The importance of research assessment to accelerate the development of global health innovations for emerging and neglected infectious diseases

By Maria Elena Bottazzi (Baylor College of Medicine)

Research assessment can be extremely useful as a tool to evaluate the quality and the impact of the activities needed to achieve the Sustainable Development Goals (SDGs). The SDGs, adopted in 2015 by the General Assembly of the United Nations (1), envision that by the year 2030 the world could be transformed. Targeting 17 audacious goals, the world would achieve sustainable development for all its inhabitants by implementing educational and health strategies, while also tackling climate and environmental protection. With this line of thought, in 2013 the Lancet Commission on Investing in Health highlighted in its report “Global health 2035” that to achieve global health impact, especially in Low- and Middle-Income Countries (LMICs), high priority should be given toward research & development (R&D) of affordable and accessible health products (2) . In 2018 WHO, UNICEF, and others marked the 40th anniversary of the Declaration of Alma-Ata with a conference commemorating and reinforcing the idea that to protect and promote the health of all people there is an urgent need for 1) the development and testing of new and improved diagnostics, drugs, and vaccines for emerging and neglected infections; 2) an increase in preparedness for pandemics, especially for influenza; 3) the expansion of support for non-communicable disease control programs and access to essential medicines; 4) an increase in research on comparative effectiveness and evidence to measure the quality of health systems and their self-sufficiency and resilience; and 5) the provision of resources to multilateral agencies to strengthen fiscal, regulatory, ethical, and legal infrastructure (3).

Universities, through their clinical, research, education, and service missions, are key players in helping to protect and promote the health of their communities and are increasingly becoming prominent and critical players not only in basic science discovery but also in the translation of research from the bench to the clinic and are even extending toward becoming centers for entrepreneurship and biotechnology incubators (4). To take full advantage of the benefits of translational research, however, we need to change the paradigm and improve the ways in which scientific (basic, translational, clinical, and community) research is evaluated. Academic research is becoming more robust and reproducible and is part of the building blocks or critical paths needed for biomedical product and clinical development including regulatory-enabling studies. A better understanding and implementation of the DORA principles would be an essential step toward academic institutions achieving this goal. For example, it would be very interesting to see how the changes in research assessment within an academic setting could lead to improved faculty searches and review with the goal to recruit, build and retain stronger team-based and multidisciplinary groups leading to the creation of innovative biotechnology centers of excellence tackling the SDGs.

The National School of Tropical Medicine (NSTM) and its Center for Vaccine Development (Texas Children’s Center for Vaccine Development, a.k.a. TCH-CVD) at Baylor College of Medicine (BCM) in Houston, Texas is an example of such a biotechnology center of excellence, not only contributing to the mission of BCM but also harnessing the horsepower of biotechnology knowledge of the renowned Texas Medical Center (7). The TCH-CVD is devoted to the study of the emerging and neglected diseases, which disproportionately afflict the world’s poorest people, by leading efforts toward the development and testing of low-cost, safe, accessible, and effective vaccines and diagnostics. More specifically, TCH-CVD operates as a so called “product development partnership (PDP) model” (4-6), being the only existing PDP embedded within a health sciences university.

PDPs use a partnership or consortium structure approach, comprised of public, private, academic, governmental, and/or philanthropic entities, that collectively build, secure, share, and advance knowledge, human capital, resources, and expertise for the development of global health innovations and products for the public good. To be effective, PDPs must ensure that at each partner institution, the profiles and expertise of the members (faculty or staff) that participate in the consortium are complementary and multidisciplinary. Therefore, it would be important that these institutions use more equitable assessment tools with greater weight on the quality and the impact of research while performing searches, recruiting or promoting members who are part of big consortia, program projects, or partnerships.

Because the PDP operational model relies heavily on team science, collaborative, transparent, and transdisciplinary interactions and the generation of critical path regulatory-enabling research, it is essential that groups such as TCH-CVD and others that work as consortia attempt to align, support, and lead institutional change towards the improvement of the measurements of quality and impact of scientific outputs. Team science is a critical research assessment pillar and is slowly being recognized at institutional levels during faculty evaluations, by funders as part of the application criteria and reviewing process, and by publishers when applying the Contributor Roles Taxonomy (CRediT) levels.

For example, in 2017, to address and recognize the paradigm shifts of faculty contributions in the medical biotechnology and translational research fields, NSTM participated in a series of working groups coordinated by the BCM institutional Faculty Appointments and Promotions (FAP) Committee (8). The working groups were charged to evaluate expanded areas to be considered as important factors and as part of the faculty contributions to excellence in the areas of 1) commercialization, innovation, device development; 2) health care quality, patient safety, health and science policy; and 3) academic administrative leadership or service. The working groups found merit in incorporating all these expanded areas for the evaluation of institutional faculty appointment and promotion packages, and since then the BCM FAP committee has included these criteria as part of the evaluation process (9).

I am very appreciative of the invitation to participate on behalf of NSTM at the DORA-HHMI workshop this October 2019. Learning how we can increase awareness, promote appropriate and transparent tools and metrics to establish better practices and measure the quality and the impact of scientific outputs will undoubtedly be transformational. This is especially important since biotechnology research is rapidly evolving into areas of great complexity, including big data, system biology, and gene editing, that will require novelty in managing ethical and legal repercussions, generation of intellectual property, and open access and sharing plans with the research community. My hope is that we can become a more united front improving research assessment policies and practices ultimately influencing policy and practice.