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Health diplomacy: where science meets culture
January/February 2011 | Volume 10, Issue 1
Guest Opinion by Dr. Jorge Gomez, Director, Office of Latin American Cancer Program Development, NIH's National Cancer Institute (NCI)
International research collaborations are critical to our success in fighting cancer - a problem so immense that we must gather ideas from scientists everywhere so that we can confront the disease in the most comprehensive way possible.
In addition to forging ahead with partnerships that have data as the chief priority, researchers and organizations should allow time to plan for other aspects of their projects that can produce surprising, long-lasting and mutual rewards.
Representatives from developed countries who partner with colleagues from less developed nations, where the burden of cancer is often very high, serve as ambassadors. As ambassadors, we need to recognize that our collaborators in developing countries may struggle to acquire the technologies, systems and information that we take for granted.
Another important consideration is the protocol for our collaboration. Many of the policies and safeguards upheld by NIH and other U.S. federal agencies for the protection of human subjects participating in clinical research, as well as for data integrity and monitoring, may be difficult to enforce beyond our borders. We must encourage and promote “best practices” in research outside of this country as we do in the United States.
Our interactions with foreign collaborators must be respectful of their customs, culture and the idiosyncrasies of their nations as a whole - at the local, regional and national levels - as well as of their laws and regulations. Every project affords the opportunity to enhance their research infrastructure and research capacity, such as biospecimen repositories. Moreover, our interactions must be based on our mutual professional respect, where foreign collaborators are an integral component of the team. This should be evident in the planning, implementation, data analysis and publications.
In short, these collaborations should contribute to science, but they should also strengthen the relationships between countries, increase research capacity for both nations and serve as a model for others to follow.
What does such an international collaboration look like? The United States-Latin America Cancer Research Network is a great example.
The initiative recently launched a pilot study - which will involve staff at more than 20 hospitals and research facilities in Argentina, Brazil, Chile, Mexico and Uruguay - to examine the molecular profiles of breast cancer patients and their response to treatment.
We already know that breast cancer is a collection of many subtypes with different genetic and clinical characteristics. We also know that breast cancer is less common in Latin American women than in women from developed countries. What we learn in this study will help us better understand how to categorize breast cancer, as well as how to best treat different breast cancer subtypes.
The health diplomacy of this project lies in the details. The study design, clinical protocol, informed consent and case report forms were developed in collaboration with international partners through committees that brought together the disciplines of public health, international affairs, management, law and economics. The collaborators participated in workshops and webinars and contributed to the development of standardized procedures for biospecimen collection, pathology, biomarker assessment and evaluation of patient response to therapy.
In essence, we are enhancing their research infrastructure so that they will be able to conduct clinical trials in the future that incorporate the latest genomic and applied technologies that are becoming standard in the United States and other developed countries.
Improving infrastructure is just one element of good diplomacy in international research collaboration. The goal is to treat our collaborators as equal partners and provide resources to enhance the development of areas where they may be lacking, such as training or applied technologies.
Dr. Jorge Gomez is Director of the Office of Latin American Cancer Program Development at NIH’s National Cancer Institute. An expanded version of these remarks was previously published in the NCI Cancer Bulletin.
All articles in the special Focus on Cancer section were developed by the National Cancer Institute and originally published in the NCI Cancer Bulletin and were edited for space. View the full versions of the November 30, 2010 NCI Cancer Bulletin Special Issue: Global Collaboration.
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