By Fonju Ndemesah
In order to make health research systems more sustainable and attractive for African scientists, it is essential to improve the development of capacity for research in the medical domain. In fact, it is generally recognized that health research has “a key role in the development of low-income and middle-income countries”[i]. The ministers of health and heads of delegation of African countries meeting in Algiers, on 26 June 2008 for the Ministerial Conference on Research for Health in the African Region, considering the magnitude of health problems associated with poverty and climate change, including diseases such as malaria, tuberculosis, HIV/AIDS, emerging diseases, neglected tropical diseases, the resurgence of epidemic-prone diseases and other complex emergency situations recognized the need:
The WHO has summarized existing approaches to capacity building and capacity development in five simple concepts:
African practitioners and researchers must therefore be at the forefront in the search for solutions to health problems in the continent. Most often, many African countries lack quantitative and qualitative capacity to tackle health problems because many experienced and highly skilled health researchers prefer to work outside their countries; not just because of remuneration, but also because a better environment to conduct research does not exist in their countries.
Despite this brain drain, a significant amount of health research has been carried out within universities and research institutions in Africa by both African and international researchers. Some of this work is presented in international fora and/or published in highly reputable journals, but there is poor accessibility to research findings and little of this work is disseminated locally. Moreover, the research is most often focused on the clinical side of disease prevention and care. This strategy of prevention and care has yielded limited outcome, and above all, does not result in a holistic prevention and care strategy.
There are some projects such as the Medishare Project[1] which aimed at “creating the conditions for the establishment of a durable and internationally integrated network of medical research infrastructures and institutions that can cooperate in enhancing the research landscape in the targeted African countries, and make the latter attractive for African health scientists, mainly by introducing and putting at their disposal innovative tools and practices. Those innovative tools and practices could be strategic for increasing the capacity of health practitioners, learning institutions and policy makers to embed research into their respective health system, and to deliver information or services that could contribute concretely to the health of the communities.
Regretfully, in many instances, research work stops at presentation and publication, without synthesizing and packaging results into a format that can be used by policy makers for preparation of guidelines and policies. On the other hand, policymakers are rarely involved in formulation of research agendas. For these reasons, except in isolated cases, research does not influence health practices. Sam Kinyanjui[ii] in a presentation at the Medishare conference analyzed the health research landscape in Africa. He came to the conclusion that African researchers can have a big impact if given the right support; that research in Africa is “largely externally funded, incidental rather than deliberate, narrow and short term, focused on training but not retention, and human resource but not systems capacity oriented.
Endnotes
[i] James AG Whitworth,a Gilbert Kokwaro, Samson Kinyanjui, Valerie A Snewin, Marcel Tanner, Mark Walport, and Nelson Sewankambo. Strengthening capacity for health research in Africa. Lancet. 2008; 372(9649): 1590–1593
[ii] Medishare is a European Union project funded under the Edulink programme. It aims at contributing in addressing the major global priority to combat poverty-related diseases: HIV/AIDS, malaria and tuberculosis, fostering the partners’ HEI in conceiving specific training activity for postgraduate students and traineeship, setting Pharmacoepidemiology registries and a research cell on selected pathologies. The partners of Medishare are The University of Nairobi (Kenya), The Muhimbili University of Health and Allied Sciences (Tanzania) The Makerere University (Uganda) and the Italian Interuniversity consortium (Italy).
In order to make health research systems more sustainable and attractive for African scientists, it is essential to improve the development of capacity for research in the medical domain. In fact, it is generally recognized that health research has “a key role in the development of low-income and middle-income countries”[i]. The ministers of health and heads of delegation of African countries meeting in Algiers, on 26 June 2008 for the Ministerial Conference on Research for Health in the African Region, considering the magnitude of health problems associated with poverty and climate change, including diseases such as malaria, tuberculosis, HIV/AIDS, emerging diseases, neglected tropical diseases, the resurgence of epidemic-prone diseases and other complex emergency situations recognized the need:
- For appropriate platforms to improve our capacities for sharing knowledge and evidence to inform health policies and practices that will positively impact on the health of our peoples
- For national research agendas responsive to country challenges and priorities, as well as to global public health priorities
- The urgent need for our governments to implement mechanisms for addressing these concerns and to promote research and utilize its findings in our health systems
The WHO has summarized existing approaches to capacity building and capacity development in five simple concepts:
- researchers are defined as a range of persons, from highly trained professional researchers to community health workers;
- capacity building includes development of capability for research, results exploitation, and research management;
- capacity building is needed both on the supply side (researchers) and the demand side (research users: general public, civil societies, policy makers and health programmers);
- the need to develop capacity of both institutions as well as individuals of both the supply side and the demand side by building up and maintaining the infrastructure facilities necessary to support research;
- the need to look beyond the production of capable research manpower and to pay attention to the maintenance and continuous improvement and utilization of this manpower by providing an enabling environment, career development, rewards and incentives, and avoiding brain drain, both internal and external.
African practitioners and researchers must therefore be at the forefront in the search for solutions to health problems in the continent. Most often, many African countries lack quantitative and qualitative capacity to tackle health problems because many experienced and highly skilled health researchers prefer to work outside their countries; not just because of remuneration, but also because a better environment to conduct research does not exist in their countries.
Despite this brain drain, a significant amount of health research has been carried out within universities and research institutions in Africa by both African and international researchers. Some of this work is presented in international fora and/or published in highly reputable journals, but there is poor accessibility to research findings and little of this work is disseminated locally. Moreover, the research is most often focused on the clinical side of disease prevention and care. This strategy of prevention and care has yielded limited outcome, and above all, does not result in a holistic prevention and care strategy.
There are some projects such as the Medishare Project[1] which aimed at “creating the conditions for the establishment of a durable and internationally integrated network of medical research infrastructures and institutions that can cooperate in enhancing the research landscape in the targeted African countries, and make the latter attractive for African health scientists, mainly by introducing and putting at their disposal innovative tools and practices. Those innovative tools and practices could be strategic for increasing the capacity of health practitioners, learning institutions and policy makers to embed research into their respective health system, and to deliver information or services that could contribute concretely to the health of the communities.
Regretfully, in many instances, research work stops at presentation and publication, without synthesizing and packaging results into a format that can be used by policy makers for preparation of guidelines and policies. On the other hand, policymakers are rarely involved in formulation of research agendas. For these reasons, except in isolated cases, research does not influence health practices. Sam Kinyanjui[ii] in a presentation at the Medishare conference analyzed the health research landscape in Africa. He came to the conclusion that African researchers can have a big impact if given the right support; that research in Africa is “largely externally funded, incidental rather than deliberate, narrow and short term, focused on training but not retention, and human resource but not systems capacity oriented.
Endnotes
[i] James AG Whitworth,a Gilbert Kokwaro, Samson Kinyanjui, Valerie A Snewin, Marcel Tanner, Mark Walport, and Nelson Sewankambo. Strengthening capacity for health research in Africa. Lancet. 2008; 372(9649): 1590–1593
[ii] Medishare is a European Union project funded under the Edulink programme. It aims at contributing in addressing the major global priority to combat poverty-related diseases: HIV/AIDS, malaria and tuberculosis, fostering the partners’ HEI in conceiving specific training activity for postgraduate students and traineeship, setting Pharmacoepidemiology registries and a research cell on selected pathologies. The partners of Medishare are The University of Nairobi (Kenya), The Muhimbili University of Health and Allied Sciences (Tanzania) The Makerere University (Uganda) and the Italian Interuniversity consortium (Italy).