabon President Ali Bongo Ondimba, celebrating the 100th anniversary of the Albert Schweitzer Hospital in Lambarene, Gabon is an exciting example of such potentially course-changing meetings. The symposium culminated in a "Lambarene Declaration", which emphasizes the urgent need to strengthen African science and health worker training in the fight against the "Triple Epidemic" (HIV/AIDS, TB, and malaria).
- Career opportunities with competitive conditions of employment need to be fostered. Governments must realize that expertise is exportable, so careers need to be challenging and competitive.
- Countries should have local and national scientific associations and (or) science academies to keep interest in science, to look after members, to provide expertise for Governments in making health decisions, to help universities, colleges and schools, and any other educational initiatives. The Ministerial Meeting in Bamako in 2008 was cited as an example.
- Establishing institutional reviews boards (IRBs) and national research ethics committees should be priority. These should not be an impediment but rather an agent for ensuring a high standard of ethical and quality research.
2. Examples of policies, incentives, and collaborations that contribute to in-country research
- The Macha Research Trust, Zambia, a collaboration between Johns Hopkins Bloomberg School of Public Health, Ifakara Institute, and the Government of Tanzania (Wellcome Trust)
- ‘Translational Clinician Scientist Entrepreneur' program in India.
- In Tanzania the President has committed 1% of GDP to Science and Technology in 2009, which has translated to a highly competitive budget.
- Zambia recently revised its civil servant salary structures, attracting many of the country’s professionals back from the diaspora.
- The private sector has been acknowledged as a major player in health research capacity strengthening. It was pointed out that there is need to find innovative ways of collaborations and to develop Public Private Partnerships in the field of Research.
- High levels of competencies widely exist in Africa, Asia, Latin America and elsewhere. There is need to develop a strong network and find ways to better cope with funders and researchers from others countries.
3. The role of the major funders (US PMI, UN/WHO RBM, GFATM, Gates, etc.)
Negotiating better contracts is important to ensure better deals for technology transfer, capacity building, data and publication ownership, intellectual property rights, and post-research benefit sharing – among others. The Council on Health Research for Development has created the “Fair Research Contracting” project to focus on this issue. COHRED’s fair research contracting initiative aims to identify best practices for the research negotiation process that would be useful in situations i) where there is no lawyer, ii) where there may be lay personnel who could be trained, and iii) where there is a lawyer or legal expertise.
- The Gates Foundation stands out among major funders in supporting global innovations and new ideas by endemic country researchers to tackle major public health priorities.
- Grand Challenges Canada and Wellcome Trust also play a positive role in capacity building and north-south collaboration that includes endemic country scientist opportunities.
- More major funders need to be encouraged to contribute towards local capacitation and fostering health research scientist opportunities.