OPINION
(Published in the The Monitor, Kampala, Uganda, June 25, 2006)

Uganda: Reversing Brain Drain Can Be Easy…
If rewards and promotions are based talent, not seniority

By Carel Ijsselmuiden
Last month Uganda held its maiden President’s Science Awards ceremony as a
significant effort in recognising the often unsung heroes in the sciences.

President Museveni pledged that the country’s scientists would receive higher remuneration compared to other public servants, partly to discourage them from seeking
a higher salary abroad.

Like Uganda, many African and Asian countries have suffered the loss of health care workers such as nurses to northern labour markets in the past decade. The health research sector faces the same realities.

Loss of talent

There has been much debate around the issue of loss of talent and how countries can reverse it. Certainly, in low-income countries, the economic argument is a strong one.

Other equally important considerations are: a stimulating work environment; flexibility of employment (for women or men with young children, or time to pursue professional interests or studies); opportunities to get training and build skills; opportunities to take on
responsibility in early career. This means to have the possibility to become a project leader, manager, programme leader to participate in a multi-country team, or to travel and represent the organisation.

Equitable labour exchange

We need a dialogue between countries to have an equitable exchange of labour and avoid the wholesale ‘poaching’ of talent from the south to the northern labour markets.

Common responses have been to propose legislation or rules to encourage (or oblige) people to work in the country where they are trained. Beyond this, there is a lot of discussion and description of the ‘brain drain’ problem but few proposals for long-term solutions. But in this discussion about legislating against the flight of talent and improving dialogues between countries, some simple facts and solutions have not been addressed at all.

Institutions and managers with a modern style and dynamic programme will attract talent, even against higher salaries abroad. Donors and research sponsors can do a lot to increasing retention of talent by appreciating how some of their actions encourage brain drain.

Government leaders and their policies should engage these two groups to support a more professional approach to encouraging health research in the poorer countries.

How to do it

Leaders of southern health research organisations should learn the lessons of many northern counterparts and organise themselves to give more attractive work
opportunities, especially responsibility to researchers early in their careers. To motivate their staff, leaders of research organisations should create good governance and strong policies that encourage professional management of their talent base.

Today’s leading organisations are based on individual performance, not seniority. The best performers are rewarded with opportunities, responsibilities and salary increases – they can be of any age (even older too!) There are also staff rotation mechanisms, such as temporary attachment to project teams, shorter-term contracts – even for senior managers – to make room for new talent in an organisation.

All this creates an environment where professionals gain experience working in different teams and where they have frequent opportunities to assume new roles and move up in the organisation. Southern research organisations that embrace professional management practices and take investment in their people seriously will come out on top. This includes government departments, universities, health research councils and
NGOs.

Africa’s new leaders

Institutions that take this on seriously will become Africa’s leaders. They will build better quality partnerships, produce better quality research and attract more donor money.

And, as development donors focus more on measuring the performance of the organisations they fund, those institutes that are professionally managed will receive
more donor investment.

In my experience as a manager working with many African research colleagues and institutions, a big part of the issue is clearly a question of the old-style versus new-style of management. In the old style hierarchical structures, a researcher has to wait until 50 years or older before advancing to a position of responsibility.

The new-style approach

The new-style approach recognises talent and enthusiasm regardless of age. The current environment is most demotivating and a big limiting factor for young and mid-career professionals and technical specialists – the lifeblood of a national health research system.

Why would someone who can progress in a competitive, merit-based promotion system remain at home where the primary reason for promotion is age or political affiliation?

Clearly, working under a ‘lid’ means that talent moves sideways, migrating to research systems that award competence and commitment.

This seems to happen mostly in the public sector. Looking at the more commercial research systems such as the Pasteur Institutes in francophone Africa, it seems clear that there is much to be gained from modernising management in national health research.

Market forces

The development situation has its own ‘market forces’ that affect the human resources situation for health research. Through their funding and programmes, donors provide solutions to countries. But they are also a part of the problem that inhibits development of human resources for health research.

Project-based funding for southern research organisations does not encourage development of a professional cadre in institutions, or of their infrastructures. The fact that overheads are usually not covered in grant financing creates fragmented institutions without the essential support services needed to make research effective.

This includes a lack of sustained activities such as research support staff, IT and database development, research communication, publishing and library services, or professional staff focused on policy analysis or impact assessment.

In many regions, donors continue to work with the same group of intermediaries or ‘trusted contacts’ year-after-year, instead of using competitive processes based on
deliverables. This prevents new and younger research players from putting their ideas forward, stifling creativity and limiting the possibility for new talent to develop.

COHRED’s country support   

In our work to support countries in building their health research systems, the Council on Health Research for Development based in Geneva, encourages donors to support development of human resources in health research by working with wider groups of people and including more new players in projects and programmes, especially at the managerial level.

Donors should encourage broader south-south and north-south partnerships that involve new groups of people, beyond the same groups that have privileged access to donors and donor agendas. They should create a more open playing field for research funding
and lead by example.

A research manager from West Africa explained that a team of young malaria researchers she mentors hope to remain in their country and pursue their careers at home after studying partly abroad. I expect that this is the case with the majority of young researchers. The problem is the lack of opportunities to do solid work in their country.

Look toward the system

We should also look beyond ‘researchers’ towards the system. A July symposium to be held in Nairobi will focus on Human Resources for Health Research. It is looking at four key topics: research environment; networking in research; engaging communities; and
communication. These are topics that are usually forgotten yet they need to be addressed to make health research work – beyond health researchers.

Pressure Groups
The media and communication in the developed nations, communities – through organisations, lobbyists, pressure groups, and other modes – have greatly influenced how nations fund health research. Yet, in the low income countries this is not the case.

What is it that will communicate the relevance of health priority-related) research to populations, and how will these communities communicate their interests back to policy makers and researchers?

These are some of the questions we will be trying to address in Nairobi, and from there, in our ‘country-based’ science communication initiative that we started jointly with the Institute of Public Health at Makerere University.

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Prof. IJsselmuiden is the director of the Council on Health Research for Development, an NGO-based in Geneva. He has spent more than 20 years working in the fields of rural health care, public health and academia managing and building research teams in
South and southern Africa.