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IN MY OPINION

Canada must not abandon its young global health researchers

We need a consistent policy for funding global health research.

By VALÉRY RIDDE | JAN 15 2018

See a response to this piece from Jean Lebel, president of IDRC.

Amid increasing calls for public policy to be more firmly grounded in scientific data, research clearly has a role to play in determining the content and guiding the implementation of actions funded by Canada to support the world’s poorest countries. Canada is a key actor in global health funding, especially with regard to development projects. In 2015, Canadian assistance in the health domain totalled about $US 860 million.

Many Canadian universities now offer courses of study in global health. They have trained a large number of students and young researchers who have carried out their work in low- and middle-income countries (LMICs). While many foreign students come to Canada to pursue these courses of study, young Canadians are also eager to get involved in this field and work towards resolving health problems in LMICs. These young people will become the experts and researchers who support LMIC programs funded by Canada in years to come.

Canadian funding for global health research was the topic of a brainstorming workshop held in Ottawa in October 2017. However, there has been no significant discussion of eligibility criteria for research grants – a discussion that is clearly long overdue.

On the one hand, the International Development Research Centre, whose mission is to support “research in developing countries,” decided late last decade – although without consulting the research community, as far as we are aware – that it would no longer allow young Canadian researchers to receive grants in the role of principal investigator.

At the time, and after an agreement had already been established between the IDRC, my research team at the Université de Montréal, and various co-investigators from three African countries, the IDRC suddenly decided that it could not provide us with funding in Montreal because the funds could only be managed by institutions in Africa. While my African colleagues were very happy to partner with us and to have co-developed the research program, they nevertheless did not want to be the primary recipients of these funds, because they didn’t have the administrative capacity to manage an additional budget at that time. To avoid losing the funds, they had to agree to manage them – and then return part of them to me in Montreal by means of a subcontract, thereby forfeiting the management fees that our institutions took along the way.

In this same period, when the Fonds de recherche du Québec – Santé (Quebec’s health research funding agency, or FRQS) learned that one of the grants they had awarded me for global health research was intended in part for use in Africa, it simply eliminated those budget lines from the overall grant. I was losing almost 50 percent of the total grant amount. So I had money to analyze data in Montreal, but none to actually collect any in Africa! Evidently, certain research funding organizations are less open to the world than one would expect, since their accounting rules don’t allow money to be spent in Africa from a budget based in Quebec.

What’s the logic behind training Canadian researchers to work in global health, but not giving them any way to access the resources they need to pursue their careers? Is it really such a problem to fund researchers at Canadian institutions who work in LMICs in partnership with their colleagues in those countries? In a book that was published by the IDRC in 2017, and which drove me to write this article, the authors decided to ignore the contribution of Canadian researchers by leaving out any mention of contributions made by researchers at Université de Montréal in the research program mentioned above. Even our African colleagues will be surprised by this, because from the beginning of this program, we have always emphasized (in a very visible way) our focus on international collaboration, co-development and co-coordination, as a matter of respect for our ethical and interdisciplinary principles. And after all, this mode of collaboration and co-development is a core element of Canada’s stated principles for global health research.

IDRC continues to award occasional field research grants for Canadian (or landed-immigrant) doctoral students, but once they have their doctorate in hand, nothing else is available for researchers at the start of their career. Their only option is as co-researchers on a grant held by a researcher from an LMIC. While it is admirable as a general principle that Canadian taxpayers are funding work directed by researchers from LMICs (even if the selection processes for these projects often fall short of the standards of transparency generally agreed upon in the academic community), this policy is a disastrous one for young Canadians and permanent residents doing research work at Canadian institutions.

We all know that one of the most important recruitment criteria at Canadian universities is career advancement for the researchers and the ability to receive grants as principal investigators. This certainly isn’t the best possible criterion, and institutions will have to change. In the meantime, though, this mode of financing is disastrous for the next generation of Canadian researchers. If I’m lucky enough to have a research career today, it’s because I received funding from IDRC as a principal investigator in 2007, during my time as a postdoctoral fellow, having defended my thesis in 2005. No other institution would allow me to do that, since FRQS and the Canadian Institutes of Health Research also deny postdoctoral fellows the right to serve as principal investigators. This grant, and the funds that my African partner sent back to me in the program I mentioned earlier, were essential for obtaining a university position. Without them, I would be in the same precarious situation as many young researchers at Canadian institutions – and, unfortunate as it is, in the same position as all of the current generation of young researchers trained in global health research.

Now, on the other hand, one might respond that CIHR exists precisely to fill this gap and provide funding for researchers from Canadian institutions. Obviously, things aren’t quite that simple. Global health hasn’t been a priority for the CIHR for a long time; the Global Health Research Initiative established in 2001 is gone now, along with the leadership needed to develop this initiative.

In addition, as a result of the major budget restrictions imposed over the past few years, the success rate for acquiring doctoral grants from the Institute of Population and Public Health, which includes global health, is only about 11 percent. Among students and young researchers seeking to start a career in global health, these “11 percenters” will certainly be the most fortunate. Still, the later stages of their careers look considerably less promising, despite their excellence.

To be sure, important progress has been made in recent years. For example, researchers are no longer required to constantly justify their research in LMICs by its potential benefits for the health of Canadians! Nevertheless, there is no longer any specific funding for global health, and the various recent announcements relating to financing programs do not seem to suggest any real policy shift in that direction. With global health no longer a priority at CIHR, IDRC funding was useful to start a career in areas of study that the CIHR selection committees considered too far removed from Canadians’ needs, and with less traditional research approaches that are nevertheless essential in the context of partnerships with researchers from LMICs.

Obviously, my concern here is not for my own personal interest, since my career is well-established and I have decided to leave the Canadian academic community. Rather, I hope to open a debate on behalf of the new generation of global health researchers to make sure we don’t wind up with hundreds of Canadian experts with a PhD in global health who can’t find a position at a research institution. Of course, academia isn’t the only possible career path, but it should continue to be an option for those who want to pursue it. Their research and their expertise will also be useful to improve the health programs that Canada finances in LMICs, and will continue to finance for a long time. Incidentally, I also wish to thank the four doctoral students who agreed to read over this text and help me improve it.

Canada needs to develop a consistent policy for funding global health research. Obviously, it must continue to support students and colleagues in LMICs, provided that the projects are selected according to internationally recognized criteria of scientific excellence. However, this should not be done at the expense of (young) Canadian researchers – nor of the research investments that the leaders of LMICs should also be making on their side, rather than simply benefiting passively from the transfer of Canadian funding described earlier. Establishing an equitable partnership in global health research also requires that we deal with the challenge of financing researchers at Canadian research institutions.

Therefore, in addition to continuing its investments in development assistance for global health, and strengthening those investments as needed, it is essential that Canada also make a parallel effort to ensure sustainable careers for young researchers at Canadian institutions. To achieve this, the following recommendations for research granting agencies may serve as a useful starting point for further discussion:

  • Allow postdoctoral students and young researchers at Canadian research institutions to apply for principal investigator status in competitions held by IDRC, CIHR and FRQS.
  • At the federal level, develop a policy that values the unique contribution of Canadian researchers in the field of global health, in order to further strengthen Canada’s international reputation in this area.
  • Increase the number of global health grants awarded by funding agencies for doctoral and postdoctoral students.
  • Increase the transparency of IDRC’s grant awarding process while respecting internationally recognized criteria of scientific excellence.
  • Authorize expenditures abroad for global health research by funding agencies that do not currently allow it.
  • Launch a Global Health Research Professorship for researchers at the start of their career.

Valéry Ridde has worked as an associate professor in global health at Université de Montréal’s school of public health, and held a research professorship in applied public health at CIHR. He is a full-time researcher at the Université de Montréal Public Health Research Institute, and has just been named research director at the Institut de Recherche pour le Développement in France. 

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