80 years of health research in Panama
Dr. Jorge Motta is a Consultant Physician in Panama. He is a past director of the Gorgas Memorial Institute for Health Studies in Panama. He shares his experiences on research in Panama, and the institute’s contributions to national and international research, over the past 80 years.
You headed the Gorgas Memorial Institute for Health Studies, what is this Institute about? Why was the Gorgas Memorial Institute for Health Studies established?
Gorgas Memorial Laboratory was established to continue the work on infectious diseases that affected for centuries and continues to affect our region. It was given that name to honor the person that was in charge of the sanitation of Havana and latter Panama City, Dr. William Crawford Gorgas. His work made possible the construction of the Panama Canal and had great impact in the sanitary policies of our continent. He ended his illustrious career as the physician in charge of the US troops in Europe during World War I where he faced his last great public health challenge with the influenza pandemic of 1918.
I was the Director General of Gorgas from 2004 to 2008. At present, I am a research associate.
Today, tropical disease research is done worldwide. How do ensure that Gorgas is not duplicating what is done elsewhere? What criteria do you use to select research projects?
Gorgas has is evolving to become Panama’s national institute of public health because it has taken on responsibilities of research, reference and health training. At present, we work on tropical diseases that affect our country and region like malaria, Chagas, and cutaneous leishmaniasis. We also have large programmes on HIV, HPV, influenza and other infectious diseases. Gorgas tries to resolve specific national and regional questions and this type of work, focused on specific country problems, is less prone to duplication of what is done in other continents.
In the last five years, Gorgas began to engage in research related to non-communicable diseases. I would not be surprised if, in 20 years, our chronic diseases portfolio is larger than infectious diseases.
Today, project selection criteria are the opportunity and interest of the researcher. This will change as Gorgas will align with the defined priorities health research needs of the country, especially in research projects financed by Panama.
The Institute has been in existence for more than 80 years, what are some of your achievements?
Our early work on mosquito insecticides and antimalarials. The knowledge derived from human clinical trials with early antimalarials done in the 1930s and also being one of the first laboratories that tested the effectiveness of insecticides like DDT. Gorgas also established a reputation for excellent work in entomolgy, parasitology and arbovirolgy. More recently, Gorgas contributed to the rapid identification diethileneglicol as the cause of a massive population poisoning which has probably been Panama’s greatest public health tragedy.
How have you ensured that other low resourced nations benefit from these achievements?
Gorgas is a reference laboratory for HIV and other virus for Central America. Since 2006 we have directed a regional health training centre that has benefited more than 400 trainees from the region in topics related to influenza pandemic preparedness.
Typically, research is not high on the agenda in many low income countries. How has Gorgas managed to sustain research over the years? What is your advice to other research institutes in developing nations?
It has not been easy and continues to be a struggle. It takes time and good work to gain citizens’ confidence; and in this way influence politicians.
My first advice is to find a way to obtain a political commitment from the highest authorities i.e. the President or the Prime Minister. This requires constant and skilled diplomatic work that is made easier if the institution is recognized and respected in the country. In countries where there is a ministry of science and technology, this work is easier because there is someone at cabinet level arguing in favor of research.
Other advice is to compete in the international arena. Here the struggle is also not easy because of the intense competition for funds. Here research institutions from developing nations have to work at least twice as hard. I remind members of our institute that there is only one standard and that we have to produce proposals up to the international standard.
What are some of the challenges has Gorgas has faced over the years?
The periodic changes in the heads and directors of Ministry of Health, which is the entity for which we work, makes difficult the coupling of research results to defined public health agendas. The other challenge is the weakness of the public administration procedures, which makes simple things – such as procurement of reagents – an exhausting job. Finally what I consider the greatest challenge is maintaining the professionalism of its staff and fighting off the infiltration of party politics into the institute’s governing structure.
You were recently elected as Chair of the Joint Coordinating Board of the Special Programme for Research and Training in Tropical Diseases, what do you envisage as your role in this committee?
This is an opportunity for me to advocate effectively for developing health research in countries that suffer a disproportionate burden of poverty related infectious diseases.