COVID-19 renews interest in reciprocal innovation
November/ December 2021 | Volume 20 Number 6
Opinion by Fogarty Director Dr Roger I. Glass
The COVID-19 pandemic has spotlighted how crucial it is for scientists around the globe to collaborate with each other. We have much to learn and the next great discovery can come from anywhere. At Fogarty, we have long appreciated the benefits research partnerships bring to all parties involved.
Science advances made in low-resource settings often result in frugal technologies that can save health care dollars here at home. Innovative uses of communication technologies developed in low- and middle-income countries (LMICs) can be ideal for use in rural areas of the U.S. And disease outbreaks or unique populations in LMICs can be opportunities for research discoveries that improve health everywhere.
opinion pieces from Fogarty Director Dr. Roger I. Glass. Reciprocal innovations like these were the topic of a recent meeting hosted by Indiana University (IU). The organizers defined the concept as a mutual benefit addressing a shared challenge between an LMIC and high-income country, achieved through equitable partnerships that include continuous learning and innovation.
As a diarrheal disease expert, my favorite example of this is the simple formula for
oral rehydration therapy. Originally used to treat a cholera outbreak in Bangladesh in 1968, it is now the standard of care for children with diarrhea in the U.S. and globally, resulting in a 100-million-dollar-per-year industry.
The Lancet heralded it as one of the greatest medical achievements of the 20th century.
When Costa Rica was grappling with the budgetary challenges of rolling out the
human papillomavirus (HPV) vaccine to protect against cervical cancer, a study funded by NIH and the Gates Foundation was conducted that showed a single dose was as effective as the multiple doses that were then being administered in the U.S. This is a wonderful example of how we can improve care, as well as increase global access to an effective tool that will reduce suffering and save lives.
A number of
significant breakthroughs in prevention of HIV/AIDS transmission were the result of global clinical trials, including stopping mother-to-child transmission, providing protection through circumcision and instituting treatment as prevention. When an HIV outbreak occurred in Indiana’s Scott County, IU turned to its research partners in Kenya for advice on how to respond. Given the ubiquity of cellphones in Africa, it is an ideal place to study how best to provide diagnosis and treatment through mobile devices. One such
tool developed in Uganda for HIV/AIDS treatment has been adapted for use in the U.S. in helping people overcome opioid addiction.
In Zimbabwe, where psychiatric services are extremely limited, researchers used a task-shifting approach to expand care. They trained lay health workers to deliver problem-solving therapy for anxiety, depression and other common mental disorders in a safe and comfortable setting—a discreetly located bench. Called the Friendship Bench, the concept is being adapted for use elsewhere in Africa as well as in New York City.
A task-shifting approach is also being used to improve the neurodevelopmental outcomes of children in low-resource settings in Africa and the U.S. IU researchers are studying an intervention that trains caregivers to provide cognitive stimulation and social support. Neurodevelopmental interventions are most effective if administered early, when the brain is growing rapidly and has the greatest plasticity. With nearly 250 million young children in resourced-limited settings at risk for poor development, this is incredibly valuable for families everywhere.
During COVID, we have seen an explosion in the use of telemedicine, a practice that has been pioneered by many scientists in LMICs, where it has been a vital tool for expanding health care, especially for those in rural settings. Lessons learned from those experiences can provide insights to care providers in the U.S. as they conduct more of their consultations virtually.
The increasing complexity of global health research means that multi-disciplinary, multi-national collaborations are critical. Each partner brings different ideas and perspectives to the table, making the sum greater than the total of its parts. We also have to take science where the problems are because the frontiers of science may not be at home. Developing equitable research partnerships make reciprocal innovation possible—bringing health benefits for us all.
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