Millions of people in low- and middle-income countries (LMICs) stand to benefit from better health research but progress is stalling from a lack of support for clinical researcher careers, warns a new report from the Academy of Medical Sciences developed in partnership with six national academies in Africa, Asia and Latin America.
Clinical researchers are health professionals, including doctors, nurses and other clinicians, who combine direct patient care with scientific research. They occupy a unique position at the interface of health research and patient care, and their contributions are essential for ensuring that evidence-based innovations reach the patients who need them most.
The report sets out four recommendations to strengthen the clinical research workforce in LMICs - regions that have the highest health burdens and mortality yet also stand to make the greatest gains from unlocking the full potential of health research to improve lives.
Across many LMICs, the lack of formalised, recognised career pathways means that young researchers face significant barriers to entering and progressing within the field. The report finds stark similarities in these barriers across regions, despite the diversity of countries involved, with regulatory and ethics approval processes identified as an unexpectedly significant obstacle for early-career researchers.
Professor Shakila Thangaratinam FMedSci, Vice-President (International) at the Academy of Medical Sciences, said: “Investment in clinical research is an economic and public health necessity but talented researchers can only thrive when the system - the pathways, the funding, the recognition - is in place to support them. This report makes the case that strengthening clinical research pathways requires coordinated action across the whole health research ecosystem, and the Academy of Medical Sciences is committed to supporting that work, both here in the UK and globally.”
The report’s four recommendations call on academic institutions, health policymakers, funders and regulatory bodies to act by:
- Recognising clinical research as a formal career pathway, with improved collaboration between academic institutions and health systems to develop clear policies that integrate research and clinical practice.
- Academic institutions actively fostering interest in clinical research from the undergraduate stage onwards, through structured mentorship and incentives for research activity.
- International and domestic funders offering greater flexibility in their funding schemes, recognising that clinical researchers often progress more slowly due to the dual demands of research and patient care.
- Focusing efforts on understanding and addressing the burden of regulatory and ethics approval processes on early-career clinical researchers, with a view to streamlining these without compromising rigour.
The report emphasises that these are not challenges for individual researchers to overcome alone. Strengthening clinical research pathways requires systemic change at institutional and national levels, and the report stresses the importance of shifting towards domestic-led financing for health and research – ensuring that funding is directed by country voices, priorities and context-specific needs. As the report notes, the economic returns from better population health are well established, making investment in clinical research both a health imperative and a sound economic decision, particularly as research and health budgets come under increasing strain from shifts in international funding.
The Academy’s work was informed by evidence-based gathering workshops held in Africa, Asia and Latin America, alongside commissioned research from the Centre for Capacity Research at Liverpool School of Tropical Medicine. The international working group brought together expertise from the Academy of Sciences of South Africa, African Academy of Sciences, Academy of Sciences in Malawi, National Academy of Medicine and National Academy of Sciences in Brazil, National Academy of Science and Technology in the Philippines and the Indonesian Academy of Sciences.
Read the full report: https://acmedsci.ac.uk/file-download/global-clinical-research-career-pathways-report
Read the external analysis: https://acmedsci.ac.uk/file-download/global-clinical-research-career-external-analysis
Read the executive summary: https://acmedsci.ac.uk/file-download/global-clinical-research-career-pathways-executive-summary