How global health institutions and funders can empower local researchers

Local and community-based organizations are increasingly recognized as best placed to respond to emergencies and to provide practical and effective solutions to health problems. Localization of research plays an important role in strengthening future responses to humanitarian crises by having local expertise, based on sound data analyses at the local level, and systems in place to deal with crises. But donor practices, funding structures, and a lack of investment in capacity development continue to place local organizations at a disadvantage from winning grants, directing research efforts, and producing research outputs.

Circumstances can contribute to the research imbalance, said Salome Charalambous, associate professor and group chief health officer at The Aurum Institute, a South African-based organization that aims to impact the health of communities through evidence for policy and translating policy into practice. Such circumstances include a higher level of expertise in high-income countries, including in writing for academia or grants in the English language. Researchers from the global north also tend to have a broader network of contacts, access to conferences, and are better able to raise money through funding mechanisms present in their own countries.

The Aurum Institute is working to level the playfield by providing opportunities for researchers to access educational opportunities in their own country or get into Ph.D. programs overseas. Ensuring researchers are encouraged and have time to write manuscripts through writing workshops, mentorships, ring-fenced writing periods, and support for fellowship applications provides them the opportunity to build a publication record, which is essential for grant applications.

While researchers from the global north are often well-meaning and committed, the parachute approach — where institutions based in the global north lead on field studies without inputs from or investment in local investigators —  can lead to research on less-recognized issues and provide solutions that may be difficult to implement or impractical in the setting, cautioned Charalambous.

Devex asked Charalambous what global donors and health institutions can do to better support local organizations to lead on research in their own countries.

This conversation has been edited for length and clarity.

Why are local scientists and experts better positioned to come up with solutions for their own communities?

It's important for locals to be very intimately involved in identifying the research question and contributing to the research design to ensure that findings can be translated into policy. Locals have better relationships with government stakeholders, understand their needs, and can communicate more effectively about the research question and the implications of findings. Often, if research is done by a foreign institution in isolation, the research findings could take longer to implement — especially if engagement with the government has been lacking. Secondly, identifying a problem and how to resolve it are often done better by people who are based in the country and understand the context and how things work. However, the expertise in developing countries is often inferior, so there needs to be a partnership. It is how the partnership is put together that is important. Communities may also have their own perception of risks that influence their acceptance of health advice and may prefer local health actors who are seen as having more empathy, despite lacking expertise.

How do you view the investment in capacity building in recent years?

Investment in capacity building has not always been so deliberate. Often, local organizations have to find money elsewhere to fund capacity building, or the individuals themselves have to find ways of funding their own development. Funders, generally, allow a certain amount of money for overhead costs and local organizations can then use that for capacity-building activities, but those overheads are intended to sustain the organization and the costs are usually completely underestimated. There are some agencies that specifically fund training and development, but often, a substantial portion of those grants are for the international entity that submitted the applications, and much smaller portions go to the local institutions or to the candidates that are being developed. Meanwhile, the local individuals end up funding their own capacity development using their personal funds, or they might receive funding for university fees but not for their time, and so are only able to dedicate time for training activities after hours.    Funders need to consider that to fully support capacity development, provision needs to be made to fund the time of individuals to allow them to spend working hours on their training.

What kind of donor requirements or practices can still hinder local organizations in winning funding?

One of the biggest ones is that the criteria for evaluating proposals have not changed substantially to allow for more equitable consideration of local investigators. Previous standard criteria for evaluating investigators include publication records, grants obtained since completion of doctoral studies, and so on. Many local investigators may have fewer publications and less illustrious grant experience but more years of implementation experience, working closely with government partners, and holding important positions in the national landscape. These criteria are considered less important by many funding mechanisms which then place local applicants at a disadvantage, although these attributes are similarly important in ensuring success in grant implementation. Many grant mechanisms aim to include local investigators but fail to amend their criteria to allow for this inclusivity.

The other difficulty is around how many grants are structured, which often leads to large proportions of the grant going to organizations from the global north. Some stipulate a required number of partners and don’t advise on the proportionality of funding. Very often a substantial part of the grant, even if the project is based in a developing country, goes to partners based in the global north.  

What can funders and global health institutions do to address these issues and better support local organizations?

A deliberate intention to fund capacity development within projects is important. It can depend on the grant type and donor country — some funders can’t fund education efforts if they're funding health projects, for example, so there are some structural problems. But funders need to endeavor to include capacity development in their grants and be deliberate in measuring that this occurs. Capacity development is often included in an application, but then core budget expenses are underestimated, so capacity development often doesn’t materialize. The European and Developing Countries Clinical Trials Partnership, or EDCTP, is a good funder in that they insist that capacity development is written into a grant, and they monitor intensely to ensure that this aspect is not neglected.

Funders should also allow for networking opportunities, particularly for early investigators, who need to develop their network and build collaborations. For many of them, access to conferences is minimal, but conference attendance is important to allow early investigators to understand their field, conceptualize research ideas, and develop collaborations for future grant proposals.  

The other really important part is to allow for a substantial amount of indirect costs. Some funders are generous and allow for as much as 25% of costs to be included as indirect costs.  These funds help to support the organization's infrastructure. However, most funders are reluctant to allow for more than 10% indirect allowance, which usually results in additional funds being needed to ensure the governance of the study and oversight of the project is appropriate.  Often, this results in senior management being overstretched with very little time to develop their expertise in the field and to contribute to the dissemination of study results, including key authorship of manuscripts. In many cases, manuscripts are written by writers from organizations based in the global north which means that these individuals are viewed as the experts in the field rather than the partners from the global south.

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This piece is sponsored by The Aurum Institute as part of our Roots of Change series. Click here to learn more.