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

The paper reviews and reflects on TDR’s evolving approaches to strengthening research capacity in low- and middle-income countries (LMICs) since its inception in 1974. Initially, most tropical disease research was conducted in high-income countries, with limited LMIC capacity. TDR established a research capacity strengthening (RCS) programme to train individuals and build institutional capacity so endemic countries could generate and implement solutions to their own health problems. Oversight was provided by expert committees and embedded within UN-system collaborations. Regular reviews shifted emphasis over time from institutional strengthening (1980s) to human resources (1990s), and more recently toward demand-driven national health research systems and implementation/operations research. The purpose is to document lessons learned, describe models and tools developed, and highlight enablers and barriers to sustainable capacity in LMICs.

The paper situates TDR’s work within a broader, now widely accepted international effort to strengthen health research capacity in LMICs. It references prior analyses and reviews demonstrating the need for integrated, demand-led national health research systems, the value of multidisciplinary research (including social sciences), and lessons from decades of capacity initiatives. It draws on internal and external reviews of TDR programmes, examples such as the Multilateral Initiative on Malaria and ANDI, and good-practice guidance developed through ESSENCE on Health Research on planning/monitoring/evaluation, research costing, and principles of capacity strengthening.

This is a narrative, programmatic perspective from the TDR secretariat. It synthesizes historical programme documentation, internal reviews and committee recommendations, administrative grant records (e.g., TDR Information Management System), and illustrative case examples (e.g., MRTC in Mali; CIDEIM Regional Training Centre). No formal comparative or experimental methodology is described; rather, the article provides descriptive evidence, key metrics, and lessons learned from implementation across multiple decades.

• Institutional strengthening evolved from early non-competitive, long-term institutional grants to competitive, program-based grants requiring scientifically meritorious projects linked to local control needs and including training components (by 1987).
• Partnership Grants (from 1988, with Rockefeller Foundation) supported up to 5 years of LMIC–high-income institution collaborations, building infrastructure, training, and staff development; such competitive formats tended to favor more established LMIC institutions, prompting targeted schemes for low-income countries at various times.
• 1974–2010: TDR awarded grants to over 490 institutions in 45 countries.
• Impact examples: Contributions to malaria policy (e.g., long-lasting insecticide-treated bednets, understanding insecticide resistance, community-based management), creation of durable institutions (e.g., Malaria Research and Training Centre, Bamako), support of networks/centres of excellence, launch of ANDI (2008) with identification of pan-African centres and transition to UNOPS, and establishment of Regional Training Centres (CIDEIM–Americas; Gadjah Mada–SE Asia; Astana–Europe; RITM–Western Pacific; two more planned in Africa and Eastern Mediterranean).
• Individual capacity development: 1,438 postgraduate training grants (1975–1996), about one-third to least developed countries; high costs of traditional PhDs (~US$100,000) led to the ‘sandwich’ PhD model to enhance relevance and reintegration. 356 postgraduate training grants were awarded during 1997–2010; over 85% of trainees returned to home countries and remained active, often in leadership roles. After a restructuring lull, 22 new postgraduate and 9 postdoctoral awards were made in 2014.
• Additional instruments: re-entry grants (2-year research support to facilitate early-career reintegration), visiting scientist and postgraduate research grants, and career development grants to sustain research careers.
• Sustaining capacity challenges and responses: • Career pathways: Limited protected research time and heavy teaching loads in LMICs; emerging responses include CAMES promoting research and the NMIMR postdoctoral programme in Ghana to build competitive African researchers. • Leadership and management: Institutional success correlates with capable, committed leadership and long-term linkages more than academic titles. TDR piloted 10 leadership training grants (from 2007) but discontinued the scheme in 2010 due to limited demonstrable institutional impact; now disseminates project planning/evaluation training via Regional Training Centres and an online Professional Membership Scheme (PMS) launched 2012, which reached 292 registered members and over 5,000 visitors in 12 months. • Research aligned with national priorities: Emphasis on dissemination and translation into policy/practice; new initiatives include SORT IT to solve operational challenges in public health programmes and the Implementation Research Toolkit to address implementation bottlenecks.
• Coordination and harmonization: Fragmented funding led to selective support; ESSENCE on Health Research (launched 2009, secretariat at TDR) coordinates funders and aligns support with country agendas, producing good-practice documents on PM&E, research costing, and capacity strengthening principles.
• Enablers and barriers: Key enablers include strong leadership, sustained funding, infrastructure, equipment, networks, career paths, and mentoring; barriers include weak leadership, diversion to non-research tasks, political interference, poor remuneration/conditions, and weak quality control.

The descriptive evidence indicates that multifaceted, sustained investments across individuals, institutions, and systems can build durable research capacity in LMICs that contributes to public health impact. Early institutional grants established core capabilities; later competitive partnership and program-based grants improved quality and relevance by linking research to control needs and embedding training. Individual support, particularly context-relevant training (e.g., sandwich PhDs) and re-entry grants, improved reintegration and retention, with high return rates and progression into leadership. Networked approaches (MIM, ANDI, Regional Training Centres) fostered South–South and South–North collaboration, diffusion of skills, and regional hubs of excellence. Persistent challenges—career pathways, leadership/management capacity, and alignment with national priorities—are being addressed through targeted training (project management, implementation research), postdoctoral opportunities, and platforms recognizing professional development. Coordination mechanisms such as ESSENCE reduce duplication and promote alignment with country needs, while tools like SORT IT and the Implementation Research Toolkit aim to translate research into improved policies and practices. Overall, the findings support a shift from isolated training or infrastructure inputs toward integrated, demand-driven, implementation-focused capacity strengthening linked to health system impact.

Over four decades, TDR has contributed to building and sustaining research capacity in LMICs through an evolving portfolio: institutional strengthening, competitive partnership programmes, extensive postgraduate and early-career support, and regional and continental networks. The programme’s main contributions include scalable training models (e.g., sandwich PhD), catalytic institutional investments (e.g., MRTC), networking initiatives (MIM, ANDI), and pragmatic tools and platforms to enhance management and implementation research. Future directions emphasize: strengthening postdoctoral career pathways and protected research time; systematic development of leadership and research management capacity; expanding regional training hubs and alumni/mentoring networks; improving gender equity; and focusing on implementation-oriented, output-driven training and research tightly aligned with national priorities to increase evidence generation and uptake in health programmes.

This is a narrative programme account rather than a formal evaluative study; standardized impact assessment methods are not fully established, and attribution is challenging given multiple funders and actors. Competitive grant formats may have favored already-strong institutions, potentially widening disparities. Some initiatives (e.g., leadership training grants) lacked sustained institutional engagement and were difficult to evaluate. Fragmented funding environments can lead to selective support and neglected groups. The article relies on internal records and illustrative cases, which may not capture all contextual variations or negative outcomes.