Open your eyes to Africa

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