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[KARACHI] Highly qualified health researchers in Pakistan lack autonomy in their work and do not have sufficient incentives to sustain their research efforts, according to a new study.

The research, published in the September issue of the journal Health Policy and Planning, suggests that such conditions could be one reason why many of those sent abroad for PhD training do not return home.

More than 50 Pakistani researchers who received government funding to carry out doctoral training abroad over the past three decades were interviewed as part of the study. On average, each researcher had published 15 research articles, and trained nine students since returning to Pakistan.

"This is a unique study because there is very little literature on this topic that is empirical," says Adnan Hyder, lead author of the study, which was jointly carried out by the Johns Hopkins University, United States, and the Pakistan Medical Research Council in Islamabad.

According to Hyder, Pakistan has invested substantially to develop a critical mass of scientists, spending on average US$35,000 to train each researcher. But it has never attempted to assess the impact of its investment. "Our findings should be used to develop better programmes for health research capacity development in Pakistan," he says.

Syed A. Mujeeb, a researcher at the Jinnah Post Graduate Medical Centre in Karachi, agrees with the conclusions of the study, and adds that many individuals cannot pursue research in developing countries because they do not have access to scholarly information and published articles. "Most journal articles we need are prohibitively expensive," he says.

He adds that another hindrance faced in Pakistan is that "for each and every thing you want to do as a public-sector researcher, you need to get permission from the government, which is normally a waste of time and energy". Furthermore, "there is no value attached to research, or recognition for research work in Pakistan. So researchers become frustrated and decide to migrate elsewhere."

The study is one of the first attempts to assess the impact of efforts to develop capacity in health research in Pakistan. But, the authors say they lack the comparative data from other developing countries needed for cross-country analysis. "Such evaluations are critical to develop plans for the reduction of the 10/90 gap in health research investments," they say, referring to the fact that countries shouldering 90 per cent of the global disease burden receive less than 10 per cent of medical research funding.

Hyder is also concerned about the lack of a universally accepted framework or set of indicators to evaluate efforts to develop capacity in health research. "We should develop such guidelines," he says.

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