I recently attended a conference in Uganda on building research infrastructure in Africa. Sixty percent of the delegates were African students and trainees.
There I met an inspired second-year medical student from Makerere University in Kampala, Pius Mulamira, who described efforts to assess the education and health status of villagers in his country. The university sponsors students to perform community-based appraisals throughout Uganda. The findings are striking but nothing is ever made of them; they are graded and forgotten. What if we could analyze these reports, he asked, and organize a global movement to address some of the needs?
That's where Universities Allied for Essential Medicines (UAEM), the organization that I was in Uganda to represent, might be able help. UAEM is a student- and trainee-led organization focused on neglected diseases - that collection of parasitic, helminthic, and bacterial infections that afflict the poorest people on the globe. Our goals are to increase access to medicines and to scale up R&D. Our proposals1 are supported by 10 Nobel laureates and 2,300 students and faculty. UAEM now has chapters at 40-plus universities including Harvard, Stanford, McGill, and Johns Hopkins, and European institutions are also becoming involved. But we do have a problem: Our campaign has been restricted to the industrialized world.
To understand neglected diseases, you have to be in tropical countries because - to paraphrase bank robber Willie Sutton - "that's where the disease is." I went to find out if UAEM would ignite interest at African universities.
I learned a lot along the way. First, the culture of science in Africa is, well, nonexistent. There is strong interest among students in performing research, but becoming a medical scientist is taboo - it's considered to be selling out. Applied public health interventions are en vogue, from senior investigators to 20-year-old grad students. There isn't a critical mass of scientists, the quality of the science is low, and bright students feel that their talents are being wasted. It is this sentiment, not higher pay, that motivates researchers to go to Europe or the United States. This rang true to me; my physician parents left India 28 years ago for similar reasons.
Junior investigators in Africa, some with NIH awards, overcome the problem by fostering ties with labs in developed countries. But, they must be careful to avoid - forgive the pun - parasitic relationships with hungry Western investigators who are interested in them only for sample collection. With these ties, junior scientists can now explore creative ideas using high-quality resources and can receive guidance when needed. In turn, tropical disease laboratories in developed countries receive crucial insights, reagents, and advice. A new Ethiopian-based resource, the Young African Scientists Network, is developing this networking concept to retain more African scientists. In the US, Scientists Without Borders (www.nyas.org/borders) is doing the same.
I'm not established as an independent investigator (or anything close), but I realized that I could offer myself as an ambassador of sorts to my young African colleagues, and vice versa. One idea that quickly gained traction was that UAEM could build a stand-alone curriculum on neglected diseases, developed jointly by students and faculty from Africa and the US and featuring multidisciplinary perspectives from health economics, research, and clinical medicine. The curriculum will be made freely available online in an open-access format.
Another issue raised is that there is no meeting ground for students who think alike. Together, we are creating a nucleus of trainees interested in discussing research and public health in Africa.
Mulamira and his fellow medical students are eager to jumpstart the first UAEM chapter in Africa. Hopefully this will be the first of many throughout the continent.
If you have an interest in neglected diseases, please join us. E-mail me, join our list-serv (https://lists.riseup.net/www/info/univ-list), and check us on the Web at www.essentialmedicine.org. When interest is demonstrated, particularly by trainees, then the political and academic communities respond.
Sandeep P. Kishore is a Tri-Institutional MD-PhD Student at Weill Cornell/ Rockefeller/ Sloan-Kettering Institute (Sunny.email@example.com).
To read more from Sandeep or to discuss topics related to public health in Africa, please visit the Public Health in Africa Forum