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NNadir

(34,645 posts)
Thu Jun 23, 2022, 07:03 PM Jun 2022

I have funds to buy reagents, but not remedies

This heart breaking commentary appeared is found in the current issue of Nature, an issue with multiple accounts of inequity in science, in the World View Sections:

I have funds to buy reagents, but not remedies

Subtitle:

Ignoring the challenges of research in low-income countries only perpetuates inequity.


by Kondwani Jambo, Nature World View, June 22, 2022.

It may be open sourced. Here's some excerpts:

Recently, I was showing visitors our brand new, white-walled laboratories at the Malawi-Liverpool-Wellcome Programme (MLW) in Blantyre, Malawi. To demonstrate the power of our US$250,000 flow cytometer, I used a $250 vial of antibodies, obtained through grant funding from the UK Medical Research Council. I did this on the first floor, overlooking the city’s Queen Elizabeth Central Hospital.

There, people are dying because they lack access to a $2 course of generic antibiotics or to a hospital bed. Holding a reagent worth enough to treat more than 100 people, as I look out of the window at a hospital with many more patients than the 1,350 it officially has space for, it’s impossible to not feel guilty.

I am an immunologist at the MLW, where I lead a research group, and I’m also a tenured senior lecturer at the Liverpool School of Tropical Medicine, UK. My research focuses on understanding human immune responses, including the nature of herd immunity, with the aim of optimizing vaccinations.

I tell myself I could be elsewhere in the world, holding the same vial of antibodies — and the Queen Elizabeth Central Hospital would still be underfunded and overcrowded. But I’m in Blantyre, which means I’m constantly torn between my research and moral obligations. It’s gut-wrenching to study antimicrobial resistance using expensive genomic sequencing platforms, while not being able to provide a generic antibiotic to a patient who walked kilometres to reach the hospital.

But that’s just how the funding works. Like many global-health researchers, I am permitted to spend money on research consumables or kitting out my lab, but can’t financially contribute to local clinical infrastructure such as hospitals or supplies of medicines. This feels unfair...

...Publishers, meanwhile, could provide a dedicated space for authors to describe the limitations and restrictions under which research is conducted. This could be a short section, entitled ‘context of the research’, in a paper where the authors can detail what it took to do the work, and what is and isn’t possible in that particular setting. For example, when I carry out bronchoscopy studies in Malawi, I must avoid risky repeated invasive sampling of patients, because there are few critical-care facilities to treat them if anything goes wrong. If journals allowed manuscripts to include such detail, then editors and reviewers could make better-informed decisions about the relative value of follow-up experiments, and focus instead on the work already generated and its potential benefit to human health...

...As I look through the window of my lab, leaning against a machine that cost a quarter of a million dollars, it’s disheartening to know that if nothing is done, the logistical and psychological burden of conducting excellent research here in Malawi will grow, and the inequity gap will widen. Simple changes here could matter a great deal.
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