Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Whose eyes are being called to open?
- Astier M. Almedom (30 September 2005)
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What did Africa not do that others did; borrow five pillars from “the Asian Tigers”.
- Anthony Lwegaba (9 October 2005)
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Stopping Africa's brain drain
- Peter R Mason (25 October 2005)
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Astier M. Almedom, Henry R. Luce Professor in Science & Humanitarianism Tufts University, Boston, Massachusetts, USA
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Dear Editor, I applaud the BMJ for dedicating a theme issue to the African continent. It is particularly encouraging to see that Inwani Malweyi's personal view made it to print. But why weren't more countries represented? Could it be that out of the 300+ original submissions only a few made it through the editorial review process for reasons unrelated to quality and originality of their content? Were the editors and reviewers' eyes open to Africa? Does the BMJ intend for this theme issue to open the eyes of its own editors and reviewers to Africa, or is it merely asking African scholars to open their already wide open eyes to the BMJ? How many Africans do you have in your editorial team? It is my belief that there are many manuscripts out there that are worthy of publication, sometimes with the help of dedicated minor editorial support. I have served as peer-reviewer to the BMJ in the past. I was not sent any articles for review for this theme issue. I shall be happy to support the BMJ by helping to edit African submissions to meet your requirements. Competing interests: None declared |
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Anthony Lwegaba, Lecturer, Public Health UWI School of Clinical Medicine & Research, QEH, Barbados
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It was a worthwhile effort to focus on Health in Africa. Topics covered had a wide range of subjects in attempt to tackle Africa’s poor health, part of its record-breaking underdevelopment. Probably the Economist magazine, in 1992, put it best when it pointed out that the solutions might be uncovered and by extension applicable to health by asking what post-colonial Africa didn’t do that other countries at same level did to become the recently rapidly emerging developing countries. From my experience in both continents and reviews, I identified five missing development pillars, somehow confirmed by BMJ Oct 1, 2005 issue. First, a visionary and committed leadership formulates a development road map for the country to follow. Concepts such as 2020 from and in South East Asia have galvanized communities towards a common development goal. Africa’s leadership crises led to schisms, weak governments, power struggle and widespread wars. Secondly, heavy investment in human capital, towards functional education for all, builds a skilled health labour force that drives every undertaking. Thirdly, accountability in all sectors, complimented by sound remuneration and enforcement as anticorruption measures. Fourthly, build a supportive environment for all forms of investment, including policies and laws for fair play, infrastructure such housing, utilities and industrial parks. Lastly, borrow efficient technology and management systems and adopt them to solve local problems. Africa has wasted vast resources on inappropriate technology. Africa’s inefficient display of opulence is evident right from the moment you visit the overcapitalized apparently magnificent departmental headquarters with vast fleets of official vehicles and equipment much of it dysfunctional and staffed by underemployed officials that guide the affairs of illiterate sickly people who have no basic amenities, and hardly live long enough to see their 50th birthday. Small and simple can be efficient. Competing interests: None declared |
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Peter R Mason, Director General BRTI, P O Box MP 1667, Mt Pleasant, Harare, Zimbabwe
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The 1st October edition of BMJ has highlighted many of both the opportunities and problems facing health research in Africa [1], a continent that has perhaps benefited less than others from the technological developments that have had enormous impact on disease prevention, management and even elimination. Quite rightly, questions are asked about why Africa has not been able to take advantage of these developments. It has been pointed out that far from improving, Africa is characterized by decreased involvement in research collaborations and loss of its most valuable asset, the expertise of its people, to more developed countries [2], whether in the north or the south. Perhaps one of the most important factors in ensuring that Africa’s talent remains in Africa is to demonstrate that research can be a rewarding career path, both economically and intellectually. This requires commitment towards supporting research, and acceptance that good research merits a reasonable standard of living. We are all aware that a combination of lack of recognition of the importance of research by African governments, and the financial constraints facing these governments, has meant that research rarely receives significant financial support. I have been in Africa for more than 30 years, have worked in the same university for 27 years, and have reached the most senior academic position possible – and my reward is to take home less than US$250 per month (even when calculated at the most optimistic rate of exchange). This is hardly what a researcher with such experience would expect in any country in the industrialized or post- industrialized world. Why do I do stay here? Because of course of commitment, and a feeling of fellowship with my colleagues certainly. But also because I am able, through the experience I have gained, to supplement this income through collaboration in research projects. As a result I do not need to worry that there is not enough money to pay rent and electricity and food and school fees for my family. I, and a few of my colleagues, can do this because we have had opportunities to learn the skills of negotiation for appropriate rewards for collaboration, as well as the skills needed for competing for international research funds that provide salary support. Other colleagues have to get their extra income from other sources – at best by doing private clinical practice, but so often as part-time taxi drivers or chicken farmers. How much better for them to use their skills and knowledge more effectively in research – but the reality is that few in Africa recognise that competitive research is a career option that can be intellectually stimulating and financially rewarding. It was for this reason, amongst others, that I and colleagues in Zimbabwe started what we believe to be a unique experiment for Africa – a health research institution that was totally responsible for its own policies, philosophy and agenda and that would be independent of both national government and of any single international organization for its core activities. The Biomedical Research & Training Institute was founded in 1995 as a non-profit making company in Zimbabwe, with a commitment to supporting health research and training in southern Africa. From the time of its founding, the BRTI has provided support to more than 40 large research studies, the majority funded by international sources including WHO, Wellcome Trust, NIH, CDC, IAEA, Kellogg Foundation, Rockefeller Foundation, Plan International, embassies and others. The studies have focused on the most important health problems of the region, diarrhoeal diseases, HIV, malaria and tuberculosis, though many other health issues have been the subject of smaller studies. We require only that such research is ethical, addresses regional health priorities and most importantly provides support for capacity development of African students and faculty. The BRTI provides the infrastructure for financial management, for human resource management and for logistical support, so that researchers can attend to the more pressing matter of doing the research. We made a policy decision at the start of BRTI to keep the research staff at the Institute small, and instead to encourage financial, intellectual and research experience support to those already employed in local institutions. The talents and experience of the staff are then not lost to the home institution, and staff members begin to understand that research can be a rewarding career. In all 18 Zimbabwean postgraduate students, in biomedical and clinical fields, have been supported by research at BRTI, many of them being staff employed in universities or national institutions. We have also provided support for 20 undergraduate students completing research projects in many fields, including social science and economics. The BRTI has also provided field experience for students from Canada, the USA, Britain, the Netherlands and others – enabling local and foreign students to share experiences and develop friendships. In addition to this support for academic students, the BRTI recognizes the crucial importance of training for career development. To respond to this, the BRTI has organized short, 1-2 week, training courses in areas of need, and since 1996 we have enrolled more than 500 participants from 22 countries in Africa in 45 courses. The courses have included general topics, such as writing grant proposals, research management, quality control, research methods, data management and analysis, ethical issues in research and the skills of writing papers for publication. Courses are also held on more specific and practical topics such as those of serological techniques, antimicrobial assays, diagnostic techniques and the use of microscopes. The aim is to improve the ability of local African researchers to prepare good proposals for research, to compete effectively for available research funds and to conduct research activities in accordance with the principles of good research practice. We appreciate that colleagues in South Africa have also recognized the importance of these skills in developing capacity for research [3], and we would encourage them to implement their ideas in the way that we have. When the BRTI was started it was considered an experiment – one that would show that such an approach to research development was viable. The BRTI was to be African in concept, and to be financially independent - free of any of the constraints of ever-changing policies of national institutions, and also free of the potential for “scientific colonialism” of international control. There were many who said that such an idea was not feasible in Africa and it could not be self-sustaining. Ten years later we are still here. We have seen the continued growth in its research activity, the continued growth in its training activity and the increasing recognition of its status as a “centre of excellence in research and training” in the southern Africa region. Moreover, this has been achieved at a time when Zimbabwe has experienced the most rapid economic and social decline of its history, and at a time when so many of the sponsors of research and training have, sadly, withdrawn their valuable support from Zimbabwe. What do we want from the developed world? Others have noted that in trade, Africa asks, not for aid, but for fairness [4], and we ask the same thing in research. We ask for recognition of our achievements. We ask that applications for research through our institution are treated on the basis of scientific merit, and not as “another request from Africa” that should be regarded as suspect because of the economic, social and political events around us. We ask for support so that we can answer questions in order to improve the health of our people and so that we make our own contribution to the world body of knowledge. We ask for sponsors to allow that we give reasonable rates of pay for staff, and we ask that sponsors allow for researchers to supplement their meager incomes – not so we can drive around in big cars, but so we can give our families those things that our colleagues in the north take for granted. We ask for recognition that infrastructures do not come free and that sponsors allow a reasonable overhead payment to be made for the BRTI activities and development. We ask for support for students and others, not just from Zimbabwe but from the region, to attend training courses so they can improve their skills and capacity for conducting good, ethical and productive research. The training fees that we charge are on a cost-recovery basis and so are much, much less than similar fees in the developed world, and those fees help to support an African institution. We ask these things so that our researchers, and our potential researchers, can learn the skills that will enable them to compete for research funds on an equal footing with researchers in the more developed world. We ask for support to show African scientists that research is a viable and rewarding career option to which they can aspire. This is the way to combat the “brain drain” and to keep Africa’s best talent in the place where it belongs. Helping to solve the many health problems of Africa. 1. Clark J. Open your eyes to Africa. British Medical Journal 2005;331: 2. Johnson J. Stopping Africa’s medical brain drain. British Medical Journal 2005;331: 3. Volmink J, dare L. Addressing inequalities in research capacity in Africa. British Medical Journal 2005;331: 4. Malweyi I. Africa does not need aid, but the opportunity for fair trade. British Medical Journal 2005;331: Competing interests: None declared |
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