Capacity building features in most international research projects, but that isn’t enough to make real change, according to a leading Tanzanian scientist.

Fredros Okumu, director of science at the Ifakara Health Institute in Dar es Salaam, urges international funders and research project leads to start a dialogue with African partner organisations to ensure that capacity building is not just “project-based” but constitutes “long-term investment in careers”.

“What we’re saying is you’ve got to partner with the people on the ground but at the same time build their capacity so that in the coming days they’re in charge of the agenda as well. And this is just an ethical responsibility that the community as a whole should take.”

Okumu is the co-author of an open letter to international funders of science and development in Africa published April in the journal Nature Medicine which has reignited debate about the financing of research in the region.

“We wanted to start a conversation,” Okumu told SciDev.Net, keen to dispel any impression of “belligerence” towards the international community.

The letter cites an announcement in January by the US President’s Malaria Initiative (PMI) of $30 million in funding to the global non-profit health organisation PATH, headquartered in the US, to support a consortium of institutions working towards malaria elimination. Not one of the consortium partners was from Africa where the vast majority of malaria cases are found.

“The current funding structures create an imbalance of power and a monopoly that favours Western institutions […and] lock out African institutions,” the letter states, adding: “These structural inequities must be examined, and they must end.”

“International goodwill” has “shifted the needle for disease control in Africa” acknowledges Okumu, adding: “Overall we are very appreciative of the gains made as a result of this international goodwill.

“Having said that, as a country, or group of countries, you want to reach a stage where there is sustainability, and that means that the people with the resources right now contribute not just to financing today’s needs, but also towards building a more sustainable future.

“We need aid for sure. But we also need stronger partnerships and technical, expertise. That means we must be investing in local capacity as well, both in terms of the technical capacity but also in terms of the leadership capacity.”

In a statement responding to criticism about the funding consortium, PATH said it was designed to facilitate access to technical expertise and supplement local capacity.

Okumu acknowledges that “because of historical underpinnings […] most of the experts today are found in the north.” But “what we do have a lot of in Africa is lived experiences and I think lived experiences plus local knowledge is a great component of the overall understanding of any disease and we should not underestimate the value of that.”

On 15 April the PMI issued a direct response to the letter in Nature Medicine, admitting: “We haven’t done enough in working directly with local institutions. And we want to do more. […] We welcome the ideas of local researchers, leaders, and organizations to help us do so.”

Okumu is keen to stress, however, that not all the onus should be on western nations. “We need strong institutions in [African] countries, and we need the governments of those countries to rise up to the challenge as well,” he said.

Ngozi Erondu and Katherine Ginsbach, specialists at the O’Neill Institute for National and Global Health Law, have set out three immediate steps funding organisations could take to address the imbalance: diversify funding evaluation panels to ensure that local communities are represented; look beyond the number of publications a researcher has to consider community impact and operational experience, and reconsider funding call requirements with individuals based in high-income countries.

In an article for Skoll World Forum, they write: “By establishing equity early in the process with partners, it allows specific goals to encompass the needs of all partners, focusing on both short-term and long-term goals. Without equitable partnerships as a priority for funders, global health remains a patronizing and neo-colonial activity.”

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