Strengthening capacity for health research in Africa

Health research has a key role in the development of low-income and middle-income countries. There are several current initiatives that have greatly contributed to capacity strengthening of health research in sub-Saharan Africa, including those supported by WHO and Tropical Disease Research (TDR), the Swedish International Development Agency (SIDA) and Department for Research Cooperation (SAREC), the European Union, the Bill & Melinda Gates Foundation, the International Clinical Epidemiology Network (INCLEN), the Fogarty International Centre, the National Institutes of Health (NIH), and the Wellcome Trust. However, enormous challenges remain for sub-Saharan Africa to establish a common framework for sustainable research capacity strengthening. The Global Ministerial Forum on Research for Health in Bamako will give emphasis to the challenges of research for development and health, the need for more health-system research, and a greater intersectoral approach to science, technology, and health. That health research is indispensable for improving health, equity, and development is now widely accepted, yet how sub-Saharan African countries can develop their fragile health systems and their own capacity to do health research is rarely discussed. A recent African-led initiative—the Initiative to Strengthen Health Research Capacity in Africa (ISHReCA)—has identifi ed nine key requirements to strengthening health-research capacity in Africa (panel 1). We focus on these requirements and suggest practical strategies for sustainable capacity strengthening in African institutions. In many sub-Saharan African countries there is a nonconducive environment for research: the legislative framework has not kept pace with new trends in research, such as genetics research, ethical conduct of clinical trials, material exchange, and intellectual property rights. These legislative gaps hamper multi-institutional research such as clinical trials. Governments must appreciate the need to make greater commitments to provide strategic planning, legislative reforms, and funding for eff ective management of research activities. The recently launched International Centre for South–South Co-operation in Science, Technology and Innovation—under the auspices of the United Nations Educational, Scientifi c and Cultural Organization (UNESCO) in Kuala Lumpur, Malaysia—can provide policy advice and ease the exchange of experiences with policy makers. Science is a global activity, and some of the best African researchers move to countries where their eff orts are better rewarded and appreciated. High-profi le advocates are needed to promote science within African society, to ensure that research gets its share of the national budgetary allocation and attracts additional external funding. This could be done by national academies of science—the African Academy of Sciences and the African Union. Politicians and policy makers need to consider how science and technology can contribute to development, including achievement of the Millennium Development Goals. African governments should recognise that funds allocated for research are a good investment. More appreciation of the benefi ts of research might lead to greater commitment to providing dedicated funding to national research budgets. Science can also contribute directly to wealth creation, through product development partnerships with industry and entrepreneurs. Strong and sustained advocacy is needed, similar to that undertaken for the provision of AIDS treatment at aff ordable cost. One example of an institution able to support such advocacy is ISHReCA, created after meetings in 2007 in Kilifi , Kenya, and Cape Town, South Africa, which brought together health researchers in Africa and international health-research funders. ISHReCA aims to promote self-sustaining research groups that can initiate and carry out high-quality health research in Africa. Its mission also includes helping the translation of research Lancet 2008; 372: 1590–93