Through GLOHRA, global health research contributes to development objectives
How can global health research and development cooperation strengthen each other? GLOHRA, a network for global health researchers in Germany, is providing part of the answer.
When Indian public health scientist Dr Sandul Yasobant came to Germany in 2017 to take his doctorate at the University of Bonn, he quickly became fascinated by the One Health approach that his PhD supervisor, Prof. Dr. Walter Bruchhausen, introduced him to. The more Dr Yasobant learned about One Health, the more clearly he recognised the many potential applications of the approach for the management of zoonotic diseases in his home country.
Today, seven years and nine research publications later, Dr Yasobant has founded India’s own One Health Centre of Excellence. In a cooperation between this Centre and the University of Bonn, he leads the Indian team of a research project called ‘OHHSIN: One Health System Strengthening in India’. The project is jointly funded by the German Federal Ministries for Economic Cooperation and Development (BMZ) and for Education and Research (BMBF) through the Alliance for Global Health Research (GLOHRA). This collaboration between the Indian One Health Centre of Excellence and the University of Bonn is a striking example of how GLOHRA is creating new opportunities for mutual learning for German and international research partners working together on an equal footing.
Why the GLOHRA network was created
Several factors led to the creation of GLOHRA: Germany’s growing ambition to contribute to international global health efforts; universities’ recognition of their “third mission”, i.e. their social responsibility in times of multiple global challenges; and overly narrow research funding criteria that meant it was often difficult for interdisciplinary global health researchers to get funding.
Prof. Bruchhausen, GLOHRA Co-Speaker and co-leader of the Indian-German OHSSIN project, says: ‘One research funder would say “Your proposal is too social for us” while another would say “This is too biomedical”. Interdisciplinary research was a clear priority for the global South but it wasn’t built into the German system of research funding.’ This changed when GLOHRA started operations in February 2020, just as the COVID-19 pandemic hit.
Initially, the GLOHRA network was funded solely by a €3 million budget from the BMBF. But in June 2022, BMZ came on board with an additional €700,000 of funding over 18 months. The aim of this additional funding was to strengthen cooperation with partners in low and lower-middle income countries (LMICs) in order to develop capacities and to turn research findings into policy and practice on the ground.
Identifying and mitigating against concrete One Health risks
The Indian-German OHSSIN research team, in collaboration with the All India Institute of Medical Sciences and the Datta Meghe Institute of Higher Education & Research, jointly developed the ‘One Health Risk and Disease Prioritisation Index’ (now patented by the Indian government) to identify and prioritise emerging One Health threats in three western Indian states – Gujarat, Rajasthan and Maharashtra.
The team trained health facility staff and community health workers in the use of this index to identify One Health risks and to mitigate against them, including by alerting and collaborating with veterinary departments and wildlife rangers. In total, more than 1,000 people were trained at 15 different training events held in both urban and rural locations across the three states. Both sides of this Indian-German research collaboration regard the experience as invaluable:
The collaboration allowed me to apply the One Health approach that I first learned about in Germany to the real-life settings in India. This is where key learnings happen – when you jointly put your theoretical understanding into practice in the field.Dr Sandul Yasobant, Indian Institute of Public Health Ganhinagar
Prof. Bruchhausen fully agrees:
As researchers, we’ve found it extremely helpful to be involved with the real life implementation of One Health approaches by our Indian partners. This has been development cooperation in the true sense of the word.Prof. Dr. Walter Bruchhausen, Global Health – Social and Cultural Aspects, Bonn University and GLOHRA Co-Speaker
Using mobile phones to manage chronic disease in Uganda
Another GLOHRA project co-funded by BMZ that has enabled rich mutual learning and capacity development is the IMPEDE-CVD project in Uganda.
This project has assessed the effects of a mobile phone app that enables adults with high blood pressure in a rural community in Uganda to contribute to the cost of their medication. ‘Only 9.4% of adults in Uganda with hypertension have controlled blood pressure. A key issue is the cost of medication. Many rural communities rely on governments supplies but these are inconsistent and often out of stock,’ says the project’s international team lead Dr Robert Kalyesubula from Makerere University, founder of the African Community Centre for Social Sustainability (Access Uganda).
About 190 adults with high blood pressure were recruited to use the app to contribute towards the costs of their medication. At the same time, 120 health workers were trained in identifying and treating patients with high blood pressure. The initial project results are promising: 74% of participants have made least one contribution via their mobile phone which, in turn, has brought down the prices as the local clinics are now able to buy the drugs in bulk. More patients have accessed treatment and about 90% of them now have controlled blood pressure because they are accessing medication and adhering to the prescription.
Dr Kalyesubula says the cross-disciplinary collaboration between social research scientists from the University of Heidelberg, data scientists from Charité University in Berlin and programming from mTOMADY (the multi-payer platform that connects beneficiaries to different health financing mechanisms) as well as local health workers, nurses and doctors has led to huge cross-learning about gaps and needs in a project of this kind.
We keep on coming up against challenges and then together we solve them. In the process, we’ve been able to do advanced research in a rural area and build local teams who know how to do social science research and how to apply for and manage grants without international support.Dr Robert Kalyesubula, Makerere University, and ACCESS Uganda
Building bridges and breaking down silos
Meanwhile, back in Germany, the German GLOHRA network continues to grow. Membership now stands at more than 1,000 and although the additional funding from BMZ will end in December 2023, the hope is that it has demonstrated what inter-ministerial cooperation can achieve to boost the impact of the BMBF funding.
Nora Anton, who heads the GLOHRA Secretariat and is Director of Global Engagement at the Charité Centre for Global Health, says that right from the start GLOHRA’s aim was to be more than just another network:
Our ambition was to build community and forge new connections that reflect the complexities of global health challenges. It’s great to see how our push for interdisciplinarity and new ways to collaborate is gaining traction and reaping rewards.Nora Anton, Managing Director of the GLOHRA Secretariat
Prof. Bruchhausen agrees that GLOHRA is helping to create a virtuous circle of learning, with all sides profiting from the cooperation: ‘In the case of the OHSSIN project, for example, we are taking the understanding we gained on the ground in India back to the German global health research community, so ensuring that future research better fits the needs of development practitioners and ultimately the needs of the people being served. In doing so, we increase the chances that development cooperation will be sustainable and successful.’