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The 2012 world health report 'no health without research': The endpoint needs to go beyond publication outputs
Abstract
Le thème du Rapport de la Santé Mondiale 2012 est «pas de santé sans recherche» et est un appel à l’action pour combler les lacunes mondiales dans la recherche en santé. Combler l’écart entre les «nanti »et les «démunis» est vital si nous voulons être à la hauteur de l’appel de ce thème et utiliser la recherche pour apporter des améliorations sur le terrain. Les nombres absolus de publications scientifiques et des publications par habitant ont été utilisés comme les principaux indicateurs pour évaluer la capacité mondiale de la recherche et identifier les zones à lacunes. A l’échelle des pays, nous estimons que cela reflète un seul côté de la médaille. Bien que l’absence de stratégies nationales de recherche en santé empêche une allocation optimale des ressources, une réalité toute aussi importante sur le terrain est la transcription inadéquate des résultats de la recherche dans la politique et la pratique, l’autre côté de la médaille.
El tema del Informe sobre la Salud en el Mundo del 2012 es “No hay salud sin investigación” y es un llamado a la acción para subsanar las diferencias globales en la investigación en salud. El resolver las diferencias entre lo que “se tiene” y lo que “no se tiene” es vital si queremos a cumplir con las expectativas planteadas en este estudio y utilizar la investigación para realizar mejoras en el campo de la sanidad. Los números absolutos de publicaciones científicas y publicaciones per cápita se han utilizado como los principales indicadores a la hora de evaluar la capacidad global de investigación e identificar las áreas en las que existen brechas. Sin embargo creemos que a nivel nacional este enfoque solo refleja un lado de la moneda. Aunque la falta de una estrategia nacional de investigación en salud dificulta la distribución óptima de los recursos, sobre el terreno es igualmente importante una traslación inadecuada de los resultados de la investigación en políticas y en la práctica – el otro lado de la moneda.
... The practical effect that research can have on health needs to be improved, and this can be done through operational research to close the implementation gap; thus, the simple number of publications cannot be equated with the advance in tropical health, according to a later study by Zachariah et al. (2012). ...
Introduction: The importance of tropical medicine cannot be overstated, since by the end of the 2030s, most humans will live in the tropics and will need protection from tropical diseases. Nevertheless, until now, there are no bibliometric studies about tropical medicine as a whole; all previous studies are limited to diseases, countries or particular journals, and are often limited to brief periods of time. Here we present an analysis of historical trends for the world and for the Revista de Biología Tropical in celebration of the journal’s 70th anniversary. Objective: To assess geographic and historical trends in the study of tropical medicine included in a general database, the Web of Science and from a detailed analysis of one journal of particular importance for the field in the neotropical region. Methods: We limited our data to journals covered by the Web of Science category “tropical medicine” in the Science Citation Index Expanded (data updated 19 January 2022) and the Journal Citation Report on 30 June 2021. Results: We retrieved 69 480 articles, of which 44 % resulted from international collaboration with 194 participating countries; articles may reach 17–21 citations each, and the countries with outstanding results in the database include USA, Brazil, UK, Kenya and Switzerland. Research focus changes as diseases such as HIV, Dengue and tuberculosis become more or less important over time, but overall there was much research on Plasmodium, leishmaniasis and schistosomiasis. The journal Revista de Biología Tropical has significantly increased the number of topics covered, but still publishes studies about tropical biomedical subjects. Conclusions: While countries with large research budgets have a large presence in this database, lower income tropical countries like Brazil and Kenya have done a remarkable contribution in the field of tropical medicine. The Revista de Biología Tropical has been publishing quality research about tropical medicine for the last seven decades.
... In principle, we encouraged 'local research, with local ownership, for local solutions'. This experience highlights the importance of engaging throughout the research process with decision makers [10,11]. A PubMed search found studies from Nigeria [12], Ghana [13], Togo [14], and Zimbabwe [15] that assessed ADRs at a country-widelevel and showed shortcomings in the quality of reporting, but unlike Sierra Leone none of these studies performed a reassessment to assess if there were improvements thereafter. ...
Background: The quality of pharmacovigilance data is important for guiding medicine safety and clinical practice. In baseline and follow-up studies after introducing interventions to improve the quality of reporting of Individual Case Safety Reports (ICSRs) in Sierra Leone, we compared (a) timeliness and completeness of reporting and (b) patient outcomes classified as ‘recovering’. Methods: Baseline (January 2017–December 2021) and follow-up (June 2022–April 2023) studies of ICSRs in the national pharmacovigilance database. Interventions introduced following recommendations from the baseline study included: updating standard operating procedures and guidelines, setting performance targets follow-up of patient outcomes, and training. Results: There were 566 ICSRs in the baseline study and 59 in the follow-up study. Timelines (reporting < 30 days) improved by five-fold (10% at baseline to 47% in follow-up). For the completeness of variables in ICSRs (desired threshold ≥ 90%),this was 44% at baseline and increased to 80% in the follow-up study. ‘Recovering’ outcomes reduced from 36% (baseline study) to 3% (follow-up study, p < 0.001). Conclusions: Significant improvements in timeliness, completeness, and validation of ICSRs were observed following operational research in Sierra Leone. While enhancing pharmacovigilance and patient safety, this study highlights the important synergistic role operational research can play in improving monitoring and evaluation systems.
... The enabling factors for such research uptake included: (1) the relevance of the research topic; (2) the early engagement of six decision makers of IPC implementation in the conduct and reporting of research findings, thereby creating ownership of these research findings and the responsibility to act on the recommendations; (3) training of the PI of the previous study in research communication [30] and effective dissemination of study findings to the national IPC committee and other key stakeholders; and (4) the PI of the previous study being the WHO IPC focal point; as a result, he worked closely with the national IPC committee and was able to encourage research uptake and provide technical support for implementing recommendations. This experience highlights the importance of "local research, with local ownership, for local solutions", as well as the importance the early engagement of decision maker in conceptualizing and conducting the study [36,37]. ...
Introduction:
Infection prevention and control (IPC) is crucial to limit health care-associated infections and antimicrobial resistance. An operational research study conducted in Sierra Leone in 2021 reported sub-optimal IPC performance and provided actionable recommendations for improvement.
Methods:
This was a before-and-after study involving the national IPC unit and all twelve district-level secondary public hospitals. IPC performance in 2021 (before) and in 2023 (after) was assessed using standardized World Health Organization checklists. IPC performance was graded as: inadequate (0-25%), basic (25.1-50%), intermediate (50.1-75%), and advanced (75.1-100%).
Results:
The overall IPC performance in the national IPC unit moved from intermediate (58%) to advanced (78%), with improvements in all six core components. Four out of six components achieved advanced levels when compared to the 2021 levels. The median score for hospitals moved from basic (50%) to intermediate (59%), with improvements in six of eight components. Three of four gaps identified in 2021 at the national IPC unit and four of seven at hospitals had been addressed by 2023.
Conclusions:
The study highlights the role of operational research in informing actions that improved IPC performance. There is a need to embed operational research as part of the routine monitoring of IPC programs.
... Resource constraints and the lack of technical and management capacity have been identified as major obstacles in conducting regular national health surveys that capture policy-relevant topics. In some settings, survey data exist, but their role in driving policy decisions is absent due to several reasons [4,5]. The literature focusing on the use of scientific evidence, including survey data, in health policy is relatively rich, describing the roles of responsible institutes, funding agencies, policy authorities and stakeholders [6][7][8]. ...
Background
Health surveillance and survey data are helpful in evidence-informed policy decisions. This study is part of an evaluation of the National Health Examination Survey (NHES) programme in Thailand. This paper focuses on the obstacles in the translation of survey information into policies at a national level.
Methods
In-depth interviews with relevant individuals and representatives of institutes were carried out for the data collection. A total of 26 focal informants included executives and staff of NHES funders, government health agencies, civil society organisations, health experts, NHES programme managers and researchers in the survey network.
Results
Utilisation of NHES data in policy-making is limited for many reasons. Despite the potential users’ positive views on the technical integrity of experts and practitioners involved in the NHES, the strength of employing health examinations in the data collection is not well recognised. Meanwhile, alternative health surveillance platforms that offer similar information on a shorter timescale are preferable in policy monitoring and evaluation. In sum, the lack of governance of Thailand’s health surveillance system is identified as a key element hindering the translation of health surveys, including the NHES, into policies.
Conclusion
Despite an adequate capacity to conduct population health surveys, the lack of governance structure and function has resulted in a fragmented health monitoring system. Large and small survey projects are conducted and funded by different institutes without common policy direction and alignment mechanisms for prioritising survey topics, collective planning and capacity-building programmes for survey practitioners and users. Lessons drawn from Thailand’s NHES can be helpful for policy-makers in other low- and middle-income countries, as effective governance for evidence generation and utilisation is necessary in all contexts, regardless of income level and available resources.
... Mentorship is critical for developing capacity [39,40]; however, it is often lacking in RCB activities in LMICs [38,41,42]. While each PHIT project noted the essential role of mentorship for their RCB activities, mentorship resources were limited requiring creativity in supporting trainees. ...
Background:
Inadequate research capacity impedes the development of evidence-based health programming in sub-Saharan Africa. However, funding for research capacity building (RCB) is often insufficient and restricted, limiting institutions' ability to address current RCB needs. The Doris Duke Charitable Foundation's African Health Initiative (AHI) funded Population Health Implementation and Training (PHIT) partnership projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia) to implement health systems strengthening initiatives inclusive of RCB.
Methods:
Using Cooke's framework for RCB, RCB activity leaders from each country reported on RCB priorities, activities, program metrics, ongoing challenges and solutions. These were synthesized by the authorship team, identifying common challenges and lessons learned.
Results:
For most countries, each of the RCB domains from Cooke's framework was a high priority. In about half of the countries, domain specific activities happened prior to PHIT. During PHIT, specific RCB activities varied across countries. However, all five countries used AHI funding to improve research administrative support and infrastructure, implement research trainings and support mentorship activities and research dissemination. While outcomes data were not systematically collected, countries reported holding 54 research trainings, forming 56 mentor-mentee relationships, training 201 individuals and awarding 22 PhD and Masters-level scholarships. Over the 5 years, 116 manuscripts were developed. Of the 59 manuscripts published in peer-reviewed journals, 29 had national first authors and 18 had national senior authors. Trainees participated in 99 conferences and projects held 37 forums with policy makers to facilitate research translation into policy.
Conclusion:
All five PHIT projects strongly reported an increase in RCB activities and commended the Doris Duke Charitable Foundation for prioritizing RCB, funding RCB at adequate levels and time frames and for allowing flexibility in funding so that each project could implement activities according to their trainees' needs. As a result, many common challenges for RCB, such as adequate resources and local and international institutional support, were not identified as major challenges for these projects. Overall recommendations are for funders to provide adequate and flexible funding for RCB activities and for institutions to offer a spectrum of RCB activities to enable continued growth, provide adequate mentorship for trainees and systematically monitor RCB activities.
... Total number of obtained papers was categorized into eleven groups according to the study topic (28). In each group, all papers (after adjusting for duplicates) were classified based on the study design, subject category, WHO classification (29) and Australian National Health and Medical Research Council (NHMRC) criteria (30). WHO criteria for research classify the studies to know whether research meets health needs and improve health outcomes or not. ...
Background: Diabetes has become a daunting health and medical challenge as well as a hefty economic burden for societies over the past decades. This study was designed to shed light on the overall trend of research across Iran regarding mental health status of diabetic patients.
Method: Search process of the present study is part of search strategy of Iran Diabetes Research Roadmap (IDRR) study. We performed a thorough search about Iran diabetes research output in national (Iranmedex, Magiran, and SID) and international (Pubmed, ISI and Scopus) databases up to 2015. After removing duplicates, 426documents were remained and categorized by subject category, methodology, WHO classification and NHMRC criteria.
Results: Most of obtained studies were concerned with quality of life, treatment, intervention, and behavioral disorders. Based on WHO categories, most studies revolved around epidemiology, causes and determinants of health-related outcomes. Methodological classification showed cross-sectional as the favored method of research. In the Australian classification system, most studies were clinical studies. The year 2010 and 2011 had the greatest spike during the study period.
Conclusion: Overall trend in publication rate of papers related to the mental health is relatively growing. However, the lack of priority setting is obvious and there is a pressing need for more in-depth evaluations, prioritization of study type and interventional studies based on the needs of patients suffering from diabetes.
Background: This study aimed to provide comprehensive analysis of research output in the field of diabetes and exercise in Iran.
Method: Search process of the present study was a part of search strategy of Iran Diabetes Research Roadmap (IDRR) study. All publications of Iranian authors about diabetes and exercise in national (SID, IranMedex, and Magiran) and international journals (PubMed, Web of Science and Scopus) up to 2015 were reviewed. After screening and adjusting for duplicates, 180 studies were remained and categorized by subject category, methodology, WHO classification and NHMRC criteria.
Results: Among 180obtained articles, in term of subject area mostnumber of documents was about the type of sports (55%) followed by social aspect of exercise and physiologic effects. Aerobic exercise (52.5%) was the most common exercises studied. Moreover, overall trend of publications was relatively increasing during the study period. More than half of the papers were randomized clinical trial (RCT) (51.11%).
Conclusion: Although trend of papers subjects was relatively scattered, most of exercise studies in Iran were about the type of sports with more focus on aerobic exercises in patients with type 2 diabetes. Future research in this field should be directed more toward cohorts and systematic reviews that provide high level of evidence. However, quality assessment for all studies should be carried out in future research.
Background: Despite the benefits of diabetes patient education, it is imperative to analyze the status of researches in this field and identify research gaps and priorities if our limited health resources are to be used wisely and effectively. This study is a part of Iran Diabetes Research Roadmap study to find the knowledge gap in the field of diabetes patient education in Iran.
Methods: All publications of Iranian authors about diabetes patient education in national (SID, IranMedex, and Magiran) and international journals (PubMed, Web of Science and Scopus) up to 2015 were reviewed. Overall, 306 studies were categorized by subject category, methodology, WHO classification and NHMRC criteria.
Results: Most numbers of samples in the subject category were about the effect of self-care training (28%) and then model-based educational interventions (13%). Moreover, trend in publication rate of papers related to the patient education topic is relatively increasing with time, despite some difficulties points. Half of the papers were cross-sectional and 46% of them were interventional studies.
Conclusion: Although trend of papers subjects was relatively scattered, most of patient education studies in Iran were about assessing the positive effects of self-care education similar to other countries. However, quality assessment for all studies should be carried out in future research.
Universal health coverage, with full access to high-quality services for health promotion,
prevention, treatment, rehabilitation, palliation and financial risk protection, cannot be
achieved without evidence from research. Research has the power to address a wide
range of questions about how we can reach universal coverage, providing answers to
improve human health, well-being and development. All nations should be producers of research as well as consumers. The creativity and skills of researchers should be used to strengthen investigations not only in academic centres but also in public health programmes, close to the supply of and demand for
health services. Research for universal health coverage requires national and international backing. To
make the best use of limited resources, systems are needed to develop national research
agendas, to raise funds, to strengthen research capacity, and to make appropriate and
effective use of research findings.
http://www.who.int/whr/2013/report/en/index.html
Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Medecins Sans Frontieres (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world.
As part of a cluster of articles leading up to the 2012 World Health Report and critically reflecting on the theme of "no health without research," Martin McKee and colleagues examine the question of what to do to build capacity in the many countries around the world where health research is virtually non-existent.
Very limited operational research (OR) emerges from programme settings in low-income countries where the greatest burden of disease lies. The price paid for this void includes a lack of understanding of how health systems are actually functioning, not knowing what works and what does not, and an inability to propose adapted and innovative solutions to programme problems. We use the National Tuberculosis Control Programme as an example to advocate for strong programme-level leadership to steer OR and build viable relationships between programme managers, researchers and policy makers. We highlight the need to create a stimulating environment for conducting OR and identify some of the main practical challenges and enabling factors at programme level. We focus on the important role of an OR focal point within programmes and practical approaches to training that can deliver timely and quantifiable outputs. Finally, we emphasise the need to measure successful OR leadership development at programme level and we propose parameters by which this can be assessed. This paper 1) provides reasons why programmes should take the lead in coordinating and directing OR, 2) identifies the practical challenges and enabling factors for implementing, managing and sustaining OR and 3) proposes parameters for measuring successful leadership capacity development in OR.
The 20th anniversary of the groundbreaking report of the Commission on Health Research for Development inspired a Symposium to assess progress made in strengthening essential national health research capacity in developing countries and in global research partnerships. Significant aspects of the health gains achieved in the 20th century can be attributed to the advancement and translation of knowledge, and knowledge continues to occupy center stage amidst growing complexity that characterizes the global health field. The way forward will entail a reinvigoration of research-generated knowledge as a crucial ingredient for global cooperation and global health advances. To do this we will need to overcome daunting gaps, including the divides between domestic and global health, among the disciplines of research (biomedical, clinical, epidemiological, health systems), between clinical and public health approaches, public and private investments, and between knowledge gained and action implemented. Overcoming systematically these obstacles can accelerate progress towards research for equity in health and development.
Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world.
We describe the initiation and establishment of The University of Zambia - University College London Medical School (UNZA-UCLMS) Research and Training Project, an entirely African scientist-led, south-north partnership. In its 16 year existence, the project, by successfully obtaining competitive grant funding, has transformed itself into one of Africa's most productive African-led R&D programmes with training and visible research outputs. The project serves as a role model and now networks R&D and training activities with six southern African (10 institutions) and six European countries. This project case study illustrates that deep commitment is essential for success and that the factors which facilitate success in R&D in Africa need to be evaluated. The long-term prospects for sustaining the UNZA-UCLMS Project appear bright and are dependent on several factors: the ability to retain trained African scientists; obtaining continued competitive or donor grant funding support; and serious investment by the African governments involved. The recent 255 million Euros EDCTP investment in sub-Saharan Africa through south-north partnerships is expected to enhance existing African-led R&D programmes. African governments and scientists must rise to the challenge.
The Ministerial Summit on Health Research in November 2004 and the World Health Assembly in May 2005 called for more research in developing countries to strengthen health systems and to help achieve the Millennium Development Goals (MDGs) by 2015 (1, 2). Research, we believe, has to be a component of a strategic process rather than an end in itself. Ill-health and premature deaths from preventable causes persist, especially among poor children and women, in spite of available cost-effective interventions (3), in part because there is a gap between what is known and what gets done in practice, i.e., the 'know--do' gap. This gap between available knowledge and its application in policy and practice is not new, but systematic approaches to address it are urgently needed. New approaches should promote the use of best available scientific evidence and strategic research. They should also harness field experience and innovation with an emphasis on problem-solving to address priority health problems, both at the global and local levels. To bridge the know-do gap, knowledge must be leveraged effectively to achieve better health (4). The generation and sharing of knowledge are necessary steps in its effective application. Global debate continues on how this gap can be bridged. Evidence-based medicine and health policy represent genuine efforts to ensure that the best evidence informs policy and practice, but much remains to be done. Developing countries are underrepresented in randomized controlled trials and systematic reviews. This under-representation contributes to the mismatch between best evidence and what is relevant, applicable, feasible and affordable in such countries (5). The situation is even more tenuous beyond the clinical setting, given the complex nature of public health and policy, where questions rarely lend themselves to traditional research approaches. There is debate on what constitutes best available evidence and how to harness it in policy and practice. The research literature refers to a hierarchy of evidence from systematic reviews of randomized controlled trials, to common sense and expert opinion. Moreover, the definition of knowledge is sometimes used interchangeably with that of information or evidence. It has been argued that information is explicit and factual, while knowledge results from the integration of information with belief and context. This implies that while information can flow easily, knowledge is embedded in people (6). The perception of knowledge differs according to culture. Ultimately, it is knowledge that drives people to act. What makes us believe in an idea enough to transform it into decisions and actions? In the context of strengthening health systems in developing countries, it is timely to revisit basic conceptions of evidence, information and knowledge. Beyond research and the various sources of useful knowledge, the key challenge lies in understanding the steps and processes involved in decisionmaking and implementation. These are complex and influenced by many factors including the user's context, the presence (or lack) of an enabling environment, perceived relevance and type of knowledge in question. …
Operational research in low-income countries has a key role in filling the gap between what we know from research and what we do with that knowledge-the so-called know-do gap, or implementation gap. Planned research that does not tangibly affect policies and practices is ineffective and wasteful, especially in settings where resources are scarce and disease burden is high. Clear parameters are urgently needed to measure and judge the success of operational research. We define operational research and its relation with policy and practice, identify why operational research might fail to affect policy and practice, and offer possible solutions to address these shortcomings. We also propose measures of success for operational research. Adoption and use of these measures could help to ensure that operational research better changes policy and practice and improves health-care delivery and disease programmes.
Is a published research paper an important indicator of successful operational research at programme level in low-income countries? In academia, publishing in peer-reviewed scientific journals is highly encouraged and strongly pursued for academic recognition and career progression. In contrast, for those who engage in operational research at programme level, there is often no necessity or reward for publishing the results of research studies; it may even be criticized as being an unnecessary detraction from programme-related work. We present arguments to support publishing operational research from low-income countries; we highlight some of the main reasons for failure of publication at programme level and suggest ways forward.
We evaluated the international training course of the Research Institute of Tuberculosis, Kiyose, Japan, by e-mailing structured questionnaires to participants who attended the course from 2001 to 2007. Of 62 responding participants, 34 developed action plan projects (APPs) and 28 developed operations research projects (ORPs). Among respondents drafting APPs, 27 (79%) started implementing projects, and 24 (88%) completed over half of their planned activities. Among respondents drafting ORPs, 11 (39%) started projects but no scientific papers were published. The main reasons for the failure to implement ORPs were due to lack of time, funds, and disapproval by supervisors. A sequential training model may better address barriers to teaching and assisting ORPs.
Operational research is increasingly being discussed at institutional meetings, donor forums, and scientific conferences, but limited published information exists on its role from a disease-control and programme perspective. We suggest a definition of operational research, clarify its relevance to infectious-disease control programmes, and describe some of the enabling factors and challenges for its integration into programme settings. Particularly in areas where the disease burden is high and resources and time are limited, investment in operational research and promotion of a culture of inquiry are needed so that health care can become more efficient. Thus, research capacity needs to be developed, specific resources allocated, and different stakeholders (academic institutions, national programme managers, and non-governmental organisations) brought together in promoting operational research.
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.
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Strengthening capacity for health research in Africa
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Strengthening capacity for health research in Africa
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