Soft Research on Malaria

Dear GrantDoctor,

I have followed your advice, sought out career-center help, jogged, and walked slowly through the Internet, and I am still searching.

Here is my area, and that may be part of the problem. I am an African-American citizen seeking funding for a Ph.D. program at an African university to study patient-compliance issues regarding the disease-state malaria. I hold an M.A. in medical anthropology.

I either find grants for hard medical study of malaria, and not with the social science factor, or I find grants for the social science factor but only for postdoc research. I am in-between and have done my best to structure my search and my request for funding to various institutions to reflect this odd standing within these two fields. Any pointers?


Dear Phoenix,

Considering the extent of the problem, malaria remains an underfunded disease. About $100 million is spent each year on malaria research and prevention. That's just a few pennies for each person who gets sick from malaria each year. According to new data from the Multilateral Initiative on Malaria, between 700,000 and 2.7 million people die each year from malaria, about three-quarters of them African children.

The good news is that the funding trend is upward. The Wellcome Trust and the U.S. National Institute of Allergy and Infectious Diseases, part of NIH, have both dramatically increased support for malaria research in recent years, and several international efforts have arisen, notably from the World Health Organization (WHO). WHO has committed itself--along with the United Nations Development Program, the UN Children's Fund, and the World Bank--to cutting in half the number of malaria deaths by the year 2010.

Even better is news that there is an increasing international focus on "capacity building"--that is, on building infrastructure so that underdeveloped countries will have the capacity to test and implement new medical technologies. This goes beyond cutting-edge "hard" medical science to issues of logistics and development of medical infrastructure--work that has a social sciences component. If, as I expect, you are eager to do practical, applied, important work, your interests may fit very well into this relatively recent pragmatic reorientation of the international research effort.

You imply in your message that you have exhausted the usual avenues. Perhaps you have. But the GrantDoctor rarely misses an opportunity to teach a lesson--and besides, there's a chance you might have missed something. So I'll start with the options you've probably already tried and ruled out, if only for the benefit of other readers.

In the U.S., the most important source of funding for international medical research is NIH, in particular the National Institutes of Allergy and Infectious Diseases (NIAID) and the John E. Fogarty International Center for Advanced Study in the Health Sciences (FIC). According to its mission statement, the FIC "promotes and supports scientific research and training internationally to reduce disparities in global health." Kathleen Michels, program director of Fogarty's Division of International Training and Research, suggests that you visit FIC's Web site for general information and their online directory of international funding opportunities.

So now, Phoenix, I'll tell you what you probably already know: The NIH isn't an ideal fit. They can't help you, at least not directly. They don't offer the sort of predoctoral fellowship you are seeking. They do offer some graduate-level training grants, but they're almost always for study at NIH research centers--"or selected institutions nationwide." They offer nothing that will support you in a Ph.D. program at an African university. Furthermore, though they are interested in developing public-health capacity, they aren't particularly interested in patient-compliance issues.

But don't give up just yet. You are, after all, determined to do your work--or should be--and you won't take "no" for an answer--or shouldn't. So what other avenues are available? Michels of the Fogarty Center writes: "Patient compliance issues are not a specific interest of ours, but could be included in a relevant proposal on malaria which is a specific interest of ours."

Read between the lines: The NIH cannot support you directly, but that doesn't mean they can't support you. Most of their grants are either institutional program grants or single (senior) investigator research grants. The trick is to hook up with an established researcher who is doing work that interests you--preferably a researcher who is already well funded. If you haven't already done it, that is the next step: Seek out a researcher. Even if you were to find a graduate traineeship that will fund you directly, an established researcher who is enthusiastic about your participation will greatly increase your chances. By the way: Michels encourages you to contact her directly to get more advice. Drop me a line and I'll send you her e-mail address.

How do you find an appropriate researcher? Read the literature in your field. Figure out who's applying for and winning grants (most agencies post this information online). Give those senior researchers a call or send them an e-mail and express your interest in working with them. Don't be a pest, but don't be a shrinking violet, either. Persist. Most researchers will be impressed by determination: They are looking for motivated students. Once you've found a scientist who is willing to go to bat for you, the details--trivial things like getting admitted to an appropriate degree-granting institution and finding money for food and shelter--may well fall into place, though there are no guarantees.

The GrantDoctor is well aware that this is not the way most future graduate students usually go about things. It's much more common to decide what institution they wish to attend and then, once there, to figure out what they will do there and with whom they will work. But you seem to have a pretty good idea already of what sort of work you want to do, and--anyway--who you work with is way more important than the institutional affiliation of that person.

Once you've found a scientist to work with, you can offer to help develop a research proposal that includes funding for your position. If you're a strong candidate with good ideas, you can probably be persuasive--and helpful. And if you're not a strong candidate with good ideas, you should read and study until you become one. The Fogarty Center and NIAID have several programs aimed at scientists doing malaria research in Africa--especially scientists based at African universities. To learn more about these programs, visit the FIC and NIAID Web sites. A Sampling of Ongoing Malaria Research in Africa

  • University of Ibadan College of Medicine, Nigeria: Incorporating sociocultural/economic characteristics of mothers/care-givers in home management of childhood malaria

  • Centro de Investigacao en Saude de Manhica Maputo, Mozambique: Malaria transmission intensity and mortality burden across Africa

  • Ministry of Health and Population - Community Health Sciences Unit, Malawi: Optimal antimalarial drug policies in Malawi; monitoring and limiting evolution of resistance to widely used drugs

  • International Centre of Insect Physiology and Ecology, Kenya: R&D partnership in bioprospecting for antimalarial, mosquito repellent, and insecticide plants in East Africa

  • Université du Mali Ecole Nationale de Medecine et de Pharmacie, Mali: Surveillance and control of drug-resistant malaria

You should also keep your eye on WHO's Multilateral Initiative on Malaria/Tropical Diseases Research (MIM/TDR) Task Force on Malaria Research Capability Strengthening in Africa. The WHO/TDR Web site says: "The MIM/TDR grant provides support to core African research groups for the development of malaria control tools." This is a major international initiative; it is not, however, a traineeship for graduate students. The trick--as with NIH's FIC programs-- is to hook up with a well-funded senior researcher.

It is good that you know exactly what you want to do. But you should be willing to settle for less than a perfect situation, at least in the short term. You may not be able to do exactly the work you want to do and still eat--in part because that may not be the work that needs doing. WHO-sponsored research programs span sub-Saharan Africa (see sidebar), from Mali to South Africa. Many of these programs seek to document and understand pesticide and drug resistance patterns (and other issues) as they relate to the spread of malaria. Another goal of current efforts is to expand the local capacity for clinical trials of potential vaccines and malaria treatments. None of this is patient compliance, precisely, but it is important research with a social-science component, and your background in medical anthropology may prepare you well for this kind of work.

Best of Luck.

--The GrantDoctorDue to the high volume of questions received, The GrantDoctor cannot answer all queries on an individual basis. Look for an answer to your question published in this column soon! Thank you!

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