EDCTP-Africa CDC Workshop
Collaborating to improve gender-related and regional disparities in research funding
19-20 November 2019, Africa Union Headquarters, Addis Ababa
About
The report
The report of the workshop is one of the EDCTP contributions to facilitate collaborations between European and African scientists geared towards closing regional and gender imbalances seen in previously funded EDCTP1 and EDCTP2 projects. The report was authored by Shingai Machingaidze, EDCTP Project Officer together with EDCTP Africa Office staff with feedback from the workshop participants and approved by Dr Michael Makanga, EDCTP Executive Director, in May 2020. EDCTP’s support for the implementation of this workshop is part of the EDCTP Work plan 2019 activities, funded under Horizon 2020.
About EDCTP
The European & Developing Countries Clinical Trials Partnership (EDCTP) is a public–public partnership between 14 European and 16 African countries, supported by the European Union.
EDCTP’s vision is to reduce the individual, social and economic burden of poverty-related infectious diseases affecting sub-Saharan Africa. EDCTP’s mission is to accelerate the development of new or improved medicinal products for the identification, treatment and prevention of infectious diseases, including emerging and re-emerging diseases, through pre- and post-registration clinical studies, with an emphasis on phase II and III clinical trials. Our approach integrates the conduct of research with the development of African clinical research capacity and networking. The second EDCTP programme is implemented by the EDCTP Association and supported under Horizon 2020, the European Union’s Framework Programme for Research and Innovation.
Content
Preface
Executive summary
Overview of sessions: Day one
Overview of sessions: Day two
Recommendations
Preface
Researchers and key stakeholders were invited a two-day workshop jointly organised by EDCTP and Africa-CDC to share experiences and suggest ways in which a more level playing field could be created for individuals, institutions and countries.
The second EDCTP programme, EDCTP2, was launched in 2014 with the remit to accelerate the development and implementation of medical innovations to tackle the huge burden of poverty-related infectious diseases in sub-Saharan Africa, through partnerships between European and African institutions.
Since then, we have funded multiple landmark projects and supported the development of both leading and upcoming African scientists. We have also made an important contribution to the development of clinical research capacity in the region, as well as national capacities for ethical review of clinical research proposals and regulatory oversight. By the end of 2019, we had supported projects involving 208 institutions in 37 countries and 126 fellows in sub-Saharan Africa.
Scientific excellence is at the heart of EDCTP’s work. Poor quality research and innovation wastes precious resources and is also potentially dangerous, giving a misleading picture of the efficacy and effectiveness, as well as safety of medical innovations. Competitive calls for proposals and peer review are well-established tools for assuring scientific excellence, and core to EDCTP’s processes.
Nevertheless, this approach has its drawbacks. In particular, disadvantaged groups can struggle to compete, and funding may tend to be concentrated in centres that have already received support in the past. Given the overt and implicit discrimination, women are often unfairly disadvantaged, and face greater challenges in balancing work and family life. Countries with less well-developed health research systems struggle to compete with countries with institutions with a long history of health research and well-established centres of excellence.
These challenges were recognised in the first interim evaluation of the EDCTP2 programme. The EDCTP2 review panel recommended that EDCTP take action to improve the gender ratio and achieve more equitable distribution of funding across countries and regions.
In response to this recommendation, and to identify key issues and ways they might be overcome, we collaborated with the Africa Centres for Disease Control and Prevention (Africa CDC) to jointly organise a two-day workshop at the Africa Union’s headquarters in Addis Ababa, Ethiopia, on gender-related and regional disparities in funding. Researchers and key stakeholders were invited to describe their experience and suggest ways in which a more level playing field could be created for individuals, institutions and countries.
We are grateful for the many constructive and practical suggestions, which will feed into our future strategic planning and implementation of activities. While EDCTP cannot alone solve major challenges such as women in science or language barriers, it can ensure it fully plays its part in ensuring that all individuals, institutions and countries have the opportunity to achieve their full scientific and career potential.
Dr Michael Makanga
EDCTP Executive Director
Executive summary
The workshop aimed to facilitate discussion to: clarify the challenges underlying regional and gender imbalances within health research in sub-Saharan Africa (with a focus on EDCTP-funded projects); identify collaborative short-, medium- and long-term strategies to improve both geographical and gender distribution of funding; and align EDCTP efforts with those of like-minded partners.
Overview of sessions
Day one
Welcome and Introductions
Dr Thomas Nyirenda (EDCTP Strategic Partnerships and Capacity Development Manager) welcomed participants.
Dr Leonardo Simao EDCTP High Representative for Africa, opened the workshop by highlighting the tremendous effort and investment made by EDCTP, together with other regional and international partners, to build capacity in Africa to conduct world-class clinical research. While these efforts were to be commended, he stressed the disparity gap across the continent in terms of gender, human and infrastructure capacity for research that needed to be addressed. He emphasised that while EDCTP and other partners should continue to contribute in their varying capacities, it is crucial for African governments to take the lead in ensuring that investments in health research and health systems are a priority reflected in national budgets.
Shingai Machingaidze, EDCTP Project Officer, South Africa, provided participants with an overview of the EDCTP programme, as well as an analysis of the EDCTP grants portfolio for 2003-2019. She outlined the objectives of the workshop, as well as the expected outputs.
Objectives of the workshop
Specific objectives
To brainstorm practical solutions to address regional, sub-regional and gender research and research capacity imbalances.
To discuss and prioritise potential strategies and plans to address these gaps (over short-, medium- and long-term timeframes).
To identify potential synergies and complementarities with the work of EDCTP strategic partners to address these gaps.
Expected outputs
- A clearer understanding of factors underlying regional and gender imbalances within health research in sub-Saharan Africa (with a focus on EDCTP-funded projects).
- Potential collaborative strategies to improve the geographical and gender balance of funding (short-, medium- and long-term strategies).
- Potential opportunities to align or synergise EDCTP efforts with those of like-minded partners.
Tackling gender issues in science
Women in science – Busting barriers
Presentations by Professor Veronique Penlap (a senior scientist) and Dr Agnes Kiragga (a junior scientist) gave an insight into their personal journeys as they progressed their careers in science. Despite a career gap of over 25 years, many of the challenges the women faced were similar.
Professor Veronique Penlap (University of Yaounde 1, Cameroon) highlighted some of the major obstacles faced by women in science, especially in resource-poor settings. She emphasised the need to find solutions to bridge the gap between men and women in science, advocated for more women to be trained, empowered and integrated in science, and for women to be included in decision making around science. She suggested that solutions to some of the challenges are already known; however, they are resource-intensive and not always available within organisations, which usually have multiple competing interests.
She outlined various strategies that could be employed to address gender imbalances in science at individual, institutional and country levels. Women should be encouraged to acquire a good education, gain the necessary skills and knowledge to be successful in their chosen career, and also to be self-confident, determined and ambitious. Mentoring and partnership with families, schools, communities, as well as with relevant stakeholders, are also important. Having strong female role models who share their success stories can also have a positive impact.
In addition, she pointed out that addressing poverty, economic development and social progress within countries is important, as these all contribute to the marginalisation of women. Professor Penlap ended her talk with numerous examples of women who have excelled in science.
Suggestions to EDCTP for consideration:
- Specific calls dedicated to women scientists.
- Ring-fenced calls for training of female scientists and balanced African regional representation.
- Establishment of an EDCTP Centre of Excellence for Gender in Science.
- Promotion and guidance for women.
- More training for women (e.g. grant writing, funding management).
- Joint projects for female scientists.
Dr Agnes Kiragga (Makerere University, Uganda) is an EDCTP Career Development Fellow. She highlighted the steps she had to take to progress her career as well as the challenges she faced, many of which were similar to those outlined by Professor Penlap. She highlighted that African women in science are often required to balance many different things, such as building a career, family life and motherhood, extended family, grant writing and publications. She highlighted the importance of having a supportive partner.
In order to address gender imbalances in science, she provided several potential solutions including: encouraging young girls to take STEM school subjects; supporting clubs for women in the workplace; regular networking events for women in the workplace; funding mechanisms targeting women; ensuring women are represented on job interview panels; and mentoring of upcoming junior female scientists by established female scientists.
Analysis of gender statistics from EDCTP-funded projects and reviewers
Professor Keymanthri Moodley (Stellenbosch University, South Africa) is a member of the EDCTP Scientific Advisory Committee (SAC) and of the EDCTP SAC Working Group on Gender. She highlighted the multiple challenges and gender imbalances specific to women in science in Africa and within EDCTP. She pointed out that globally women in STEM fields reach 30% but within sub-Saharan Africa that same proportion of 30% is for women in all subject areas. Similar to earlier speakers, she highlighted challenges women face, including the limited number of role models and mentors in STEM fields; multiple socio-cultural expectations (roles as mother, wife/partner, daughter); and work–life balance.
She commended the progress in the increased representation of women in science in countries such as South Africa and Egypt, where it has reached 43.7% and 42.8% respectively, and highlighted various organisations contributing to reducing the gender gap. She also highlighted the legacy of colonisation, whereby patriarchal heritage has ultimately led to patriarchal science. Specific to South Africa, she highlighted multiple problems women face, including racial discrimination, rape culture, gender discrimination, social disadvantage, under-representation in academic leadership, and career interruption due to maternity leave.
Professor Moodley presented an analysis of the gender distribution of the lead applicant across various EDCTP grants (both submitted and awarded); the gender of peer reviewers; and the gender composition of the scientific review committee meetings. In each case, women represent approximately one third.
Suggestions to EDCTP for consideration:
- Continued data collection and monitoring of women’s representation in science.
- Continued data collection and monitoring of women’s representation in science.
Ensure gender-neutral language and gender balance in calls and EDCTP activities.
Advocate for applications from female coordinators and encourage females to participate in evaluations.
Create opportunities to showcase women’s research, for example as plenary speakers.
Panel discussion: Experiences of women in science
The panelists shared their experiences of developing careers in different scientific fields and responded to questions from other participants. The session was moderated by Lara Pandya (EDCTP Strategic Partnerships Officer).
Akhona Tshangela (Africa CDC, Ethiopia) described her public health journey from the National Institute of Communicable Diseases (NICD) of South Africa as a medical scientist to epidemiologist. She highlighted the specific additional challenge of racial discrimination in post-apartheid South Africa. She suggested that policies should address gender imbalances and gave two examples of prominent documents: The African Union’s ‘The Africa We Want/Agenda 2063’ and ‘Maputo Protocol’ from 1995, on which the African Bill of Human Rights is based and which informed the South African discrimination act and the Ethiopian Health Extension Programme. Although the Africa CDC was only recently established, it will consider the above documents as it develops its workforce.
Suggestions for better inclusion of women:
- Recruitment algorithms that are designed to promote recruitment of women.
- Gender-representative panels instead of “manels” (all-male panels).
- Acknowledgement that men also have an important role to play in addressing gender imbalances.
- Ensuring that gender inequality is addressed with measures at an institutional level.
Professor Pauline Byakika (Makerere University, Uganda) gave an overview of her career progression while also having a family – emphasising the importance of focus, hard work and mentoring. Key challenges included a lack of role models and inadequate career development support. She emphasised the importance of having a supportive partner and argued that men should be sensitised to the desire of women to further their careers. Women can be successful if they have supportive mentors and if they carefully plan their lives early on to include career development. The strategy is multipronged and there is no magic bullet.
Suggestions for better inclusion of women:
- Grant reviewers should be sensitised to consider reasons for re-entry grant applications after a lengthy absence.
- Institutions should create positive and supportive environments and develop programmes to facilitate career development while also balancing family life.
- Career development programmes should be aimed at young women.
- Men should be sensitised from community level up to senior management in the workplace.
Professor Penlap discussed the many difficulties that she faced while setting up a research facility in Cameroon. She tried many avenues for funding and opportunities, while also facing resistance from her husband and children. She emphasised the importance of having a husband or partner who is supportive of a woman’s career in science. She concluded by stating that women should become skilled on a personal level, learn how to advocate and convince people, and develop capacity while also partnering with others in the field.
Professor Keymanthri Moodley reminded the group to look to the future, to the new generation of women. These women are already prioritising careers as well as family and it is important for more senior women to appreciate how these women see themselves.
Discussion points:
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Nicaise Ndembi (Nigeria) highlighted the fact that the NICD in South Africa had numerous women in top leadership positions – strategies for this success should be shared.
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Sarah Joseph (UK) asked whether names should be visible on grant applications when they are reviewed or whether they should be anonymised.
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Maowia Mukhtar (Sudan) emphasised that there is no common solution and that solutions need to be country-specific. Women needed to take the lead and fight for their place in science.
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Abraham Alabi (Gabon) suggested diverse solutions for a diverse Africa. In-country resources would never be enough, so help from collaborators was necessary. He also suggested a separate EDCTP fellowship call for women.
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Eleni Aklillu (Sweden) pointed out that gender disparity is also a problem in Europe, including Sweden. A gender-context component should be included in all grants and those reviewing grants should be gender-balanced. She also suggested extended fellowships for women should be considered, for example to accommodate women who are returning from maternity leave.
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Farah Nabil (Sudan) argued that newer generation women already have autonomy. While Professor Byakika agreed, she pointed out the reality is that in many parts of Africa can still be considered “old-fashioned” settings and the traditional issues that disadvantage women still need to be addressed.
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It was suggested that women who reach senior positions tend to drop out of research, to accommodate the demands of senior management, resulting in early/mid-career gaps. The panelists responded that there needs to be a balance and that younger scientists need to be mentored by these women in senior management. Each institution should also allow for these gaps to be filled, by male replacements if necessary, to ensure continuity and growth of African scientific institutions.
Tackling disparities in regional research capacity in sub-Saharan Africa
Research capacity: can we level out the playing field?
Dr Thomas Nyirenda (EDCTP Strategic Partnerships and Capacity Development Manager, South Africa) presented an introduction to practical steps in addressing geographical and gender gaps in research projects in sub-Saharan Africa. In EDCTP grants the following observations are the most common:
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Both in Europe and Africa, the same few countries dominate in winning grants.
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There is more male participation across awardees.
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Coordination of projects is usually led from a few countries, mostly European, especially for bigger grants.
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Language barriers are often cited as a challenge in francophone and lusophone countries.
In light of these observations, extra effort is required to explore the underlying causes of disparities and to identify measures to address them.
Actions taken at EDCTP level include national health research system strengthening for all sub-Saharan Africa member states. This work is carried out in collaboration with the WHO Africa Region and through a Scientific Advisory Committee working group. Figure 1 shows the improvement in national health research strengths between 2014 and 2018.
The EDCTP SAC Working Group on Gender has broad terms of reference, which include scoping what other research funders are tracking and doing. For example, the online sex and gender modules of the Canadian Institutes of Health (CIHR) are mandatory for all research submissions, regardless of domain, and for all peer reviewers.
The SAC agenda includes discussions about countries in conflict, countries with inadequate regulation of research, language barriers, and the advantage that countries successful in the past now have. Responses have included calls that specify inclusion of under-represented geographical regions.
At the secretariat level, officers ensure gender balance among reviewers and advise reviewers when gender should be applied as a tie-breaker in ranking of proposals.
Figure 1: Changes in national health research system ‘barometer scores’ 2014–2018.
Analysis of regional statistics from EDCTP-funded projects
Professor Paulo Ferrinho (Ferrinho, Universidade NOVA, Lisbon, Portugal)
is a member of the EDCTP Scientific Advisory Committee (SAC) and the SAC Working Group on Capacity Development. He provided a detailed analysis of the EDCTP grants portfolio for clinical research and capacity-building in sub-Saharan Africa. He highlighted the successes of the programme to date and also pointed out the challenges, including differences between anglophone, francophone and lusophone countries. Research capacity in sub-Saharan Africa faces multiple challenges, including weak political commitment, poor physical or technological infrastructure for research, insufficient and irregular funding for research, and high turnover of research staff (partly due to low salaries).
In the discussion following his presentation, the following points were raised:
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The visibility of EDCTP Networks of Excellence needed to be increased, to raise awareness of the work they are doing and what they can offer to researchers from underrepresented countries.
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The award of grants to institutions rather than individuals may exclude talented individuals who do not belong to a leading institution or network.
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Not having a PhD or MD qualification is excluding people from applying to EDCTP even though they have extensive research experience.
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EDCTP could explore opportunities to work with ANDI Pan-Africa Centres of Excellence in Health Innovation, which bring together investors to help accelerate translation.
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The scientific community, including those in affected countries, fellows and researchers should be able to comment on the EDCTP Strategic Research Agenda.
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EDCTP may be able to identify and work with other partners to tackle regional disparities.
Panel discussion: Partnerships and collaborative strategies
The panelists shared their different experiences in partnering to tackle the regional research gap. The session was moderated by Ana Lucia Weinberg (EDCTP Strategic Partnerships Officer).
The panel consisted of Dr Leonardo Simao (EDCTP High Representative), Dr Sarah Jarvis (IAVI, UK), Temitope Isedowo (AFriLabs, Nigeria), Marissa Vicari (CIPHER, International Aids Society, Switzerland), and Dr Raji Tajudeen (Africa CDC, Ethiopia). Each of the panellists shared their perspective and organisational experience, and discussed the challenges in partnering and collaborating towards a common cause of building research capacity in Africa. This discussion was continued on day 2 in breakout sessions.
Dr Leonardo Simão
Dr Sarah Jarvis
Temitope Isedowo
Marissa Vicari
Dr Raji Tajudeen
Networks: A collaborative approach to close regional and gender disparities in research
Networks are known to be an efficient tool for bringing scientists and institutions together. This session provided an opportunity to hear the perspective of four different organisations/networks.
Dr Raji Tajudeen is Head of the Division of Public Health Institutes and Research at Africa CDC. He summarised the five pillars of Africa CDC – surveillance and disease, preparedness and response, laboratory systems and networks, information systems, and public health research and institutes. Among several possible solutions for closing the gender and geographical gap in Africa, he mentioned Africa CDC’s regional approach, which include Regional Collaborating Centres (RCCs) as well as RISLNET and REDISSE networks. He emphasised the need to leverage partnerships to address capacity gaps and pointed out that Africa CDC is partnering with numerous organisations in order to implement its programmes.
Rodrigues Matcheve is the Project Manager for Trials of Excellence in Southern Africa (TESA), an EDCTP Regional Network of Excellence. He began by describing challenges before 2009 – parallel efforts towards addressing research and clinical trials, silo working at national levels, and lack of sensitivity to gender issues in science across sub-Saharan Africa. He provided a brief summary of each of the four EDCTP-funded networks, their composition and strategies for addressing gender and geographical disparities. Combined, the Networks of Excellence proposed several solutions:
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Identify and establish linkages between strong and weaker countries/institutions (for EDCTP Fellowships as well as Networks of Excellence) to promote partnerships and mentoring.
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Include weaker institutions as co-applicants on grant applications, so they can upgrade their capacity.
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Facilitate access to specific skills of northern partners, with dissemination through South-South partnering.
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Create awareness and training on gender in institutions and also provide senior leadership teams with training to update their leadership skills.
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Issue bursaries for female scientists to travel with their families (to study or to attend conferences).
The four EDCTP Regional Networks of Excellence facilitate regional collaboration by uniting diverse institutions that bring to the network individual strengths in skills-based competencies and shared infrastructures for conducting clinical trials in areas such as GCP, GCLP, data management, laboratory techniques and epidemiology, in the context of ongoing clinical research. By collaborating, they learn and develop, and thereby raise the quality of clinical research and practice in sub-Saharan Africa.
Temitope Isedawo is the Director of Programmes at AfriLabs. AfriLabs is a network of 174 innovation centres across 45 African countries that supports hubs to develop entrepreneurs who will create jobs and innovative solutions to African problems. Among its objectives, AfriLabs has a commitment to capacity building, mentorship, networking and forming links that will serve as building blocks for the next generation of thinking. With such an extensive network already in existence and growing, this provides an opportunity to bring together young people with various interests in technology. Closing the gender and geographical gaps in research will require major advancements in technology and technology uptake on the continent.
The EDCTP Alumni Network and online platform was launched in 2017 to foster excellence and collaboration among the next generation of researchers (funded via EDCTP Fellowship calls). The EDCTP Alumni Network’s activities are coordinated by the EDCTP Secretariat (Shingai Machingaidze and colleagues in the Africa Office). Four working groups were established – for HIV (chaired by Professor Nicaise Ndembi), TB (chaired by Dr Abraham Alabi), malaria (chaired by Professor Pauline Byakika) and NIDs (chaired by Professor Takafira Mduludza). Together the Alumni Network and these working groups are aiming to create an enabling environment for students and early-career researchers, as well as established researchers, facilitating access to collaborators (South and North), cross-training of students and junior researchers, and sharing of resources within Africa.
Overview of sessions
Day two
Participants were randomly assigned into one of four groups for day 2 activities. Each group was assigned a facilitator to guide group discussions.
Summary of Recommendations for EDCTP
Gender-related recommendations
To EDCTP and various collaborating partners:
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Women should be encouraged to acquire a good education, gain the necessary skills and knowledge to be successful in their chosen career, and be self-confident, determined and ambitious.
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Mentoring and partnership with families, schools, communities and other stakeholders should be promoted to create enabling environments for women in science.
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Strong female role models who share their success stories can have a positive impact; such role models should be given opportunities to motivate others.
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Policies should be aimed at promoting careers for women in science with support and funding from both the public and private sectors.
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To collaborate with the African Union Women, Gender and Development Directorate, which is responsible for leading, guiding, defending and coordinating the AU’s efforts on gender equality and development and promoting women’s to encourage women in science initiatives.
To EDCTP Secretariat
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Consider anonymising proposals sent for review, to minimise risk of bias.
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Consider launching a separate fellowship programme for women or additional fellowship calls.
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Allow scientists with master’s degrees and work experience to apply for fellowship schemes (many excellent scientists, including women, are currently excluded from funding opportunities).
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Gender context should be addressed by all applicants – sections on gender could be added to all application forms and evaluated in the review of applications.
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Consider organising re-entry grants for women who have taken career breaks.
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Make travel grants available for women to travel with their families either for study or to attend conferences.
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Maternity cover for female scientists should be incorporated into grants – either by allowing a grant to be put on hold during maternity leave or by employing maternity cover (additional salary support required).
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Recognise the achievements of women at all levels (not just senior scientists).
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Collect data on gender to support evidence-based recommendations.
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In addressing these recommendations, the quality of applications should not be compromised to favour women – activities should better enable women to compete on a level playing field with men.
Regional disparities recommendations
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The visibility of EDCTP Networks of Excellence and the EDCTP Alumni Network should be raised, to increase awareness of the work they are doing and what they can offer to researchers from under-represented countries and female scientists, as well as collaborators.
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EDCTP RIA grants should facilitate the cross-training of researchers from under-represented countries so that they can gain hands-on experience in managing clinical trials.
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As grants are awarded to institutions rather than individuals, talented scientists who do not belong to a network can be excluded from participating in science. To address this issue, funding agencies such as EDCTP should develop mobility grants for scientists to work with a research group in a different country or region and jointly apply to EDCTP or other funders (going beyond traditional affiliation).
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The current eligibility requirement for a PhD or MD qualification is excluding people with many years of research experience from responding to EDCTP calls. Addressing this issue could have far-reaching implications, particularly for under-represented countries.
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Rules of participation permitting, EDCTP should consider having calls for proposals specific to lusophone and francophone researchers.
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EDCTP should explore the possibility of accepting applications in French and Portuguese.
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The scientific community, including those in affected countries, EDCTP Fellows and researchers should be able to comment on the EDCTP Strategic Research Agenda.
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Continued networking within regions and countries should be encouraged
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EDCTP should identify partners with which it can collaborate to tackle regional disparities; the EDCTP partnerships team should explore how other funders are addressing this issue.
Closing remarks were given by Dr Raji Tajudeen on behalf of Africa CDC and by Dr Leonardo Simão for EDCTP. Participants were thanked for actively engaging and contributing to a rich meeting, which provided EDCTP with a wealth of ideas and recommendations to take forward.