Academic Research Organizations in Latin America
Dr. Jhonny Beltrán
This text constitutes the personal opinion of the author, issued based on his experience and his interpretation of bibliographic sources.
Academic Research Organizations -ARO- (Academic Research Organizations) could be defined as those that have the human and technological resources that allow them to face specific research initiatives, and that are normally linked to universities or academic institutions.
In the context of biomedical research, various organizational prototypes could be considered as AROs
- 1. Institutes or university centers created expressly for this purpose
- University hospitals or medical centers with autonomous research divisions.
- Organizations that are dedicated to the provision of formal research services.
As there is a significant gap between conducting research activities and the ability to generate new knowledge according to existing needs, medical centers dedicated exclusively to conducting sponsored clinical studies, but unable or not, can be excluded from the definition. interested in getting involved in the significant development of research, or to those educational organizations where courses or training in epidemiology or research are given, but who do not participate in the production of new knowledge in a consistent or significant way.
Traditionally, and in contrast to AROs, there are also Contract Research Organizations (Contract Research Organizations), which were born from the need to supply the entire logistics chain necessary for the development of a clinical trial that goes from the development of a drug until it becomes available to the treating physician and his patient. They can provide a whole range of services, ranging from design to writing publishable texts. However, few incipient initiatives in our environment behave more like mediators or negotiators of the sponsors of the industry, limiting themselves to monitoring the execution of a project, without giving too much importance or having divisions destined to the management or support of the local investigative infrastructure.
The existence of such heterogeneous organizations can be seen differently in our environment or in the context of a highly developed country. In the North American or European environment it could be interpreted as a “division of tasks”, in which each of the actors assumes a role in a highly specialized and interrelated environment. In Latin America, the different actors of the investigative process – government, private industry, academic institutions, health services and professionals – can be perceived as separate entities for this purpose, so different that they cannot be interrelated.
And it is in this scenario that in Colombia, universities, scientific organizations and university hospitals should play a more important role in understanding and managing the investigative process as a whole, aiming because the contributions of all actors can be combined to advance in the development of the country.
Numerous academic institutions in the world carry out research in response to problems. Organizations like the Harvard Clinical Research Institute (HCRI) pride themselves on conducting high-quality, impactful studies that improve patient care and update public health regulations and standards of treatment. This type of institution has a technological weaponry and financial resources for this, and they do not close themselves to any of the possible sources of financing. In the competitive North American or European academic milieu, although there is a distinction between proprietary and industry-sponsored research, there has never been a prejudice of regarding proprietary research as “sponsor-less” and therefore independent in a naive sense. .
Unfortunately in our environment, organizations of an academic nature, jealous of a supposed scientific independence and sometimes slaves of publication metrics, have ignored, or do not know how to properly interact with the real sector, which prevents them from having greater access and use of resources from sources other than institutional or governmental. It is not unusual for the directors of medical schools or university hospitals, as well as some scientific leaders in our midst, to refer to sponsored clinical research as a simple maquila with no added values.
This academic zeal, which in the Latin American village may be influenced by anti-imperialist prejudices or by an archaic vision of scientific development, ignores the modern need to work in networks to achieve new advances. The idea that science continues to be built alone by geniuses like Pasteur or Fleming can be both incorrect and destructive. It is true that our countries must exercise critical judgment when deciding to participate in large, industry-sponsored research, but it is necessary to judge the big picture in the right context. While international industry sponsored clinical research tends to address issues endemic to developed countries (hypertension, obesity, cardiovascular disease, or cancer), while employing our patients as study subjects, it is also necessary to take into account that:
- Non-communicable diseases have ceased to be a problem only in developed countries, to become a serious issue in Latin America as well.
- Non-participation in large multinational trials may result in a lack of evidence about the safety and efficacy of drugs in our populations.
- There is hardly any other environment more useful for the clinician to consolidate the scientific method and epidemiological concepts than that of randomized clinical trials. There is little doubt that participation in highly controlled and monitored studies allows gaining an experience that can be extrapolated to conducting local studies. Methodological, logistical, and ethical aspects such as the application of informed consent, the management of electronic case report formats, and the structuring of complex databases are topics that Latin American doctors in training tend to learn in an artisanal way, but that can be demanding and highly complex. The contacts and learning opportunities that are generated in the interaction of academic, clinical and administrative personnel involved in conducting an international study can be reinvested in the creation of spaces and capacities to design, execute and analyze high quality local studies, which, together with the experience of the clinician, can give this recipe a masterful flavor. And by the way, jobs and economic resources can be generated. The most important AROs in the world generate a high impact. They serve within the university community and sell services to highly demanding external sponsors. They are profusely multidisciplinary and provide solutions to the real problems of humanity. Although it is true that for the AROs of our countries to achieve the necessary size that allows them to assume leading roles worldwide, they must first provide solutions to local needs, not for that reason they should isolate themselves or stop learning from other models, some imported of the real sector, or to recognize that in science there are also economic interests that are necessary, but adjustable.
At the end of the day, as Francisco Cajiao says in his opinion column in the newspaper El Tiempo of May 2, 2016 “The recommendations of the OECD”, it is better to be in the group of more developed states than to persist in the doubtful merit of be among the most unequal.