All nations need home-grown research

Countries without home-grown medical research are operating blind to the specific health needs of their citizens. Their governments cannot know what is wrong, how to fix it, or where to direct resources for the best health gains. For a few, ignorance is all but deliberate — a side-effect of authoritarian governance that feels threatened by open scrutiny of the population’s health and the dissent that might follow. Researchers from North Korea, for example, have published just five papers since 1996, according to a team of authors examining international research output ahead of the next World Health Report, due later this year. The poorest countries of the former Soviet Union are also struggling at the bottom of the league table, along with many African countries, particularly those emerging from war.

What can be done? The authors urge international donors to invest in research infrastructure, encourage international networks, and reward collaboration wherever politically possible. Surprising advances can be achieved even without much political co-operation — Gabon, The Gambia, and the Republic of Congo all punch above their weight by hosting research institutions funded and managed by high-income countries, they write. Others, such as Botswana, Cape Verde, Swaziland and Mauritius, have more committed governments and may need small investments — perhaps through international consortiums — to kick-start high-quality local research. Experience tells us that investment in health research must last for at least 10 years, encourage leadership and good management (not just teaching and research skills), and create sustainable career pathways for graduates.

‘Countries don’t need a national airline, but they do need a national health research strategy,’ the authors conclude — all countries, not just the lucky few.

McKee M, Stuckler D, Basu S. PLoS Med 2012;9(4):e1001209.