Article
9 December 2011, Vol. 3, No. 2 AJHPE
Introduction
Biomedical research is a powerful tool for solving health challenges in
developing regions. The present study is aimed at describing the needs
of biomedical science training in Africa from the experience of young
African scientists at home and in the diaspora. A total of 107 young
scientists were recruited through existing international networks and
interviewed via a web-based program, on the current status of biomedi-
cal research in their different institutions, as well as the major obsta-
cles faced and their aspirations. This survey revealed that although
considerable efforts have been made in strengthening research capacity
in Africa, much remains to be done. Biomedical research in Africa is
seriously hindered by obstacles such as lack of infrastructure, expertise,
energy supply, institutional support and financial support from govern-
ments. We encourage applied research and public-private partnership
to foster implementation of research findings into goods and services
for public benefit.
Background
With the disproportionately large share of the global burden of communi-
cable and non-communicable disease in sub-Saharan Africa, one would
expect that the solutions to these problems be home-grown. Unaccount-
ably, the capacity for this is grossly lacking. An overwhelming major-
ity of African countries fall well below the average on standard indices
of science and technology capacity.1 The infrastructural and legislative
environment in many African countries is not conducive to research.2
Moreover, over the years, Africa has witnessed a steady loss of university
staff, which has led to low scientific research output, weak preparation of
the next generation of African biomedical scientists, and doubt about the
capacity of African universities to produce globally competitive gradu-
ates.3,4
Biomedical research is a powerful tool for solving health challenges.
Therefore various initiatives are underway to strengthen biomedical
research capacity in Africa.1,2,5,6 These activities are largely based on
input from senior scientists in Africa and abroad. In order to give
voice to young African and African diaspora scientists on these issues
Build AfReCa! (Build African Research Capacity), a global network
of young scientists, was recently started. Build AfReCa! represents
Africa’s rising pool of scientific talent. The present survey is the
first effort at defining the needs of biomedical research training in
Africa and of Africans. This study describes the needs of biomedical
science training in Africa from the experience of young scientists.
The findings address policy makers, service providers, governments,
academic institutions, and students to assess and strengthen capacity
building in Africa.
Methods
The survey was based on voluntary, anonymous participation and in-
volved 107 young scientists and postgraduate students from English-
and French-speaking Africa, studying or working in Africa or outside
continent. Participants were recruited through existing international
networks like Build AfReCa!, African Network for Drug and Diag-
nosis Innovation (ANDI), African Regional Groups of the Student
Council of the International Society for Computational Biology (RG-
SC-ISCB) and Central Africa Nutrition Graduate Students Network
(AGSNet-Central Africa).
The questionnaire was designed in English and French, based on par-
ticipants’ identification, institution and research area, obstacles en-
countered with the research work, needs, career plan and preferences.
The questionnaire was filled by the participants online, via the Mon-
key Survey web-based program (www.surveymonkey.com).
Data collected with each version of the questionnaire were summa-
rised using the Monkey Survey tool and exported into Excel 2007
format. Answers from the French version were translated into English
and the two datasets were merged before analysis. Results were ex-
pressed as frequency distributions for each question, and correlation
between variables assessed by cross-tabulation (Pearson’s Chi-square
test p<0.05). The statistical analysis was conducted with SPSS ver-
sion 17.0 and Epi Info version 3.5.0.0. The charts and tables were
designed on Microsoft Office Excel 2007.
The needs of biomedical science training in Africa: Perspectives from
the experience of young scientists
Denis Zofou1, Seye Abimbola2, Carmelle T Norice3, Moses Samje4, Zoumana Isaac Traore5,
Oyewale Oyediran A6, Chinedu Oraka7, Daudi Mussa Kadigi8
1 Biotechnology Unit, University of Buea, Cameroon
2 National Primary Health Care Development Agency, Abuja, Nigeria
3 Columbia University Medical Scientist Training Program, Columbia University College of Physicians and Surgeons, New York, USA
4 Department of Biochemistry and Microbiology, Faculty of Science, University of Buea, Cameroon
5 Parasitic Disease Epidemiology Department, Faculty of Medicine Pharmacy and Dentistry, Malaria Research and Training Center (MRTC), Molecular
Epidemiology and Drug Resistance Unit (MEDRU), Mali
6 Department of Phamacology, Faculty of Pharmacy, University of Ibadan, Nigeria
7 Zeta-12 Research Group, Nnamdi Azikiwe University Teaching Hospital, Nigeria
8 DoD/GEIS-TPDF Influenza Surveillance Program, General Military Hospital-Lugalo Dar es Salaam, Tanzania
Correspondence to: Denis Zofou (zofden@gmail.com)
Article
10 December 2011, Vol. 3, No. 2 AJHPE
Results
Study participants, site and affiliation
Overall, 107 people participated in the study; 37.4% were female and
62.6% male and 77.5% were below the age of 40 years.
All the four regions of sub-Saharan Africa took part in the survey in ad-
dition to those in the diaspora. The highest number of respondents were
from West Africa (46.7%) followed by Central Africa (21.5%) then East
Africa (15.9%). While 81.3% of the participants were residing in their
country of origin, 18.7% were currently working or studying outside their
home country.
While 48.35% of the participants were affiliated to a university, and
21.98% to a university/teaching hospital, 13.19% worked in a govern-
ment/national and 16.48% in a non-governmental research institute. Ta-
ble I summarises the distribution of research participants by position and
region of residence. Participants’ position depends strongly on the type of
the institution (x2= 91.68, p=0.0004).
Skills and research output
The study participants had publications in both local and international
journals in a wide range of topics. Respondents who have published in
peer-reviewed journals were 30.21% while 26.04% have written a grant
application wholly or in part.
Respondents had presented their work at international conferences
(34.97%), national conferences (17.48%), departmental/institution
seminars (27.97%) or at laboratory/journal club meetings (29.37%). In
general, a significantly high proportion of students who had presented
at seminars and conferences were those receiving financial support from
their host institutions (x2= 51.122, p=0.0108).
Research area and needs
Research areas of the respondents range from epidemiology and drug dis-
covery to immunological and molecular biology. Most respondents con-
duct research on infectious diseases, especially those that are prevalent
in sub-Saharan Africa. Only 6.7% (confidence limits 2.2%, 14.9%) of
the researchers were involved in clinical trials. Research techniques and
methods in use presently or in the future were a major cause of concern as
expertise and unavailability of equipment is a shortcoming to a number
of exciting projects. Needs range from the lack of basic facilities such as
a laboratory space to sophisticated equipment (Fig. 1).
Lack of training was also a major need raised by the respondents and
field of training required varied from one institution to another. When
all the desired fields of training were put together, the need varied from
basic good laboratory practice (GLP) and good clinical practice (GCP) to
biostatistics and biotechnology.
Most of the respondents preferred training to be in the form of intern-
ships at expert research laboratories while some preferred workshops and
seminars in their laboratories/institutions by visiting scientists (33.06%).
A major drawback to research as indicated by most of the respondents is
frequent faculty/institution strikes. The research or academic study of up
to 46.43% of the respondents had been perturbed by strikes ranging from
3 months to more than 4 years. Delay in research as a result of strike was
significant (p<0.05).
Work plan after research training varied widely. Work stations chosen
include public-private research institutions, NGOs, and faculty at a uni-
versity. A good number of the respondents preferred to work in Africa
(54.65%; confidence limits 23.3%, 48.0%), followed by North America
(19.77%) then Europe (16.28%).
Research funding and brain drain issues
Only 16.92% of researchers based in their home country receive 100%
financial support from their host institution, 63.08% who are also based
in their home country receive no financial support at all. There was a
significant difference in proportion between researchers who received fi-
nancial support and those who did not receive (x2=55.190, p=0.003). The
consistency of the support also varies widely from one region to another
(Cramer’s V=0.375; p=0.018). The diaspora comes first with 66.67% of
the researchers receiving more than 50% of support from their host insti-
tution, followed by East Africa (50%), southern Africa (25%) and West
Africa (12.5%), while only 15% of students from Central Africa receive
10% of financial support from their institution.
Consequently, they are bound to either sponsor their research or seek
funding elsewhere. Access to scientific papers was a nightmare to some
of the respondents. Only 20.48% of the respondents had full access to
scientific publications. Limiting factors include lack of Internet access
or connection problems, frequent power failure, and/or lack of money to
cover the costs.
Of the respondents, 36.9% were out of their country of origin in pur-
suit of education. There was a preference for overseas studies because of
better training by experts abroad, access to well-equipped laboratories,
the quest for knowledge of a particular technique, and/or acquisition of
scholarship and good assistantship. Better working conditions coupled
to job security or good pay package served as a driving force for some
choosing foreign countries for studies.
Limited research facilities in their country of origin (35.71%), limited re-
search funding (28.57%), unemployment despite the expertise (12.86%)
and the opportunity to transfer skills to scientists in resource-limited
countries (21.43%) were reasons why some researchers prefer to work
abroad.
Discussion
From this survey some positive points were highlighted regarding capac-
ity building for biomedical research in Africa. A good number of African
students have published in renowned journals and/or have had formal
presentation of their works at national and international seminars/confer-
ences. This observation may reflect growing interest in biomedical sci-
ence on the continent and the emergence of north-south and south-south
networks across Africa. Some of these include the Multilateral Initiative
Article
on Malaria (MIM) with headquarters in Cameroon, the African Malaria
Network Trust (Tanzania), the newly created African Network for Drug
and Diagnostics Innovation (ANDI), Build African Research Capacity
(Build AfReCa!), African AIDS Vaccine Programme (AAVP), etc. Such
organisations, if well designed and focused, are likely to foster biomedi-
cal research and its implementation.7
Research and publication are crucial in medical education, and scientific
publications represent a major element in the transfer of knowledge from
clinicians and academics to potential users including decision markers.8
However, considering the population and available resources, Africa is
still far from the rest of the world, and there is serious concern about
disparities across the continent. Africa produces about 27 000 papers per
year, which is about the same volume for the Netherlands. Between 1999
and 2008, Egypt produced nearly 30 000 papers, which is about three
times that for Tunisia, its regional neighbour. In west-central Africa, Ni-
geria’s total publications for the same period was over 10 000, compared
with roughly 6 500 for Kenya, the leading research economy in East
Africa. South Africa’s dominance, as might be expected, is even more
pronounced: nearly 47 000 papers during 1999 - 2008, compared with
the southern region’s next most prolific nation, Tanzania, which fielded
just over 3 000.9
Nwaka et al. identified about 2700 institutions in 47 of the 53 African
countries as lead institutions based on their position as corresponding
institutions for articles cited in peer-reviewed journals. These findings
clearly indicate the existence of significant health research and develop-
ment capacity in Africa, but the lack of intercontinental collaboration,
coupled with low levels of investment, are the major factors hindering
the continental research agenda and contributing to a lack of local owner-
ship of research undertaken on the continent and suboptimal utilisation of
available research capacity to address African health problems.10
The existing networks need to coordinate their complementary actions in
order to be more effective and avoid wastage of resources in unnecessary
replication of actions. According to the Parliamentary Office of Science
and Technology,11 ‘the global approach to international development
has shifted over the last few decades from developed countries telling
developing countries how to address their own problems, to developing
countries identifying their problems and working with developed coun-
tries to achieve the assistance they need’. Efficacious mechanisms are
therefore crucial for African countries to identify their needs and design
appropriate solutions to solve them. At this point, the importance of pub-
lic–private partnership (PPP) cannot be over-emphasised. The approach
by ANDI to create centres of excellence across the continent is laudable
and warmly welcomed since this will surely reduce some of the techno-
logical and socio-economic disparities encountered from one region to
another. African governments should be more present to provide insti-
tutional and financial support and create an environment conducive to
research and development, instead of relying on the lone support from
developed countries. Pan-African organisations like ANDI, AMANET,
Build AfReCa! and others should be particularly encouraged and effec-
tively supported by African governments.
From this survey it was also observed that biomedical research in Af-
rica or by Africans mostly consists of basic/fundamental research. The
proportion of researchers involved in clinical trials is remarkably low.
Ironically, no economy in the world has prospered without a strong re-
search policy and only few outreaches had been recorded from core-basic
research. This implies that, to be able to make good use of its immense
natural resources, Africa should go beyond the exploratory fundamental
research and implement findings to solve its numerous daily problems.
For example, discovering new antimalarial leads could really alleviate
the malaria burden only if these active ingredients are actually converted
into medicines available on the shelves. Therefore applied research and a
fair collaboration with private sector and international bodies are strongly
encouraged.
Students interviewed prefer web-based courses, short training pro-
grammes focusing on specific subjects and internships in laboratories
with expertise as teaching methods. Internships in laboratories with ex-
pertise are likely to boost technology transfer to developing countries
although this is really effective only when coupled to infrastructure de-
velopment and a powerful implementation policy. Virtual conferencing
and web-based courses may prove to be an effective low-cost strategy
for conveying education to African scientists who otherwise would be
deprived of the opportunity. Unlike conventional programmes, they
permit the involvement of a greater number of participants who would
otherwise be unable to participate in events of this breadth owing to (i)
limited travel fellowships, if any; (ii) lack of time to travel to distant con-
ference locations; and (iii) insufficient accommodation and subsistence
funds.12 Therefore communication technologies should be given prior-
ity by public and private investments. However, it is urgent for African
governments to revise their energy strategies and invest more in renew-
able energy, in order to facilitate communication and solve the recurrent
Table I. Distribution of participants by region of origin and position at the research institution
Participant’s region of residence
Total
Position at institution Central Africa Diaspora East Africa Southern Africa West Africa
Senior/principal investigator 1 1 0 2 3 7
Postdoctoral Fellow 0 4 0 0 2 6
PhD student 15 7 1 1 7 31
Master’s degree student 3 2 3 5 2 15
MD student 0 0 0 0 2 2
Research assistant 3 1 2 1 3 10
Laboratory technician 0 0 0 0 3 3
Bachelor degree student 0 0 0 0 3 3
Other 0 0 1 1 7 9
Total 20 15 7 10 32 86
NB: A total of 86 answers were recorded for the question on the participant’s position at their research institution.
11 December 2011, Vol. 3, No. 2 AJHPE
Article
12 December 2011, Vol. 3, No. 2 AJHPE
energy supply problem that constitutes a major handicap for research in
many African countries.
Human resources for scientific research are unacceptably lacking in Af-
rica. In 2004 it was estimated that in Africa (except South Africa), there
were only 70 researchers of any field per million population, compared
with 2 640/million in North America and 4 380/million in Japan.8 The
situation is aggravated by the phenomenon of brain drain in Africa. This
present study showed that about 40% of African students reside out of
their country of origin. Better working conditions coupled with job secu-
rity or good pay packages represent the major driving forces for choosing
foreign countries. For example, according to the World Health Report
(2006) only 3.3% of nurses and midwives trained in Kenya remain in
their country for a career.4 This is clear evidence that developed countries
continue to deprive developing countries of millions of dollars wealth of
investments embodied in their human resources for health.13 If locally
trained African experts migrate to developed countries because of bet-
ter offers, it is obvious that those trained out of Africa will hardly return
home. Therefore fighting brain drain requires dedicated strategies13 both
at national and international levels: (i) research should be responsive to
the country’s needs and priorities; (ii) sandwich programmes should have
priority over full training programmes; (iii) training should be accompa-
nied or followed by equipment support to facilitate in-home implementa-
tion of acquired knowledge; (iv) political strategies like visa restrictions
could be applied in specific cases; (v) decision makers in developing
countries should equally be trained towards development focused re-
search strategy; and (vi) private sectors should be strongly encouraged as
main actors in research implementation.
Conclusion
From this first attempt to identify the needs of biomedical science train-
ing in Africa from the perspective of young scientists, it clearly appears
that although considerable efforts have been made towards strengthening
research capacity in the African continent, much remains to be done. Bio-
medical research in Africa is seriously inhibited by preventable obstacles
which include the lack of infrastructure, expertise and energy supply and
institutional and financial support from governments. There is need for
applied research in the form of clinical trials to really foster the imple-
mentation of research outcomes.
There are enormous potentials embodied in African researchers. The con-
tinent would definitely experience exponential growth in health status
and health innovation if African researchers are based in and focus their
work on Africa and her many health problems. Therefore strategies to
support African researchers in Africa to better identify and combat Af-
rica’s health issues are greatly encouraged.
Competing interests
The authors declare that they have no competing interests.
Acknowledgement
We are very grateful to all the participants for their valuable contribution
to this study.
Authors’ contribution
DZ designed the survey, translated the questionnaire, participated in
the recruitment of research participants, statistical analysis of data col-
lected and the write-up. SA contributed in editing of the questionnaire,
recruitment of research participants and write-up. CTN participated in
the conception of the project, design of the survey, recruitment of re-
search participants and the write-up. MS participated in the write-up. ZIT
contributed in the questionnaire design and recruitment of research par-
ticipants. OOA, CO and DMK participated in the recruitment of research
participants. All the authors have read the final manuscript and approved
the submission.
References
1. Wagner C, Brahmakulam I, Jackson B, Wong A, Yoda T. Science and technology
collaboration: building capacity in developing countries? MR-1357.0-WB. Santa
Monica, CA: RAND, 2008.
2. Whitworth JA, Kokwaro G, Kinyanjui S, Snewin VA, Tanner M, Walport M and
Sewankambo N. Strengthening capacity for health research in Africa. Lancet
2008;372 (9649):1590-1593.
3. Anonymous. Brain Drain in Africa - Joint Statement by the Network of African
Science Academies 2009. http://www.nationalacademies.org/includes/NASAC-
braindrain09.pdf.
4. Kirigia JM, Gbary AR, Muthuri LK, Nyoni J, Seddoh A. The cost of health
professionals’ brain drain in Kenya. BMC Health Services Research 2006;6:89
doi:10.1186/1472-6963-6-89.
5. Matee MI, Manyando C, Ndumbe PM, Corrah T, Jaoko WG, Kitua AY. European
and Developing Countries Clinical Trials Partnership (EDCTP): the path towards a
true partnership. BMC Public Health Letter 2009;9:249.
6. TDR. Building capacity for research - TDR Seventeenth Programme Report. 2005.
7. Ntoumi F, Djimdé AA, Mbacham W, Egwang T. The importance and future of
malaria research in Africa. Am J Trop Med Hyg 2004;71:4-6.
8. Frantz M. Identifying strategies to improve research publication output in health
and rehabilitation sciences: a review of the literature. African Journal of Health
Professions Education 2011;3(1):7-10.
9. Adams J, King C, Hook D. Global Research Report - Africa. Thomson Reuters.
Leeds, UK. 2010. available at: http://thomsonreuters.com/content/corporate/docs/
globalresearchreport-africa.pdf
10. Nwaka S, Ilunga TB, Da Silva JS, et al. Developing ANDI: A novel approach to
health product R&D in Africa. PLoS Medicine 2010;7(6): e1000293.
11. Parliamnetary Office of Science and Technology. Scientific capacity in developing
countries. Postnote 2004;216:1-4.
12. Gichora NN, Fatumo SA, Ngara MV, et al. Ten simple rules for organizing a
virtual conference - anywhere. PLoS Computational Biology 2010;6(2):e1000650.
doi:10.1371/journal. 2010. pcbi.1000650
13. Kupfer L, Hofman K, Jarawan R, Mcdermott J, Bridbord K. Strategies to discour-
age brain drain. Bull World Health Org 2010;82(8):616-619.