The Global Health Network Annual Report 2019

Barriers and Enablers to Research and Measuring Impact
The latest Ebola outbreak and rapid spread of
the Zika virus epidemic highlighted the lack of
research capacity in low-resource regions in both
the ability to undertake observational research
to describe the diseases and subsequently
to set up the regulatory standard clinical
trials to assess potential drugs and vaccines.
These outbreaks also made visible the lack
of research being done day to day to address
local healthcare needs of these communities.
We would argue that it is the lack of day-today
research that is the true problem, because
if that capacity were in place, these researchers
could respond to an outbreak.
In preparation for future epidemics, the
World Bank led a taskforce to establish an
understanding of what research capacity exists
at present across low- and middle-income
countries (LMICs) for conducting vaccine
research. The Network’s platform utilised its
resources to assess the research capacity in
LMICs. The uptake of the survey was very popular
with over 5,000 responses. The overwhelming
response from the survey demonstrates
how well The Network communicates with
researchers and healthcare workers in LMICs.
within those institutions. This has resulted in
situations where a state-of-the-art research
group within a hospital has their own laboratory
to work on one disease (e.g. HIV or malaria),
but are also just hundreds of metres away from
other clinical groups who have no experience in
producing high quality research.
The gaps and issues reported by the researchers
who responded to the survey shows that research
should be embedded in healthcare delivery,
and in order for this to happen, institutions and/
or governments need to recognise the value of
research. If research activities are limited to one
disease or protocol, then the ability for research
is not extended beyond that specific therapeutic
area. This is not conducive to long-term research
capacity, and furthermore, limits the ability to
effectively respond to outbreaks. Importantly,
we have shown that the skills, infrastructure,
regulatory ability and oversight do not differ
significantly between disease or research types.
As the skillset for conducting clinical research is
therefore largely similar, it would be possible
to make improvements in research capacity
by working with healthcare-providing facilities
instead of isolated groups.
We already knew that over the past twenty
years there has been a steady increase in the
amount of regulatory standard clinical trials
occurring in low-resource countries. These
studies have largely been led by publicprivate
partnerships and have assessed drugs
and vaccines for HIV, TB and Malaria. These
programmes have made a remarkable impact
and have left teams within research platforms
well equipped, trained and able to undertake
clinical research. Further, these studies can
largely be credited for the strong capacity that
does exist in limited resource settings. However,
whilst these externally sponsored programmes
have invested in specific teams within hospitals
and/or universities, we found that the skills and
abilities have not necessarily been transferred
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