CORRESPONDENCE: LETTER TO THE EDITOR
Reply
Poornima Prabhakaran, MBBS, Dip Epidemiol,
Vamadevan S. Ajay, MPH,
Dorairaj Prabhakaran, MD, DM, MSc and
Kolli Srinath Reddy, MD, DM, MSc*
* Vice-Chair, Initiative for Cardiovascular Health Research in the Developing Countries (IC-HEALTH), C-1/52, 2nd Floor, Safdarjung Development Area, New Delhi 110 016, India (Email: ksreddy{at}ichealth.org).
We thank Dr. Dakik for his interest in and comments on our article (1). We largely agree with his observations about the multifactorial determinants of the low research output related to cardiovascular disease (CVD) research in low-income and low-middle-income countries. We do, however, differ with some perspectives. For example, Dr. Dakik argues that collaboration with investigators in developed countries raises the quality of published articles. Although this is true to some extent, it hampers local capacity enhancement and original research from developing-country scientists, as in most such publications, the corresponding authors are from the developed country (data not shown). Further, there are hardly any collaborative studies aimed at improving health systems, quality of care, and translational research. Collaboration with developed-country investigators, in the absence of national funding, compels developing-country investigators to accept research agendas set by their funding partners. Availability of national funding for research enables a greater balance to be attained in research undertaken by developing-country investigators. The aim of our article was to raise awareness of the low priority afforded to CVD and to argue for enhanced allocation of resources to CVD prevention and control.
In addition, there is a lack of information on how the estimated $2.4 billion spent by low- and middle-income countries in health research and development in 2003 (2) was allocated across different disease or disciplinary categories. Although anecdotal information from these countries suggests that public-sector spending on CVD-related research is limited, this question needs further systematic quantification.
Although we need to further study the issues raised by Dr. Dakik, as well as other determinants of the volume and variety of CVD-related research, we cannot ignore the advancing epidemic of CVD in developing countries. Therefore, governments need to spend at least a small portion of their funds on translational and operational research for enhancing the provision of inexpensive, effective, and evidence-based care for established CVD and to develop cost-effective strategies aimed at health promotion for primary prevention of CVD.
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References
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1. Prabhakaran P, Ajay VS, Prabhakaran D, et al. Global cardiovascular disease research survey J Am Coll Cardiol 2007;50:2322.[Free Full Text]2. Global Forum for Health Research Monitoring Financial Flows for Health Research 2006Geneva: Global Forum for Health Research, 2006http://www.globalforumhealth.org/filesupld/monitoring_financial_flows_06/Financial%20Flows%202006.pdf 2007Accessed October 8, 2007.
Related Article
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The Challenges of Cardiovascular Research in Developing Countries
- Habib A. Dakik
J. Am. Coll. Cardiol. 2008 52: 83-84.
[Full Text]
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