Journals play a key role in bridging knowledge gaps

Lia Labuschagne

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What role can scientific journals play in bringing the knowledge divide, not only between North and South, but also between researchers and policymakers?

A lively general discussion at Forum 2012 focussed on the role of journals in knowledge transfer in the field of sexual and reproductive health and rights. But the same issues relating to disseminating scientific information also apply to other disciplines.

Some current topics relating to the international output of scientific journals were introduced by Marge Berer, editor of Reproductive Health Matters, and Ann Strode, senior lecturer at the School of Law, University of KwaZulu Natal, and editorial advisory board member of AIDS Care.

Journal articles can help bridge the gap between research and policymakers (Credit: Reproductive Health Matters)

Berer commented that “there has never been so much information before, nor so many means of disseminating and using it”.

Participants in the general discussion nevertheless pointed out that, especially in developing countries, there is often a big time lag between research being completed and finding its way into text books.

Factually outdated information is often still being taught. And although new health and other policies may be adopted, there may be no change in teaching material.

Scientific journals provide a useful link across this divide, partly because their up-to-date research findings and information is increasingly becoming available in accessible, electronic format to a global readership of academics and practitioners within various disciplines.

Advocates and lobbyists also use the information in journals as the basis of advancing well-founded arguments for change of policies and practices.

Strode said journals such as AIDS Care are therefore used by both researchers and policymakers as a high-quality source of knowledge that they can provide from a multi-disciplinary perspective.

Some additional ideas to emerge from the discussion of ways to use the contents of scientific journals to aid development included translations of articles into local languages, and selecting key pieces of writing on specific topics to be made them available as thematic packages.

In terms of the North/South divide, Berer pointed out that “more authors from developed countries than from developing countries have access to the resources to publish in international journals”.

To help to redress this imbalance, she said that RHM gives preference to papers about developing countries by authors from those countries, or written with authors from those countries.

Broader issues discussed at the session included the continued debates around open and closed peer review processes, formal recognition for reviewers, and questions of ownership and funding.

Lia Labuschagne is a freelance journalist based in Cape Town

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Social media rises to the challenge of health communication

Lia Labuschagne

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Health researchers should consider the creative use of social media – and in particular of new communication tools such as “edutainment” – as part of a comprehensive communication strategy because, like anything else, research findings need to be effectively marketed.

In the words of Kirsten Patrick, clinical reviews editor of the British Medical Journal, addressing a session of Forum 2012 devoted to the topic of science and social media, “it is our job not only to do the research, but to get it out there.”

Soul City: Showing how "edutainment" can communicate health messages (Credit: Soul City)

One example of how edutainment can be done successfully is demonstrated by Soul City in South Africa – or to give it its full title, the Soul City Institute for Health and Development Communication.

This uses an entertaining storyline in television drama to influence behaviour and practices relating to health, nutrition and sexuality.  Recent themes have included medical male circumcision and the prevention of mother-to-child transmission of HIV.

Bongiwe Ndondo, monitoring and evaluation manager of Soul City, told the session that edutainment as a technique for transmitting social messages through entertainment had been practiced in traditional societies for centuries.

Soul City has brought the idea up-to-date by translating this concept into national television series, supported by 23 radio talk shows on seven community radio stations, printed material, internet-based social media such as Twitter, Facebook and YouTube, and mobile applications, in particular Young Africa Live.

She explained that research is the cornerstone of the roadmap leading to the production of a new television series, which is always “based on an extensive and rigorous research process that ensures quality, relevance and effectiveness.”

Denis Jjuuko, a media and communication consultant from Uganda, argued that social media could stimulate discussions and fill gaps left by reports in traditional, mainstream media. This was especially important in countries with limited press freedom, or where mainstream media shy away from sensitive topics.

Jjuuko said that the rapid growth of mobile technology in Africa provided an important new distribution medium. “Social media has become mainstream, and can sometimes do what other media cannot do, especially in some parts of Africa, where mainstream media may, for example, be virtually closed when you deal with certain issues of sexuality.

“In such cases you can use mobile technology and social media such as blogs and video on YouTube to get your message across.”

ResearchAfrica managing editor Linda Nordling argued that social media “give you quite a lot of control, because you can respond and you do not rely on an intermediary such as a journalist as in the traditional media.”

She also said that social media were also “important in terms of ‘narrow casting’:  talking not only to many people, but the right people”.

In the discussion that followed the presentations, participants pointed to some of the difficulties that researchers have encountered with social media, and indeed with attempting to engage in the public communication of their research results.

These includes the dangers of being misquoted, ethics issues – particularly when sensitive clinical trials were involved –  fears around the improper use and interpretation of data, and the adverse effects of an indiscriminate dissemination process, especially when researchers were working on sensitive topics.

Speakers on the panel also included contributions by SciDev.Net editor David Dickson and Brenda Zulu, founder of Africa Interactive Media in Zambia.

Lia Labuschagne is a freelance journalist based in Cape Town

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Cometh the hour, cometh the solutions…

Lia Labuschagne
Freelance journalist working in Cape Town

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Research on humanitarian responses to emergencies faces practical challenges relating to data collection and feasibility. In addition, there are often sensitive ethical implications relating to carrying out research in such conditions.

A case study presented at Forum 2012 by Jun Yan, director of the mental health division of China’s Ministry of Health, and Sun Xueli  of Sichuan University, looked at some of the experiences relating to mental health services after the deadly 7.9 magnitude earthquake near Wenchuan, in the Sichuan province, in May 2008.

The Wenchuan earthquake in May 2008 caused 69,000 deaths (Flickr/Wen Chuan)

More than 69,000 people had died, a further 370,000 were injured, with about 4.8 million people left homeless: in total 40 million people were affected by the disaster.

A guideline for psychological crisis intervention in emergency situations was published by the Chinese ministry of health, five days after the disaster.

Among the responses was a post-disaster mental health aid project aimed at adolescents and children. This was prompted by the fact that many thousands of school children had died, and at least 7,000 school buildings in the province had collapsed.

There were very few counsellors to provide mental health support services to children, said Jun, and teachers were ill-prepared to take on the task.

The challenge was to find quick, effective ways to treat mental problems among the affected children, and to help them get through the traumatic period following the disaster.

The response programme included setting up an education-healthcare mental health platform, based on local educational administrative departments.

A major resource was the West China Hospital of the Sichuan University, which has one of the best mental health centres in China and which formed the core of an expert group providing professional guidance. Support also came from the numerous motivated volunteers.

A pilot study was aimed at collecting evidence through a baseline survey, creating service teams, developing training material and guidelines, equipping facilities, training the trainers, and organising working teams.

The subsequent programme actions included, among others, group therapy for high-risk students, family support and therapy, prevention interventions focusing on single-parent and divorced, training teaching staff to integrate mental health issues into regular teaching, and building school counselling centres.

As an extension of the programme, a mental health outpatient service was set up in villages and towns by training part-time and full-time primary mental health staff.

Lessons learnt included the importance of multi-sector coordination and participation with government leading; the need for a provincial level expert group (consisting of psychiatrists, as well as educational and public health experts) to provide professional guidance; and support from private bodies, both locally and internationally.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Can poor countries produce their own drugs?

Lia Labuschagne
Freelance journalist working in Cape Town

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Can lower and middle income countries (LMICs) engage in producing the drugs needed to combat neglected tropical diseases? And to what extent do their governments hold the key that will allow them to do so?

Where next? Drug production is the next step after research for low and medium countries (Source: ANDDI)

These questions led to a lively round-table discussion at Forum 2012 chaired by Elizabeth Ponder, associate director for scientific affairs at BVGH in the United States.

Ponder pointed out that neglected diseases affect more than 1 billion people around the world.

Millions of people in resource-poor countries die from these diseases, she said, because life-saving drugs, vaccines, and diagnostics are inaccessible, outdated, unsafe, ineffective – or not yet created.

The challenge was put to a panel representing a wide range of interested government bodies, NGOs, funders, and research laboratories, as well as the private biopharmaceutical sector .

Most panelists agreed that capacity was not the problem; many lower and middle income countries had the scientists and technologies needed to develop the relevant products.

The main problem lay in raising the funding needed to get the drugs into production, and to ensure that they were distributed to where they were required. And this frequently required a political – as well as a financial – commitment.

Jean-Pierre Paccaud, director of business development at Drugs for Neglected Diseases initiative in Switzerland, said that it was important to understand the specific needs of the areas in which diseases occurred, and then to focus on leveraging local capacities.

Konji Sebati, director of the department of traditional knowledge and global challenges at the World Intellectual Property Organization in Switzerland, said that lobbying governments was important since “without political will nothing will change”.

According to David Walwyn, chief commercialisation officer with the company iThemba Pharmaceuticals in South Africa, “it is important to articulate clearly to governments what we want, and to set clear targets.”  Universally-accepted goals were needed so that progress could be monitored.

And Alex Ochem, of the African Network for Drugs and Diagnostics Innovation, agreed that the research capacity exists in Africa. But he stressed the sobering truth that “no matter how much research we carry out and articles we publish, if we do not get the product – the medicines – to the market, then we have failed.”

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

How to help Africa rise to the challenge of innovation

Lia Labuschagne
Freelance journalist working in Cape Town

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Turning research into innovation is a complex issue. It requires considerable human, financial and other resources. And these must be drawn together by strategies that work within specific local contexts.

At a session at Forum 2012 examining investments that have been made in Africa to address outstanding issues of research and innovation for health and development, Hannah Akuffo, deputy head of the Research Cooperation Unit at the Swedish International Development Cooperation Agency, proposed the creation of a global facility to fund and monitor innovation on the continent.

Anti-malaria bednets in Tanzania: an example of successful African innovation (Credit: Flickr/Prashant Panjiar)

“Governments need to invest innovation, not only in their own countries but also into the continent,” said Akuffo, who believes such a facility could combine practice with training, and both conduct studies on and monitor the evolution of innovation systems.

It would also formulate medium-term strategies and tactics for supporting innovation, and attract partners for collaborative efforts to increase both quantity and quality of innovations, focussing on the need for inclusive development.

Akuffo suggested an international host for such an initiative – ideally an intergovernmental organisation such as UNESO or UNDO – but that there should be a gradual shift of responsibility for specific programmes to the national level.

Partners for regional organisations could come from high-income countries and NGOs. Funding might be drawn from a combination of multinational donors, development banks, donors and international aid organisations involved in science and technology. Partner countries would provide funding out of their regular budgets.

The session was chaired by Peter Ndumbe, responsible for research, publication and library services at the WHO Regional Office for Africa, and included a review of South Africa’s Strategic Management Framework, created to stimulate local health innovation, by Glaudina Loots, director of health innovation at the Department of Science and Technology.

Case studies of successful programmes supporting innovation were presented by Budzanani Tacheba, of the Botswana Innovation Hub, and Hassan Mshinda of the Tanzanian Commission for Science and Technology.

Tacheba, quoting Steve Jobs’ comment that “innovation distinguishes between a leader and a follower,”  described how the Botswana initiative is aimed at helping the country to compete in global markets, providing a home for knowledge-intensive, technology-driven businesses.

In Tanzania, Mshinda said that research into the way that insecticide-treated nets contribute to the fight against malaria had led to the creation of a successful manufacturing industry that was currently producing 50% of the global output of bednets.

Research had earlier shown that the nets reduce malaria parasitaemia and anaemia by 60%, and improve child survival rates by 27%. A well-planned programme had led to Tanzania’s doubling the value of its export of nets, from US$50 million in 2008 to US$100 million in 2010, and to an industry that now employs employing 7,000 people.

 Innovation is far from dead on the African continent.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne is a freelance journalist based in Cape Town

Women in science: some progress, but challenges remain

Lia Labuschagne
Freelance journalist working in Cape Town

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Women researchers have long explored the frontiers of knowledge, and have in the process made major contributions towards meeting health and development challenges, according to the moderator of a panel discussion at Forum 2012 on the role of women in science in the developing world.

Yet Jill Farrant, professor of molecular and cell biology at the University of Cape Town, and an expert on resurrection plants – plants that can ‘come back to life’ from a desiccated state when rehydrated – pointed out that women have not necessarily received recognition for their achievements.

Jill Farrant: women scientists are often not acknowledged (Credit: UNESCO/L'Oreal Foundation)

For example, said Farrant, one of the 2012 winners of the L’Oréal-UNESCO Awards for Women in Science, only 16 Nobel Prizes have been awarded to women, compared to more than 500 men.

Nashima  Badsha, an advisor to the South African Minister of Science and Technology, said that gender equality was protected by the country’s constitution, and that, especially in higher education, the statistics were encouraging. Women made up most enrolments and graduates in universities, and at PhD level, the number of women was fast approaching that of men.

But these figures masked less encouraging details. For example, women still only accounted for a third of publishing scientists in South Africa, while black women were under-represented in science, and the overall employment of women in higher education was under 18% – below that in other BRICS countries.

In Brazil, according to Claude Pirmez, vice president for research at the Oswaldo Cruz Foundation in Rio de Janeiro, the number of women holding PhDs was growing strongly. But the highest positions in science were still dominated by men – the Brazilian Academy of Science, for example, remained 90% male.

Javie Ssozi, a digital media consultant from Uganda, described how information and communication technologies were giving women access to opportunities and information sharing. For example, rural women farmers could be given information about new agricultural skills or ways to deal with climate change.

But he added that policies were often not gender sensitive, and that projects could be influenced by cultural issues. For example, men often tried to decide when and how women used their mobile phones.

Finally, for Devaki Nambiar, a postdoctoral research fellow in the Public Health Foundation of India, a key issue was the personal safety of women in society. “If you can’t leave your home in safety, how can you make progress in science and technology?” she asked.

But noticeably, all but one member of the discussion panel were females, and they spoke in front of an audience consisting mainly of women.  Perhaps a case of preaching to the converted?

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne

The higher they rise, the harder they find it to collaborate

Experts in the fields of of agriculture, nutrition and health need to collaborate beyond conferences. Credit:IFPRI

I thought they worked together easily. But the further they climb the academic ladder and the more responsibilities they take on, the scarcer their interactions become.

And nothing, at this meeting, illustrated it as vividly as today’s session on Addressing Agriculture-Associated Diseases.

This international conference, organised by the International Food Policy Research Institute (IFPRI), is aimed at initiating conversations between experts in agriculture, nutrition and health, since they have complementary roles. Rajul Pandya Lorch, of IFPRI, calls it finding synergies for the three to leverage agriculture, nutrition and health.

“Our experience is that farmers appreciate collaboration but scientists work in isolation,” said Kabba Joiner, a health consultant from Burkina Faso.

There are few areas where experts work together. Srinath Reddy, president of the Public Health Foundation of India, taught me that one of them is in climate change.

“This is one of the few areas with a multi-sectoral approach,” he said.

John McDermott, deputy director general for research at the International Livestock Research Institute (ILRI), says that disciplines only come to consensus when there is a serious crisis. Then, you see some semblance of collaboration. Otherwise, in normal, day-to-day activities, even within an institution, it is difficult to find it.

Very few research institutions, he said, share facilities. They are full of compartmentalisation. “From the young at universities we need to get people out of their silos. The young also quickly learn to pick it up,” said McDermott, adding “we are best friends at big meetings like this but then it ends there”.

Even with intradepartmental collaborations, like those between malaria, TB and HIV/AIDS departments in the ministry of health, working together is like undertaking the energy-sapping stunt of climbing a tall mountain from the rear, according one delegate from Ghana.

“The higher you go, the more impossible working together becomes,” he said. That is the dilemma that experts in agriculture, nutrition and health face – yet their roles are complementary.

Dominique Charron, Programme leader at the International Development Research Centre, prays that experts will change from collaborating only at meetings.

McDermott finds few successes, among them the 2008 avian flue pandemic when animal and human health experts came together. But still, he says, it is doable

Ochieng’ Ogodo, Sub-Saharan Africa News Editor, SciDev.Net

SciDev.Net to blog from New Delhi agriculture conference

Credit: Monsanto

Next week, I will be attending an international conference on Leveraging Agriculture for Improving Nutrition and Health, organised by the International Food Policy Research Institute (IFPRI) and to be held in New Delhi from February 10-12, 2011.

Leaders in agriculture, nutrition and health from across the globe will gather to deliberate on how to create a more integrated system that mobilises agriculture to improve people’s nutrition and health.

The event will be opened by Indian Prime Minister, Manmohan Singh, and be guided by an advisory committee that includes John Kufuor, former president of Ghana and M.S. Swaminathan best known as the father of the green revolution in India

The conference will examine linkages between agriculture, nutrition and health and explore opportunities for improving nutrition and reducing health risks along the whole value chain.

I am looking forward in particular to hearing how individual countries are faring in their efforts to make these linkages, and what we can learn from them.

I will be blogging throughout the meeting, and tweeting from @scidevnet. Meanwhile check out our SciDev.Net spotlight, The Challenge of Improving Nutrition, and serve you with the conference deliberations as it progresses through this blog.

Ochieng’ Ogodo, Sub-Saharan Africa News Editor, SciDev.Net

Does social science need rebranding?

Some would argue poor living conditions and gender inequity affect health more than the biological causes of disease. Flickr/LivingWaterInternational

As Forum 2009 closed on Friday, we were left with some thoughts on the future direction of global health research. The conference in general was heavily weighted towards the need to drive health systems research and research on the social determinants of health.

Mention these issues to many lab scientists, however, and they would argue that these fields of study are far too “soft” a science for them to engage with.

This is what really damages research into the social factors affecting health. Traditional robust methods of interrogating an issue and gathering data such as randomised controlled trials have no traction when you are thinking about how a health system functions or when you are trying to evaluate a complex health intervention.

These don’t fit into neat scientific boxes in the way that parasite counts or viral loads do.

But transforming these fields will require rigorous evidence – how else will we know what changes to make to improve health systems across the developing world?

It’s good news then that the EU announced yesterday at the meeting that its next call for grants in January 2010 would focus heavily on research into the social determinants of health.

Some would argue that poor living conditions and gender inequity affect health even more than the biological causes of disease. There is only one way to find out, of course: more research, and more robust evaluation of that research.

Priya Shetty, http://www.scidev.net, priya4876@gmail.com

Global Forum for Health Research 2009, Havana, Cuba

Welcome to the blog for Forum 2009, taking place this week in sunny Havana!

The theme of the meeting, innovation, is the lifeblood of research. Without it, countries never truly develop a thriving science base and are relegated to the shadow of innovative neighbours.

It’s appropriate then that scientists from around the world have gathered in Cuba to discuss scientific and technological innovation.

Political circumstances have forced Cuban researchers to innovate and develop with homegrown talent. The question now is how these lessons can be translated to the rest of Latin America – and to Africa and Asia.

Transferring knowledge isn’t the only issue of course – developing countries need to create an innovation-friendly environment for researchers to thrive in.

I’ll be writing more about how to bridge these knowledge gaps, through better knowledge translation and South-South collaboration, for example.

Another issue that I’ll write about this week is innovation in health systems research. This is an enormously tricky topic in global health. We know that developing countries need better health systems but we know very little about the science of how to improve them.

Tim Evans, assistant director-general for for information, evidence and research at the WHO and TDR scientist Shenglan Tang are leading sessions this week on health systems research as a prelude to the first global symposium on health systems research that they are hosting next November in Switzerland.

Over dinner last night, Evans maintained that innovation is most urgently needed in health systems research. It’s certainly true that while funders and big pharma fall over themselves to pump money into research for drugs and vaccines, few line up to pour money into developing an evidence-base for improving health systems.

Do you agree? We’d like to hear your thoughts on the top priorities in innovation for developing countries. Comment below to share your ideas.

Priya Shetty, SciDev.Net, priya4876@gmail.com