Access to research, resources a barrier in Africa: Barmes Global Health Lecture addresses disparities
Dr. Agnes Binagwaho (left) and Dr. Francis S. Collins (right)
Dr. Agnes Binagwaho (left), Rwanda’s Health Minister, addresses staff in Masur Auditorium. NIH Director Dr. Francis S. Collins (right) looks on.
Development for emerging countries is not only linked to money; access to research and ideas are critical factors in growth and improvement, argued Rwanda’s Health Minister in remarks made at the NIH Clinical Center.
Dr. Agnes Binagwaho, Rwanda’s health minister, delivered the July 29 David E. Barmes Global Health Lecture. Her presentation, “Medical Research and Capacity Building for Development: The Experience of Rwanda,” was grounded in her expertise in public health in Rwanda. Binagwaho was trained in pediatrics, specialized in emergency neonatology and the treatment of HIV/AIDS and worked as a physician in public hospitals for more than 15 years.
NIH Director Dr. Francis S. Collins introduced Binagwaho, who’s served as health minister since 2011.
“Since 1990, under-five mortality has decreased by two-thirds and maternal mortality by three-quarters, while life expectancy has nearly doubled,” said Collins. “Today more than 90 percent of Rwandans have health insurance coverage. Many of us would love to see that happen in the United States.”
Binagwaho opened her remarks by discussing the 2014 Ebola virus outbreak that made such a dire impact on West Africa. She cited many media and health care sources, including the World Health Organization, the New York Times and the Lancet, as describing the outbreak as “unpredictable.” And yet, the potential for an outbreak was identified by researchers in 1982 who pinpointed Lassa, Marburg and Ebola virus antibodies in the Liberian population and urged local medical personnel to prepare for local outbreaks.
“All of that information was available on the internet. All of that information was available through [journal] subscriptions,” said Binagwaho. The problem was a lack of access to the research.
Binagwaho asserted that the research conducted in 1982 was not co-written by local scientists.
And while the findings were available online, internet access in West Africa only reaches 2 percent of the population. If researchers were fortunate enough to have internet access, downloading the papers would cost $45, according to an op-ed in the New York Times [disclaimer]. That sum is the equivalent of half a week’s salary for local physicians in West Africa.
The Centers for Disease Control and Prevention estimates the immediate impact of the 2014 Ebola outbreak resulted in at least 11,000 deaths. However, Binagwaho looked at two other impacts of the outbreak: maternal and child health and Gross Domestic Product (GDP) in the affected nations.
As a result of the epidemic, vaccination rates in West Africa declined from around 70 percent to 30 percent, while deliveries of children at health facilities declined from around 50 percent to 20 percent. Both of these indicators can have a negative impact on life expectancy. While local authorities strive to improve these outcomes, the effects of the disruption will continue to affect women and children in the region.
Another long-term impact has been on the economies of Liberia, Sierra Leone and Guinea with GDP growth rate declines ranging from 62 percent to 88 percent. A slower-growing economy leaves more people in poverty and provides fewer resources to governments trying to address medical and social challenges in their nations.
In an effort to promote a strong research culture and to maximize the impact of scarce resources, the Rwandan government has adopted a collaborative research policy. This policy applies three principles to research conducted in the nation:
1. All research in Rwanda must be conducted with Rwandan principle investigators.
2. Research conducted in Rwanda must be published with Rwandan authors.
3. All research in Rwanda must invest in the Masters Degrees of two Rwandans.
Binagwaho ended the lecture by outlining the principle that she felt should guide all researchers: “In global health, we need to be sure that the research will benefit the people we are studying.”
The National Institute of Dental and Craniofacial Research and the Fogarty International Center presented the lecture.