Published online 26 February 2009 | Nature | doi:10.1038/news.2009.127

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Carte blanche for Malawi and Kenya to spend health research funds from international donors.

Health research in Malawi and Kenya is set for a big boost. Punchstock

A funding programme for health research will for the first time hand complete control to its African recipients along with the cash, development experts say.

Launched this week, the Health Research Capacity Strengthening (HRCS) initiative will give £10 million (US$14.3 million) each to Malawi and Kenya to spend as they see fit over a period of five years. Funding will come from British and Canadian charities and government.

The money will, among other things, train researchers, refurbish labs and set up mechanisms to make sure research results are used in policymaking.

In Kenya, the funding will be channelled through a new non-governmental organisation, the Consortium for National Health Research (CNHR). In Malawi, the National Research Council will be in charge of funding decisions. The body received just US$286,000 from the Malawian government in 2008, so the new money is a considerable addition to its coffers.

At first, both bodies will receive assistance to ensure sound financial management, but this support is not expected to last longer than three years.

Loans — but not grants — have been provided on this basis before, for example, through the World Bank's Millennium Science Initiative.

"We will have representation on the two bodies but we are not going to be making the decisions," says Jimmy Whitworth, head of international activities at the Wellcome Trust, a UK medical research charity that is funding the new grant along with the UK's Department for International Development and Canada's International Development Research Council.

Fledgling funders

International development funders are meant to align their agendas with the priorities of the countries receiving support under the 2005 Paris Declaration on Aid Effectiveness. Funders normally do this by consulting developing countries when devising science aid programmes, but having a panel of in-country experts to deal with grant applications is a new approach. The donors hope the funding will help the countries develop and implement high-quality research programmes that meet their own needs.

The new way is more expensive than making funding decisions in London, says Whitworth, but the outcomes should be better. "As they are on the ground, they should be able to do it more efficiently and effectively than we would," he says.

African scientists see the funding as a vote of confidence. "The agenda will not be set in London or Washington. This is what makes this initiative so unique and important," says Thomas Egwang, executive director of the African Academy of Sciences, based in Nairobi, Kenya. It's not just about African countries setting the agenda for this one programme, he says: the grant-making capacity that will be built could inspire more health research funders to channel grants through the new funding agencies.

Currently, Kenyan health research is weak, even though the country hosts many international research projects. "Health research in Kenya is not well coordinated and it does not respond to the national health needs," says J. P. R. Ochieng, deputy director of the CNHR, which will distribute the Kenyan funding. The unpredictability of donor funding also means that many Kenyan scientists are underfunded, he adds.

Leveraging more

In the long term Ochieng and his colleagues hope to encourage the Kenyan government to put more money into health research — it funds very little at the moment. They also want to raise an endowment from international donors that could provide a more stable source of funding for medical research in Kenya.

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The HRCS initiative is unlikely to stay unique for long. In a separate programme, the Wellcome Trust has joined forces with the Indian government's Department of Biotechnology to fund postdoctoral researchers in the country through a new, independent trust based in New Delhi.

The European Union is also planning to fund a "mini-framework programme" for African researchers, similar to the much larger programmes it runs in Europe. The funding — rumoured to be in the region of €30 million (US$38 million) — would be distributed by a body hosted in Africa, based on priorities identified by Africans.

It is important that the lessons from Malawi and Kenya are communicated to other donors, says Neil French, a UK epidemiologist who has been based in Africa for most of the past 15 years. He warns against excessively high expectations for this first attempt. "Even a credible and functioning research council would in my mind be a real step forward, and given hurdles like transparency, audit and political meddling, that is not guaranteed," he says.