Feature: International research for global health
28 September 2006. By Ian Jones.
Most Wellcome Trust grants support goes to researchers in the UK, but a significant - and growing - proportion supports global health research outside the UK. Increased international funding was identified as a priority in the Trust's 'Strategic Plan 2005-2010: Making a Difference'.
Global health research is an area in which Trust funding has undoubtedly made a difference. The flagships of this funding are the Major Overseas Programmes in South-east Asia (Thailand and Vietnam), Kenya, Malawi and South Africa. All these centres have made significant contributions to the understanding, prevention and treatment of disease.
The South-east Asia Programme, for example, has pioneered the use of artemisinin combination therapies (ACTs) and other treatments for malaria. These therapies have transformed treatment of malaria in Thailand and Vietnam, and ACTs are now the World Health Organization's drug of choice for malaria all over the world.
Research at the Major Overseas Programme in Kenya covers malaria (see, for example, Funding: Malaria and environmental change) and other infectious diseases of children. Detailed studies of infectious disease at Kilifi General Hospital and surrounding areas have revealed the full extent of bacterial illness in young children and helped to shape the Kenyan Government's healthcare policy.
Research in Malawi also focuses on malaria and infectious diseases of children. The Programme has made important contributions to our understanding of cerebral malaria - its most deadly form - and has also influenced national healthcare provision, for example through establishing the Blantyre Coma Scale for assessing severe malaria cases.
The Africa Centre, based in KwaZulu-Natal, is devoted mainly to work on HIV/AIDS. It has carried out important work on the impact of HIV/AIDS on families and communities, and is an internationally important site for testing of microbicides and, potentially, vaccines.
A new strategy
Given this excellent foundation, the new international strategy revolves around these world-leading centres, while expanding opportunities for high-quality research in other developing countries.
The core elements of the new strategy are:
- Supporting people: identifying scientific leaders and supporting them and their research, to enhance the research capacity of developing nations.
- Building on excellence: supporting research in locations that have achieved real progress with Wellcome Trust funding in the past.
- Embedding research: ensuring that the research supported strengthens local infrastructures and national institutions.
- Local relevance: making sure that research tackles locally important health issues, and is geared to national priorities, as well as having international applicability.
To support these goals, several revisions have been made to the Wellcome Trust's funding portfolio. Consistent with the emphasis on supporting people, two of the most significant changes involve personal support schemes. A new Senior Fellowship in Tropical Medicine/Public Health scheme is being launched, providing five years' support; fellowships will be renewable in competition, in line with other Trust Senior Fellowship schemes.
At early career stages, funds for MSc/PhD training will be available in all areas of tropical medicine and public health, for postgraduates based at Major Overseas Programmes or other established scientific hubs in developing countries. The scheme will provide a flexible approach to Master's research training, involving a taught course at an internationally recognised centre of excellence anywhere in the world, and one year of funding on return from training to allow recipients to become embedded within an active research group.
At the same time, eligibility rules are being amended so that senior researchers who have been supported by the Trust in the past have more opportunity to apply directly for funds.
Researchers from the UK and Europe who wish to work in developing countries will also have more flexibility. Previously, researchers applied for specific schemes in tropical medicine and were attached to one of four UK Centres for Research in Clinical Tropical Medicine. Now researchers in clinical tropical medicine or public health can apply for any of the Trust's fellowship schemes and do not necessarily have to be associated with these Centres.
As well as funding individuals through its own schemes, the Wellcome Trust also remains committed to supporting international networks, collaborations, partnerships and coordinated programmes focused on the health problems of developing and restructuring countries.
The Trust has provided support for three of the Grand Challenges in Global Health projects, in partnership with the Bill & Melinda Gates Foundation, and has provided funds for public-private partnerships such as the Medicines for Malaria Venture. A new £20 million health research capacity-strengthening initiative in Kenya and Malawi (see Update - Capacity strengthening) has been established in partnership with the UK Department for International Development and Canada's International Development Research Centre.
Other international activities
Improved healthcare is also a high priority for the Wellcome Trust's Technology Transfer arm, which has funded a number of important initiatives in drug discovery for tropical infectious diseases. It has contributed £8.1 million towards a new drug-discovery centre at the University of Dundee, UK, which is working on new therapies for 'neglected' diseases such as African sleeping sickness. It has also supported a new antimalarial drug development programme at the Novartis Institute for Tropical Diseases in Singapore.
To encourage public engagement with science, the Livestock for Life initiative has supported projects to bring together researchers, policy makers and livestock keepers. The Trust also supports a programme of research into the ethics of biomedical research in developing countries, covering issues such as informed consent for clinical trials. New ways in which the public can engage more with the research supported at Major Overseas Programmes and elsewhere are currently being explored.
To support the development of medical professionals, the Trust produces interactive CD-ROM-based teaching aids on important diseases of the tropics (Topics in International Health CD-ROMs). Training courses and workshops for researchers are run in some developing countries (see Update: Advanced Courses in Uruguay).
