Establishing a Cancer Research Consortium in Low- and Middle-Income Countries: Challenges Faced and Lessons Learned
Sara E. Fischer, MPH, Olusegun I. Alatise, MD, Akinwunmi O. Komolafe, MD, Aba I. Katung, MD, Adedeji A. Egberongbe, MD, Samuel A. Olatoke, MD, Olayide S. Agodirin, MD, Oladapo A. Kolawole, MD, Olaejerinde O. Olaofe, MD, Omobolaji O. Ayandipo, Olorunda Rotimi, MD, Murray F. Brennan, MD, and T. Peter Kingham, MD
Over the past 15 years, focus has begun to shift from high-income countries (HICs) implementing programs in low- and middle-income countries (LMICs) to the more collaborative approach of building capacity within LMICs.1 In the realm of public health, this has translated into hospital training programs or large-scale project implementation.2 In comparison, relatively little emphasis has been placed on collaborative research, or building research capacity within LMICs. This is beginning to change, and several papers characterizing principles for conducting research-strengthening activities in LMICs have been published.3–8 Most research programs that have been implemented successfully in LMICs are focused on infectious disease research, which traditionally has been a high priority for the global community.
Several successful research consortia focus on HIV/AIDS. One example is AMPATH, a consortium between several Kenyan and 11 North American medical institutions. Initially, the aim of AMPATH was to develop health leadership in Kenya, but this collaboration quickly grew into a large-scale model for HIV/AIDS prevention and treatment.9 They have now expanded to cancer research and training, including a formal gynecologic oncology fellowship program. Other research consortia have also been initiated on varying public health topics.10–15
In 2013, we established the African Research Group for Oncology (ARGO), our collaborative research consortium. This collaboration is between Obafemi Awolowo University (OAU), Federal Medical Center Owo (FMC Owo), University of Ilorin Teaching Hospital (UITH), Ladoke Akintola University Teaching Hospital (LAUTECH), Ondo Trauma and Surgery Centre, and University College Hospital Ibadan (UCH), all in Nigeria, St. James University in the UK, and Memorial Sloan Kettering Cancer Center (MSK) in the U.S. Our research consortium is unique since it focuses on cancer rather than infectious diseases and was founded by surgeons, who are generally the sole providers for all solid tumor oncology care in sub-Saharan Africa. In this paper, we describe the steps taken and components needed to establish a successful collaborative research consortium. We also present challenges we encountered in building our consortium, and how we managed them.