Although many factors have contributed to the early successes of these efforts, we believe the key to our progress has been the structure of our partnership. Working with our international partners we first identified the major barriers to conducting medical and scientific research within Mozambique. We then worked with our partners to develop locally applicable approaches to overcome them. This approach is, perhaps, the inverse of “traditional” collaborations in which an international entity with externally defined research priorities seeks local support to address their priorities. Although these projects may have substantial value (both globally and locally), they are often dependent on the ongoing interests of the external collaborator and, therefore, fail to develop sustainable, broad-based research capacity in the country. Our MEPI partnership relies heavily on local priority setting and emphasizes the development of local expertise to sustain the infrastructure for research and training. Faculty and laboratory technicians from the collaborating universities have reciprocally visited to jointly design research grants, to provide training in research methods and grant and scientific writing, and to initiate research projects. The Mozambican MEPI aims were jointly designed by researchers from UEM and UCSD according to their best understanding of Mozambique’s needs, while remaining aligned with policies and priorities of the Mozambican government and key local institutions including the MOH, MOE, the MMC, MIST, UEM, Unilurio and Unizambeze, thus assuring broad ownership by local stakeholders. This innovative approach assures future sustainability as the activities are undertaken by participants and are not viewed as being imposed with externally defined goals that may negatively impact research productivity and relevance [
9]. Research will have more impact if local researchers are enabled to take leadership roles and define research priorities according to the country’s needs. The channelling of research and development funds through universities and affiliated research support centres also enhances sustainability of public institutions and combats internal “brain drain” to the private sector and NGOs.
Moving forward
There is significant potential for research collaboration in multiple areas of infectious and non-communicable diseases. Although our initial aim was to enhance research capacity and develop new knowledge about pressing local health problems, we also aligned research activities to support policies and interventions of the MOH, MOE and MIST to provide additional capability to evaluate and monitor other national health, education and research priorities.
Further steps to stimulate clinical and operational research will be undertaken by strengthening the existing relationships among UEM, UCSD, UFBA, IHMT-UL, Unilurio and Unizambeze, and other partners for study design, grant applications, publications and research methods and ethics courses. Joint planning, mentoring and exchange of faculty and research staff create synergies to better leverage limited resources. Whenever possible, equipment, human and other resources should be shared among local, regional and international institutions. Publishing findings in scientific literature is critical to sustaining the goals defined under our MEPI programme. A system of differential rewards for those who publish should be created within universities. Building additional skills through ongoing courses on grant and scientific writing, and exposure to new research methods and research ethics remains critically important. Further enhancement of the information technology infrastructure is also crucial for the conduct of contemporary research. Additional motivating factors, such as tuition waivers/remissions and fellowships for career development would also enhance faculty retention.
A network of researchers, politicians and policy makers should be created and discussion forums established to facilitate exchange of ideas so that politicians can allocate resources according to where they are most needed. The creation of modules for research training at undergraduate universities should be developed to form the basis for future research careers. Scholarships directed at generating a critical mass of researchers and resources to facilitate participation in international conferences should be made available. Additional educational alliances and research collaborations with Brazil and other Lusophone countries would also be beneficial.
Government, donors and finance agencies should establish appropriate salaries, including stipends for protected time, for internationally competitive researchers, and should create additional career posts and fellowships for postdoctoral research. To ensure the sustainability of research investments in countries such as Mozambique, we suggest research sponsors be sensitive and receptive to the financial and human resource constraints of sub-Saharan African universities and align their granting policies with the realities of local politics, bureaucracy and taxation rules. Finally, as the essential benefits of locally planned, university-based research activities are recognized by key national institutions such as the MOH and the MOE, and as Mozambique’s economy improves, additional governmental investment in locally supported peer-reviewed research should be made. This capacity could be provided either through MIST or by developing competitive extramural funding mechanisms through the MOH’s Instituto Nacional de Saúde.
Although much progress is already apparent, the timeline to achieve the overall goals of our collaboration will be measured in decades rather than months or years. Patience will be required but the increasing sense of optimism and local investment in a successful research enterprise represents a sea change within Mozambique. We believe this will have far reaching consequences that extend to improved health, accelerated economic development and an ongoing investment of local resources to sustain these gains as their multifaceted impacts are increasingly appreciated. Since many of the same obstacles have been encountered by many Sub-Saharan African countries [
9], we hope that adapting some of the same strategies can help other countries build sustainable research efforts that can help to increase capacity across the region.