Opinion by Fogarty Director Dr Roger I Glass
Research is a key driver of innovation in the health sciences, and it can spur global collaborations, build substantial financial support, empower scientific leadership and promote economic development. It was wonderful to have the opportunity to discuss these issues during the first-ever U.S.-Africa summit held this summer in Washington, D.C.
I'm encouraged by the attention many of the African leaders devote to growing the biomedical research enterprise in their countries and by the generous support some provide to strengthen medical education and research training. It was gratifying to hear more about the wonderful progress being made at the recent annual network meeting of the Medical Education Partnership Initiative (MEPI).
I was also delighted to read about MEPI accomplishments in a series of articles published in a supplement to Academic Medicine. More than 250 MEPI participants contributed papers detailing the educational innovations that have generated new thinking, energy and optimism in the field.
MEPI was envisioned by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) to address the terribly inadequate supply of health and medical personnel required to support health programs in sub-Saharan Africa, particularly around HIV/AIDS but extending to other medical needs as well. By investing in education in medicine and the allied health sciences, MEPI intends to build human capacity for health in Africa by strengthening the medical education system in an environment that values and nurtures research. Why do we see research as integral to this endeavor?
The answer is that in the 21st century, education and research in leading academic institutions in Africa, as in the United States, must go hand in hand. In the past few decades, the epidemic of HIV/AIDS in sub-Saharan Africa has overwhelmed the capacity of the medical community and called out for innovations in treatment and prevention. For more than 25 years, the NIH has invested in training African researchers to address this epidemic. Research discoveries have informed care and treatment so that a diagnosis of HIV/AIDS has been transformed from a death sentence to a manageable chronic illness.
Much of this research has been conducted by African investigators working in African academic institutions at African field sites with African populations, often but not always in collaboration with academic colleagues in the U.S. This research has been truly game changing and could not have been conducted as quickly, carefully, or effectively without outstanding local scientific leadership and implementation of solutions. The results have included the development of rapid diagnostics for detecting and monitoring HIV infections, new drugs for treatment, and new strategies for prevention, such as avoiding mother-to-child transmission, voluntary medical male circumcision, and treatment as prevention.
Research, along with health care and training, are key missions of academic health centers today. Students need to be able to access new advances in medicine, evaluate published literature, ask critical questions, and consider ways to better implement interventions that we think will work but remain to be tested. Engaging in research helps academic leadership remain competitive, funded, and knowledgeable of the advances of science, and research grants can help support an institution's growth. At a time when many African economies are expanding rapidly, innovations in the health care sector can be important drivers of this economic boom.
MEPI has been built on the idea that outstanding academic institutions in the health sciences must be excellent in education, service and research. Research can play a key role in producing effective and sustainable leadership in health, the development of knowledge and practice for the delivery of care, and for building academic centers in sub-Saharan Africa. The research perspective provided to students and faculty, the ability to raise and answer questions, and the idea that medical knowledge and practice are continually changing are being supported by MEPI sites and will hopefully endure long after the program ends.
This is a condensed version of the article, The Importance of Research in the MEPI Program: Perspectives From the National Institutes of Health, published in the journal Academic Medicine as a part of the August 2014 supplement, Medical Education Partnership Initiative: Investing in Education in Sub-Saharan Africa, detailing MEPI progress.