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

The paper examines how the Special Programme on Research and Training in Tropical Diseases (TDR) has evolved approaches to strengthen research capacity in low- and middle-income countries (LMICs). At inception in 1974, little research targeted diseases prevalent in LMICs and most work occurred in high-income countries. TDR prioritized research capacity strengthening (RCS), allocating up to one-third of resources to train individuals and strengthen institutions so LMICs could generate and apply solutions to their own health problems. The purpose is to describe TDR’s intertwined, evolving strategies—individual training and institutional partnerships—within the broader UN system context, and how periodic reviews shifted emphasis from institutional strengthening (1980s) to human resources (1990s) and toward demand-driven national health research systems, multidisciplinary research, and implementation/operations research.

The narrative references and builds on several streams of prior work: early TDR reports documenting shifts from institutional to human resource strengthening and calls for demand-driven national research systems; broader literature advocating capacity building in LMICs and integration of social and biomedical sciences; analyses of partnership models (e.g., Multilateral Initiative on Malaria) and network approaches; and critiques highlighting challenges translating research into policy and addressing fragmented, selective funding. It also cites best-practice frameworks (ESSENCE) for planning, monitoring and evaluation of RCS, research costing, and principles of capacity strengthening. Collectively, the literature supports coordinated, context-relevant, and networked approaches to RCS, with attention to leadership, career paths, and alignment with national priorities.

This is a descriptive account from the TDR secretariat’s perspective, outlining programmatic approaches and lessons learned over four decades. Evidence sources referenced include: historical TDR programme reports and external reviews; administrative data (e.g., TDR Information Management System counts of institutional and individual grants); and illustrative case examples (Box 1: establishment and growth of the Malaria Research and Training Centre in Mali; Box 2: development of a regional training hub at CIDEIM, Colombia; Box 3: synthesized enablers and barriers to sustainable research capacity). No formal hypothesis testing or systematic evaluation methodology is presented; rather, the paper synthesizes experience, documented outputs, and prior evaluations by advisory bodies (e.g., STAC) to describe the evolution and impact of TDR’s RCS strategies.

• Scope and shift of institutional support: From 1974–2010, TDR awarded grants to over 490 institutions in 45 countries. Early non-competitive long-term grants evolved to competitive programme-based and partnership grants (from 1988 with Rockefeller) linking research to disease control needs, incorporating staff development and training components. Competitive formats tended to advantage more established middle-income institutions; at times, TDR created calls targeting low-income countries to mitigate disparities.
• Catalytic impact examples: The partnership model contributed to the Multilateral Initiative on Malaria (MIM), whose principal investigators now lead major programmes and inform national malaria policies (e.g., long-lasting insecticide-treated nets, insecticide resistance monitoring, community-based malaria management). TDR support catalyzed creation and growth of the Malaria Research and Training Centre (MRTC) in Bamako, Mali, which expanded from a small unit to a leading national research center and part of the Mali International Center for Excellence in Research.
• Networks and regional hubs: TDR launched the African Network for Drugs and Diagnostics Innovation (ANDI) in 2008, identifying pan-African centres of excellence and promoting South–South collaboration, now transitioning to UNOPS. Regional Training Centres established in WHO regions deliver courses on research management and conduct (e.g., CIDEIM in Colombia, Gadjah Mada University in Indonesia, Astana Medical School in Kazakhstan, Research Institute of Tropical Medicine in the Philippines), with further centres planned for Africa and the Eastern Mediterranean.
• Individual capacity development: 1,438 postgraduate training grants were awarded 1975–1996 (about one-third to least developed country candidates); average PhD cost in UK/US about US$100,000 in early years prompted adoption of the “sandwich” PhD model in mid-1980s to ensure relevance and reintegration. From 1997–2010, 356 postgraduate grants were awarded; more than 85% of grantees returned to home countries and remained active, often attaining senior roles. After a restructuring lull (2011–2013), TDR awarded 22 new postgraduate grants and 9 postdoctoral fellowships in 2014. Re-entry grants provided 2-year research support aiding early-career reintegration and establishment of independent groups.
• Leadership and career pathways: Career path constraints in LMIC universities (heavy teaching, limited research time) hinder productivity; initiatives such as CAMES promoting research and the NMIMR postdoctoral programme (Ghana) aim to improve postdoc opportunities. TDR piloted leadership training grants (10 awards in 2007) but the scheme was discontinued due to limited institutional impact and difficulty in maintaining institutional engagement and evaluation.
• Skills development and professionalization: TDR disseminates project planning/evaluation training via regional centres; an online Professional Membership Scheme piloted in 2012 accrued 292 registered members and over 5,000 visitors in 12 months to track competencies and development.
• Alignment with national priorities and implementation: TDR initiatives such as SORT IT (with The Union and MSF) and the Implementation Research Toolkit support operational and implementation research responding to public health needs and facilitate uptake by programmes.
• Coordination among funders: Fragmented funding has led to selective support; TDR helped establish ESSENCE on Health Research (2009) to harmonize funder efforts with country agendas, producing good-practice documents on PME of RCS, research costing, and RCS principles.
• Enablers and barriers: Box 3 consolidates key enablers (e.g., capable leadership, stable funding, infrastructure, networks, career paths, mentoring) and barriers (e.g., weak leadership, political interference, poor remuneration/conditions, quality control weaknesses) to sustainable capacity.

TDR’s experience demonstrates that sustained, multifaceted strategies—combining institutional support, individual training, partnerships, and networks—can build LMIC research ecosystems and contribute to policy-relevant outputs. Shifting from non-competitive institutional grants to competitive, programme-linked, and partnership models enhanced relevance to disease control but risked disadvantaging weaker settings; targeted support for low-income countries helped address equity. Individual-focused instruments (sandwich PhDs, re-entry grants) increased return and retention (>85%) and enabled leadership development, although structured leadership grants without strong institutional anchoring showed limited impact. The creation of regional training centres and professional platforms responds to the need for scalable skills in research management and implementation. Newer initiatives (SORT IT, Implementation Research Toolkit) align research more closely with national programme needs, addressing a persistent gap in translating research into policy and practice. Given fragmented funding landscapes, ESSENCE provides mechanisms for coordination, standard-setting, and alignment with country priorities. Overall, the findings support the hypothesis that integrated capacity strengthening—attending to career pathways, leadership, institutional management, and relevance to national priorities—enhances the sustainability and impact of LMIC research capacity.

Over four decades, TDR has helped cultivate three generations of LMIC scientists and strengthen hundreds of institutions, catalyzing centres of excellence, networks, and policy-informing research. Key contributions include scalable individual training models (e.g., sandwich PhDs, re-entry support), competitive and partnership-based institutional grants linked to control priorities, regional training hubs, and platforms for implementation and operations research. Coordination efforts through ESSENCE have begun to harmonize funder practices and support country-led agendas. Looking forward, TDR will emphasize flexible impact grants, postgraduate and postdoctoral support, career development fellowships (including in industry), regional training centres, alumni networks and mentoring, gender equity, and output-oriented training directly targeting public health implementers to enhance evidence generation and uptake in LMICs.

The paper is a narrative, secretariat-perspective overview without a formal, systematic evaluation design. While it cites administrative counts and selected outcomes (e.g., number of grants, return rates), comprehensive impact assessments and counterfactuals are not presented. Some initiatives (e.g., leadership training grants) lacked robust institutional engagement and could not be adequately evaluated. The heterogeneity of settings and evolving programme objectives complicate generalizability and standardized measurement of impact, and the authors note ongoing lack of consensus on best impact assessment approaches.