Strengthening Research Capacity—TDR's Evolving Experience in Low- and Middle-Income Countries

The paper addresses how TDR (the Special Programme for Research and Training in Tropical Diseases) has evolved its approaches to strengthen research capacity in low- and middle-income countries (LMICs) over its 40-year history. Initially, most research on tropical diseases was conducted in high-income countries, and there was minimal investment in LMIC capacity. TDR set out to build both human and institutional capacity so disease-endemic countries could generate and apply solutions to their own health problems. The study is situated in the broader context of increasing global recognition of research capacity strengthening, the emergence of multiple funders, and the need to align research with disease-control priorities. It highlights TDR’s intertwined strategy of individual training and institutional collaboration, continuous programme reviews, and emphasis on multidisciplinary and implementation research.

The paper references prior analyses and reviews on capacity strengthening and TDR’s role, including: TDR programme reports and retrospectives documenting shifts from institutional to human resource strengthening and advocacy for demand-driven national health research systems; broader literature on building capacity in LMICs; analyses of the Multilateral Initiative on Malaria’s impact on African research leadership and policy change; network approaches to capacity strengthening in China and Eastern Asia; development of pan-African centres of excellence (ANDI); and good practice guidance from the ESSENCE initiative on planning, monitoring and evaluation, and research costing. The literature underscores the importance of leadership, institutional environments, mentoring, and alignment with public health priorities, while noting challenges in measuring impact and translating research into policy and practice.

This is a narrative, experience-based overview from the TDR secretariat describing evolving approaches to research capacity strengthening in LMICs. It synthesizes insights from regular programme reviews by TDR’s Scientific and Technical Advisory Committee (STAC), administrative records (e.g., TDR Information Management System), and selected case examples (e.g., Malaria Research and Training Centre in Mali; CIDEIM Regional Training Centre in Colombia). The account integrates quantitative summaries of grants and trainees over time and references to external initiatives (e.g., ANDI, ESSENCE, SORT IT) to illustrate models, outputs, and lessons learned. No formal comparative or experimental methods are reported.

• Institutional strengthening evolved from non-competitive, long-term grants to competitive programme-based and partnership grants linking research to disease-control needs and staff development. A decade after inception, 89 institutions had received support; by 1974–2010, more than 490 institutions in 45 countries received TDR grants.
• Partnership grants (from 1988, co-funded with the Rockefeller Foundation) supported up to 5 years of collaboration between LMIC and advanced institutions to build infrastructure, training, and scientific expertise, including staff development for postgraduate students.
• Institutional impacts include the development of the Malaria Research and Training Centre (MRTC) in Bamako, Mali, which grew from 4 to >30 researchers, expanded into multiple diseases, and became part of Mali’s ICER; seed funding catalyzed substantial follow-on support (e.g., USAID, NIH, European Commission).
• Network approaches strengthened regional collaboration: the Multilateral Initiative on Malaria (MIM) paired North–South institutions and trained individuals, with alumni now in national/international leadership; research contributed to policy changes (e.g., LLINs introduction, insecticide resistance surveillance, community-based malaria management). ANDI (launched 2008) identified Pan-African centres of excellence to foster R&D and manufacturing capacity and is transitioning to UNOPS.
• Regional Training Centres (RTCs) now act as hubs for skill acquisition in WHO regions. Four centres are operational: CIDEIM (Colombia, Americas), Gadjah Mada University (Indonesia, SEARO), Astana Medical School (Kazakhstan, EURO), and the Research Institute of Tropical Medicine (Philippines, WPRO), with two more planned (AFRO, EMRO). CIDEIM scaled TDR’s EPPE course and expanded a regional training network and curriculum integration.
• Individual capacity development: 1,438 postgraduate grants (1975–1996), about one-third to candidates from least developed countries; shift to a “sandwich” PhD model to combine excellence with relevance and facilitate reintegration; 356 postgraduate grants (1997–2010); >85% of grantees returned home and remained active, attaining senior/leadership roles. After restructuring, 22 new postgraduate grants and 9 postdoctoral fellowships were awarded in 2014.
• Re-entry grants provided 2-year research-based support to facilitate early-career development and establishment of independent research groups.
• Sustaining capacity requires addressing three issues: (1) career path recognition (postdocs often overloaded with teaching; emerging responses include CAMES promotion of research and NMIMR postdoc programme); (2) institutional leadership (success linked to capable, committed leadership and stable linkages; leadership development needs long-term investment in management competencies and research offices); (3) alignment with national priorities and translation to policy/practice (weaknesses noted in uptake pathways; productivity should include policy and practice impact).
• Leadership training grants (2007) aimed to complement scientific skills with management and governance exposure; despite 10 awards, the scheme had limited institutional impact and was discontinued in 2010 due to execution and evaluation challenges.
• Tools to improve practice and uptake: SORT IT supports programmes to address operational challenges; the Implementation Research Toolkit guides teams to tackle implementation bottlenecks.
• Professional Membership Scheme (Global Health Trials platform) piloted to recognize competencies and productivity; within 12 months, 292 registered members and >5,000 visitors.
• Coordination of funders: ESSENCE (from 2009) convenes major funders to align investments with country agendas, leading to jointly developed good practice documents on PM&E frameworks (2011) and research costing (2012), and a set of principles for capacity strengthening.
• Enablers and barriers synthesized (Box 3) emphasize leadership, vision, sustained funding, infrastructure, equipment and information access, networks, career paths, and mentoring; barriers include weak leadership, diversion to non-scientific tasks, adverse political climates, poor remuneration/conditions, and weak quality control.

The narrative demonstrates that research capacity strengthening in LMICs benefits from a combined strategy targeting individuals (training, re-entry, postdoctoral support), institutions (infrastructure, management, networks), and systems (policy alignment, funder coordination). Early investments in institutions and partnership models created hubs of excellence and catalyzed additional funding, while integrating training ensured a pipeline of local scientists who returned and assumed leadership roles, contributing to national policy changes (e.g., malaria control strategies). Evolving from non-competitive to competitive grants enhanced scientific quality but risked favoring more established institutions; targeted support helped address inequities for low-income settings. Persistent challenges—postdoctoral career pathways, leadership and management capacity in institutions, and translating evidence to policy and practice—require long-term, structured interventions. TDR’s recent initiatives (RTCs, SORT IT, Implementation Research Toolkit, PMS, ESSENCE coordination) directly address these gaps by enhancing research management skills, promoting implementation science, recognizing competencies, and aligning funder efforts with country priorities. Collectively, these approaches align capacity building with public health impact by emphasizing output-oriented training and evidence uptake in health programmes.

Over four decades, TDR has contributed to strengthening research capacity across three generations of scientists and hundreds of institutions in LMICs through intertwined support for individuals, institutions, and collaborative networks. The programme’s evolution—from foundational institutional grants and North–South partnerships to targeted postgraduate and re-entry support, regional training hubs, implementation-focused tools, and funder coordination—illustrates a shift toward demand-driven, impact-oriented capacity building aligned with national priorities. Future directions include: expanding postdoctoral and early-career support with protected research time; systematically developing leadership and research management capacities; enhancing mechanisms and metrics for translating research into policy and practice; addressing gender imbalances; and leveraging alumni networks for mentoring and sustained collaboration. TDR plans to continue output-oriented training for public health practitioners to accelerate generation and uptake of evidence to strengthen implementation in LMICs.

The account is a descriptive overview from the TDR secretariat rather than a formal evaluative study. The authors note a lack of consensus on how best to assess the impact of TDR support, limiting comparability and generalizability of impact estimates. Competitive grant formats inadvertently advantaged more established institutions, potentially biasing capacity gains; although mitigations were attempted, this remains a consideration. The leadership training grant scheme could not maintain institutional linkage and was discontinued without a robust evaluation of institutional impact. Fragmented global funding can lead to selective support and neglected groups, complicating attribution and system-wide assessment.