Discussion commentary for IUNS WEB page June 1998
Ricardo Uauy MD PhD
INTAU of Chile
Member of IUNS council
This discussion will address some basic principles in defining a research agenda that are specially relevant to national organizations that have an Operational/Applied Research focus.
The meaning of applied in the context of this discussion is the problem oriented approach which involves the integration of all disciplines required to answer a research question. It is as pointless to exclude the basic sciences from applied research as is to exclude the social sciences in research destined to improve the nutrition of populations groups around the world. Integrated approaches means more than just multidisciplinary research.
Nutritional and food problems in the community represent the interaction of multiple factors which may be grouped in the traditional nature vs nurture paradigm, presently stated as genetic and environmental factors. Most present problems in developing countries have an environmental component but as basic health and sanitation improve and dietary quality problems are resolved the genetic components underlying nutritional problems become more evident. In many urban centers in the developing world obesity is becoming an increasingly prevalent problem, it affects mainly the low socioeconomic groups, and in many cases it is coupled to stunted linear growth in early life. As an example the present epidemiologic characterisation of stunting and obesity should consider the genetic variables as well as the dietary, socioeconomic and cultural determinants.
Who benefits from the research: parternship not servitude
Institutions around the world, specially in developing countries are sometimes inclined to adopt their research agenda based on government or donor defined research priorities, although this may seem advantageous in the short run it is unwise unless these priorities fit with the institutional development process within the context of national and regional needs. The process should include active negotiation between donor interest, institutional needs and investigator creative thinking. The institution should always consider what are the benefits to the country, to the institution and to the local investigators derived from the research process as well as considering benefits from the expected results. It is not sufficient to receive generous funding, the costs involved for the institutions include more than direct supplies and space, they include human resource allocation, equipment utilization and maintenance and most of all time dedication of local staff, usually overstretched by existing work burden. In many cases research support will serve mainly the collaborating national institution from the donor country, in other cases, there will be little or nothing left behind locally after the project is completed. Projected publication of reports or scientific papers in the international literature are not sufficient to warrant embarking on a research project that will tie up local human resources in an inquiry of little or no local relevance. Only if the local institution and investigator benefits are clearly delineated the support of a donor should be accepted. If this is not clear it is best not accept funds, rather than be involved in a situation that benefits mostly the donor.
Who defines the research agenda: a negotiated process.
The process needs to include not only the people who will be conducting the research but also people who are familiar with present a projected nutrition and food problems in the country or region of interest. Firstly, there are some questions that have global interest either because of their relevance as international nutrition problems or because some aspects of the research provide a basic understanding of a problem that will have widespread application and thus are universally of interest. A research agenda should include setting priorities based on actual and projected country needs, thus planners and policy makers need to be involved in defining these priorities. In any case, research topics should leave room for individual investigators to orient the research approaches, there is much to be gained by allowing creativity to flourish. Creative thinkers in many cases will provide innovative solutions that would have not been surmised following traditional approaches. Freedom to question and criticize are of essence in a research setting. Sometimes it may appear difficult to balance relevance with individual .creativity but under no circumstances investigators should be forced to take a given topic, encouragement, facilitation of institutional resources should be the incentive to undertake research on priority problems.
The process should include active negotiation between donnor interest, institutional needs and investigators creative thinking. This process needs a careful assessment of costs and benefits to the country. In examining this issue the costs for the country in terms of using its limited human and institutional resources to serve a project need to be considered.
How much is too much: do not spread too thinly
Applied research institutions should define priorities and be selective in the number of research questions that they address at any given time. If the institution is spread too thinly little will be derived from the research effort. It is clear that service to the country’s operational research -needs should be satisfied but not beyond the institutional capacity to address them seriously. It is better to do well a few projects than to attempt to cover it all and fail in the process. Rigorousness in experimental design is crucial not only for laboratory studies but just as important in community based social research. Invested time and effort will be wasted unless this principles are upheld.
Invest in the future: training human resources takes time
It is important to plan ahead, when defining the projected research needs, since the human resources to address the projected needs will need to be trained, this takes time. Thus, there should always be a component of the research agenda that prepares the institution to address the coming problems. Basic science and disciplinary training is needed to prepare for the future, the ability to move from one set of question to the next requires formative components. This will allow individuals to retool and redefine their research questions. International networking, meetings and conferences provide unique opportunities for junior staff to interact with other centers that are further along the applied research path. External advisory bodies to review and propose recommendations are helpful in evaluating the relevance of research efforts in a given institution. This process should provide foresight to local policy makers and planners into what will be needed in the future. An institution should always invest some of its resources in the future, the balance between today’s relevance and future needs should be carefully sought. Institutions that are not capable of redefining their mission and adapting it to the changing socioeconomic and epidemiological profile of their country or region of influence will not maintain their leadership position. The demands of institutional leadership include anticipating future demands and being prepared to address them.