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International partnerships: View from the South…
Patricia J. Garcia MD MPH Universidad Peruana Cayetano
Heredia (UPCH)
Patricia J. Garcia MD MPH Universidad Peruana Cayetano
Heredia (UPCH)
www.globalhealthperu.org
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Outline1.Definitions
2.Research models
3. Research capacity building and partnerships
4. Principles of Good Research Partnerships
5. Peru, UPCH and experience with international partnerships
6. Lessons learned
7. How to N-S and S-S relations compare?
8. Conclusions
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1. Definitions Collaboration: the act of working “jointly” (whatever
that means) Partnership: a cooperative relationship between
people or groups who agree to share responsibility for achieving some specific goal
International Research Relationship Models (RM): styles of research interaction seen between develop and developing countries’ researchers. Several times called collaborations.
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2. Research models Semi colonial models: Quite common, unfortunately…
Postal research Researcher requests a colleague from developing country to
send biological samples Parachute research
Researcher travels to developing country for short periods of time and take back biological samples
Annexed sites research: Research site established at a developing country by a
develop country researcher/institution, led an managed by expatriate staff. Independent from national institutions, attractive for promising national academics…
Partnership models: the ideal (at least for us in the south), challenging but possible…
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Characteristic Semi Colonial Model Partnership model
Setting research agenda By outsiders Negotiated with insiders
Links with national institutions Peripheral Integral
Management By foreigner By national
Dissemination Heavily to international journals
Balanced international, national
Emphasis on sustainability and generalizability of research findings
Low More likely
Effect on National Institutions Negative Positive, builds up
academic infrastructure
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Capacity Building Pyramid
Tools
Skills
Staff and Infrastructure
Structures, Systems and Roleseffective
enable
effective
effective
enable
enable
require…
require…
require…
TrainedIndividuals
++TrainedIndividuals
Critical Mass
+ G
oo
d R
esearch P
artnersh
ips
Investment inTrainingInstitutions
3. Research Capacity Building for development in the global community requires :
Potter, 2004, modified
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4. Principles of Good Research Partnerships
Mutual trust and shared decision making National ownership Emphasis on getting research findings into
policy and practice Training, mentoring, exchange Within the national research agenda
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5. Peru, UPCH and experience with International Partnerships
Population: 29 million Geography: Broad diversity of climactic
and different the Amazon basin to the Andean mountains.
70% urban (mostly in Lima) Inca culture outside of Lima (Cuzco) Languages: Spanish, Quechua,
Aymara Peru’s food: lots of ethnic influences
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Universidad Peruana Cayetano HerediaUPCH
-1961- 2000 students- 8 Schools- Research is a priority
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Concrete example: Peru- UPCH as a Research Hub
Second country in NIH funding in Latin America ($6m), similar to Mexico ($6m),
and after Brazil ($16 m). (source NIH , average FY 2004-2005)
Populations in Brazil, Mexico and Peru are 190m, 109m and 29m, respectively
The Universidad Peruana Cayetano (UPCH) is the largest research institution in the country
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UPCH is investing in an enabling environment for research
Vice rector of Research Well establish IRB Office of Grants and contracts Small grants to promote intramural research Recognition of “Research professors” Awards for research:
Within the universityLatin American Award
Scholarships for post doctoral re-entry support Competitive, 1 per yearTo fight against brain drain National Council of science and technology, following the
example
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Year
Nu
mb
er
of N
IH G
ran
t Aw
ard
sCASE STUDY: UNIVERSIDAD PERUANA CAYETANO HEREDIA
* NMRCD = US Naval Medical Research Center Detachment
TrainingResearchU.S. FellowshipsGlue grants
NMRCD* (23 y)
U. Washington (16 y)
Johns Hopkins (21 y)
U. Alab. Birm. (15 y)
Framework
BiodiversityMinority
Inf DiseaseInformatics
Environ HealthClin Res Train
AIDS Clin Res Train
Ecol Inf Diseases
Med Students
Small grants (FIRCA)
Postdocs
Research?
AIDS
GRIP
FIC Grants
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2000 2001 2002 2003 2004 2005 2006 2007
Fund
ing
(mill
ion
USD
)
Year
UPCH: Significant increase in competitive research funding*
*All sources, national and international funding
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Successful International partnerships
Johns Hopkins25 y of collaborationTraining and research grants,
Robert Gillman et al7 graduated PhDs, 10+ in
training
U. Washington, Seattle20 y of collaboration IATRP, King Holmes et al2 PhDs, 20+ MPHs, +60 and
more in training
U. Alabama Initial masters programs
in PeruSten Vermund, now at Vanderbilt
STI/HIV research Unit Patty GarciaCTU in Peru Jorge Sanchez
Cysticercosis working GroupHector GarciaArmando G
Gorgas Tropical Medicine CourseResearch in Tropical DiseasesE. Gotuzzo
National and Global
collaborations
National
and GlobalImpact
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The Cysticercosis Working Group in Peru Since 1987 as a true horizontal collaboration
UPCH-SM universities, CDC, and Johns Hopkins
Global collaborationsBelgium, Italy, Spain, UK, Japan, Korea, etc.Ecuador, Honduras, Brazil, Bolivia, etc.
National Impact Improve policies and official Dx and Tx guidelines
Global Impactnew diagnostics, treatments, vaccines, field control.E.g. seizures associated with neurocysticercosis, impact in
management of US Hispanic populations
Diversification in sources of funding (NIH, Gates, national, private)
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STI and HIV Unit- School Public Health• Since 1999, as a true horizontal collaboration with the UW
• Working with NMRCD, MOH, USAID, NGOs• Opportunities for training and research for local and US-UK , and
LA students
• Global collaborations• UK (Imperial College), China
• National Impact • Improve policies and official Dx and Tx guidelines• Data produced is being used by the Ministry of Health, International
agencies (USAID, UNAIDS), for Global Fund prop
• Implementation of innovative interventions• GPS using PDA , mobile teams for reporting of medication adverse
events, pharmacy training in STI, cell phones, Internet
• Globalization• Sharing with countries in the region experiences in STI
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Lessons learned Research groups which operate in isolation limit
the scope and success of their work Research is essential for development and
becomes a bridge between countriesResearchers trained abroad become diplomats in their
regionsOpportunities for young researchers from abroad
Collaborators are importantBenefits in both waysExpertise from the northCollaborators understanding local needs and
resources
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Lessons learned • Good research partnerships require:
– Huge investments of time from all participants, but they are hugely rewarding in return
– Training and mentoring (in both ways), which help to establish long-lasting sustainable partnership
• Changes in life perspectives for both sides
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Lessons learned: Challenges• Heavy demands on participants, investments
from both sides (time and effort)• Takes time
– High quality projects may take longer – Start up phase can be long
• Communication to avoid confusions• Informed decisions• Mutual respect• Equity, justice• Horizontal relationship
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7. How to N-S and S-S relations compare?North to south
Needs good collaborators from North (twinning)
Can help to develop and nurture institutions
Higher investment Problems: language, how
to assure address local needs, who drives the agenda, brain drain
Advantage: expertise !!!
South to south Horizontal, peer to peer
relationship Next level for more mature
institutions in the south Cost effective Problems: assure expertise Advantage: language, similar
culture, less “fear to reach changes”, own driven agenda, less brain drain
Need for balance, even in S-S , is important to keep N-S collaborations
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8.Conclusions
International partnerships are important for capacity development
Opportunities for both develop and developing countries
Principles of good partnerships Challenges are real, but can be overcome UPCH has established good international
partnerships and has learned from the experience
Beyond science, lifelong friendship and mutual benefits
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http://www.globalhealthperu.org
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Thanks! Thanks!
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