Driving the Global Public Health Research Agenda Forward by Promoting the Participation of Students and New Researchers

ABSTRACT Objectives: Current trends suggest a movement towards driving forward a global health research agenda in Canada in order to redress global health research inequalities. In this paper, we explore how to promote the participation of students and new researchers in global health in Quebec. To accomplish this, we undertook a study in order to: 1) document the state of teaching and research activities in global health in Quebec and 2) obtain the point of view of various actors on conducting global health research in the Quebec context. Methods: Quantitative and qualitative data were collected through specialized grids and a documentation review (5 major universities), surveys (n=25), individual interviews (n=9), and two convened workshops (n=79). Results: We identified 27 courses with global health content, 36 researchers in Quebec working primarily on global health issues, and 76 global health research projects implemented over the past 5 years. A number of threats and opportunities were reported with regards to engaging in global health research activities, as were a number of strengths and weaknesses with respect to the teaching and research environments in Quebec. Conclusion: There appears to be a relatively strong and growing presence of global health in Quebec universities – although the situation varies across institutions – with room for expansion. This trend is partly attributed to an increase in federal funding for and a growing awareness and profile of global health research activities since 2001 and to a growing expertise in global health research in the province. Students and new researchers, however, continue to face multiple challenges requiring special attention and targeted investment. We conclude with a set of recommendations for key stakeholders. Key words: Global health research; teaching; Quebec; needs assessment I n a recent commentary, Canada’s Chief Public Health Officer asked “how we can effectively work with developing countries and disadvantaged communities around the world to improve health and development”.1 Addressing this question is a challenge. In 1990, the Commission on Health Research for Development found that of the more than US $70 billion spent on health research and development each year by the public and private sectors, an estimated 10% was used for research into 90% of the world’s health problems.2 This imbalance, referred to as the “10/90 gap”, has been a central concern of global health researchers worldwide.3 Since that time, the picture has slightly improved,4 although this powerful metaphor continues to capture the magnitude of inequalities in health research. At the 2007 World Health Assembly, state members were urged to implement the 1990 recommendations of the Commission in order to increase health research funds in low- and middle-income countries. Although investments in global health research* witnessed a decline in Canada in the 1990s,6 there have been concerted efforts to increase investments in global health research since 2001, notably the creation of the Global Health Research Initiative (GHRI: ; accessed October 2008), a partnership involving the Canadian Institutes of Health Research (CIHR), the International Development Research Centre (IDRC), the Canadian International Development Agency (CIDA) and Health Canada.7-9 Another key initiative emerged in 2001: the Canadian Coalition for Global Health Research (), a not-for-profit organization, was established to mobilize support for global health research through advocacy and intervention, following a nationally organized workshop of global health researchers. Also in 2002 and 2003, CIHR launched two competitions (Global Health Research Program Development and Planning Grants; Global Health La traduction du résumé se trouve à la fin de l’article. 1. Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC 2. Département de médecine sociale et préventive, Université de Montréal 3. School of Population and Public Health, University of British Columbia, Vancouver, BC 4. Global Health Research Program, University of British Columbia 5. Axe de recherche en « Santé mondiale », Réseau de recherche en santé des populations du Québec, Centre de Recherche du Centre Hospitalier de l’Université de Montréal Correspondence and reprint requests: Valéry Ridde, USI/CRCHUM, 3875 St-Urbain, 507, Montréal, QC H2W 1V1, Tel: , ext. 15928, Fax: , E-mail: Acknowledgments: This study was funded by the Global Health Axis of the RRSPQ (sponsored by the FRSQ). We are grateful for the guidance and support of the leader of the Axis, Slim Haddad. This paper benefited by the insightful comments of Slim Haddad and Erica Di Ruggiero. We also wish to thank Marie-Pierre Arsenault, Julie de Barbeyrac, Cheikh Faye, Isabelle Menard, and Nicole Saba for their assistance in data collection and review of the study’s findings, as well as the presenters and participants of the 2006 and 2007 Axis’ workshops. V. Ridde is a research fellow from the Fonds pour la Recherche en Santé du Québec (FRSQ). K. Mohindra is a global health postdoctoral research fellow supported by the Canadian Institutes of Health Research. This study was undertaken while she was a PhD student at the Université de Montréal. * Guiding this study was the following definition of global health: “Global health primarily concerns populations living in the poorest countries or in less developed regions where immense needs are far from being met. But global health is not just an issue for poor countries. Along with the interconnection of people, goods and ideas comes the globalization of environments, ways of life, and, it goes without saying, major public health issues.” 5 Research Pilot Project Grants), which led to a surprising number of responses and illuminated the number of Canadian research teams engaged in global health research involving low- and middle-income countries: more than 70 teams responded to each competition. Due to these initiatives, resources allocated to global health by CIHR have significantly increased since 2001 (see Figure 1).10 Other provincial initiatives have also surfaced; here we present the approach adopted in Quebec. Global health is one of the five strategic priorities of the Quebec Population Health Research Network (RRSPQ : du Québec (FRSQ : ). The Global Health Research Axis (hereafter referred to as the Axis) of the RRSPQ was launched in 2003. The objectives of the Axis are threefold: 1) to contribute to the development of a trans-disciplinary expertise in global health research in Quebec, 2) to develop a critical mass of Quebec researchers in global health, particularly young researchers, who will contribute to the expansion of the field and resources, and 3) to improve the performance of Quebec researchers competing for national and international research funding.11 The Axis, in conjunction with federal initiatives, has significantly increased opportunities for and the profile of global health research in the province. Key to promoting and maintaining this enthusiasm for global health research at the provincial and national levels is the role that students and new researchers will play. Elsewhere, it was argued that doctoral students and post-doctoral researchers in Canada are a “strong, untapped resource” in global health research and a variety of strategies should be pursued to ensure that new researchers are genuine partners in this endeavour.12 In this paper, we pursue this line of thinking by exploring how to promote the participation of students and new researchers in global health research in Quebec. To accomplish this, we undertook a study in order to: 1) document the state of teaching and research activities in global health in Quebec and 2) gather the point of view of various actors regarding the threats and opportunities, as well as the strengths and weaknesses, of global health research in Quebec. The ultimate objective of this study is to provide recommendations for the RRSPQ, Quebec universities, and donor institutions. The details of this study are described elsewhere;13 here we outline the key findings and recommendations, which may be of interest not only to Quebec, but to other provinces and countries (e.g., the UK14,15) currently promoting global health research agendas. METHODS Below we describe the methods adopted to address each of the two objectives of the study. Objectiv