Airing unequal health research partnerships
A meeting in Berlin brought unequal health research partnerships into the open — but will its framework kick-start progress or gather dust?
Health researchers from the developed North who 'parachute' into developing countries to collect data without regard for local scientists are thankfully now the exception rather than the norm. But there is still a way to go before developing country collaborators have a truly equal role in research partnerships.
Such partnerships were the focus when members of the neglected disease research community and government representatives, funders and development agencies met in Berlin, Germany, last week (16–18 March).
The meeting, hosted by the German Federal Ministry for Economic Cooperation and Development and the WHO Special Programme for Research and Training in Tropical Diseases (TDR), produced an 'action framework' for key stakeholders — from governments to funders — to improve partnerships (see Health researchers agree to reform North–South collaborations).
Equal roles, shared priorities
Developing country collaborators are often 'partners' in name only. They may have little say in setting the agenda for collaborative research. And if local data management and analysis skills are poor, data are often taken elsewhere for analysis, relegating local collaborators to data-producers and protocol-doers.
The new framework declares that research partnerships should allow both partners an equal role in decision-making, in carrying out the work and in sharing the benefits. It also calls for high quality research that observes appropriate ethical standards.
And it stresses that partnerships must reflect developing countries' own research priorities. In this, it echoes recent calls for more developing country 'ownership' of research, such as that by the 'Call to Action' formulated by the Global Ministerial Forum on Research for Health in Bamako, Mali, last year (see Bamako 'Call to Action' unites 69 countries on health research).
The Berlin framework also calls on research funders and donors to align their support with national and regional priorities — another component of the Bamako 'Call', itself based on the 2005 'Paris Declaration on Aid Effectiveness', which committed countries and organisations to increase efforts to harmonise aid.
Funders are beginning to experiment with a more 'hands off' funding approach (see Donors test pioneering funding model), and several funding agencies and donors have recently formed a group to promote synergy and alignment in their health research funding in developing countries.
Such welcome measures are now more important than ever, as the global financial crisis will surely squeeze available funding, making closer alignment essential to maintain and enhance effectiveness. Indeed, delegates to the Berlin meeting saw the economic crisis as an opportunity to stop long-unchecked disjointed funding policies and streamline research.
While the Berlin framework echoes many previous calls, it also ventures into new territory by setting out the responsibility of each actor in research partnerships.
For example, it takes the welcome step of calling for more core funding for developing country research institutions. Developing country researchers can only become equal partners when they and their institutions have the full human capacity and infrastructure to do so. This will require a shift from funding partnerships through 2–3 year cycles, with no guarantee of renewal, to more long-term, consistent commitments.
The framework also explicitly emphasises the importance of trust, openness and communication in partnerships. For many, the Berlin meeting was the first time that inequality in research partnerships — and what can be done to address it — had been openly and honestly discussed.
But whether the resulting framework will suffer the same fate as many previous declarations, and simply be referred to, rather than acted upon, is a worry. The document includes no mechanisms for action and the meeting set few concrete targets.
And how will the framework's impact be measured, without a rigorous analysis of the current state of research partnerships? Some plans are in place to address this concern. TDR is working on indicators to measure whether the framework is having any effect. And it is creating an online community on Tropika.net for stakeholdersto exchange ideas and examples of good practice. A follow-up meeting in two years is planned to assess progress.
But this discussion is still very much in its infancy, and setting unrealistic short-term goals would set the community up to fail. Long-term progress is paramount — it will be impossible to change practices in the many and diverse research partnerships for neglected diseases overnight. For example, we are only now beginning to see evidence of progress in funding alignment — four years after the Paris declaration was made.
With any luck, the framework will kick-start further discussion and its very existence will hopefully highlight the need to consider equity at every stage of a research partnership. But whether the Berlin framework will gather dust or be a useful document will depend on the effectiveness of the next steps.
Assistant news editor, SciDev.Net