www.globalhealthperu.org
International partnerships:
View from the South…
Patricia J. Garcia MD MPH
Universidad Peruana Cayetano
Heredia (UPCH)
1
Outline
1. 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
2
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.
3
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…
4
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
5
Capacity Building
Pyramid
enable
Trained
Individuals
Tools
require…
effective
enable
Good Research Partnerships
Investment in
Training
Institutions
+
3. Research Capacity Building for development
in the global community requires :
Skills
require…
++Trained
Individuals
effective
Staff and Infrastructure
enable
require…
effective
Critical
Mass
Structures, Systems and Roles
6
Potter, 2004, modified
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
7
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
8
Universidad Peruana Cayetano Heredia
UPCH
-1961
- 2000 students
- 8 Schools
- Research is a priority
9
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
10
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 university
 Latin American Award
 Scholarships for post doctoral re-entry support
 Competitive, 1 per year
 To fight against brain drain
 National Council of science and technology, following the
example
11
CASE STUDY: UNIVERSIDAD PERUANA CAYETANO HEREDIA
FIC Grants
Training
Research
U.S. Fellowships
Glue grants
AIDS Clin Res Train
Clin Res Train
Environ Health
Inf Disease
Informatics
AIDS
Framework
Ecol Inf Diseases
GRIP
Small grants (FIRCA)
Research?
Biodiversity
Postdocs
U. Alab. Birm. (15 y)
30
25
Med
Students
U. Washington (16 y)
20
Johns Hopkins (21 y)
15
10
NMRCD* (23 y)
5
Year
* NMRCD = US Naval Medical Research Center Detachment
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
0
1970
Number of NIH Grant Awards
Minority
12
UPCH: Significant increase in
competitive research funding*
Funding (million USD)
14
12
10
8
6
4
2
0
2000
2001
2002
2003
2004
2005
2006
2007
Year
13
*All sources, national and international funding
Successful International partnerships
Johns Hopkins
 25 y of collaboration
 Training and research grants,
Robert Gillman et al
 7 graduated PhDs, 10+ in
training
U. Washington, Seattle
 20 y of collaboration
 IATRP, King Holmes et al
 2 PhDs, 20+ MPHs, +60 and
more in training
U. Alabama
 Initial masters programs
in Peru
 Sten Vermund,
now at Vanderbilt
Cysticercosis
working
Group
Hector Garcia
Armando G
National
and
Global
collaborations
STI/HIV research Unit
Patty Garcia
CTU in Peru
Jorge Sanchez
Gorgas Tropical
Medicine Course
Research in Tropical
Diseases
E. Gotuzzo
National
and
Global
Impact
14
The Cysticercosis Working Group in
Peru
 Since 1987 as a true horizontal collaboration
 UPCH-SM universities, CDC, and Johns Hopkins
 Global collaborations
 Belgium, Italy, Spain, UK, Japan, Korea, etc.
 Ecuador, Honduras, Brazil, Bolivia, etc.
 National Impact
 Improve policies and official Dx and Tx guidelines
 Global Impact
 new 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)
15
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
16
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 countries
Researchers trained abroad become diplomats in their
regions
Opportunities for young researchers from abroad
Collaborators are important
Benefits in both ways
Expertise from the north
Collaborators understanding local needs and
resources
17
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
18
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
19
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
20
collaborations
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
21
http://www.globalhealthperu.org
22
Thanks!
www.globalhealthperu.org
23