Africa has a disproportionate burden of both infectious and non-communicable diseases (NCDs) compared with other world regions [1]. Current disease estimates indicate increases in the incidence of NCDs, including cardiovascular diseases (like hypertension and stroke), cancers, and diabetes, which are now major causes of morbidity and mortality and are projected to overtake infectious diseases by 2030 [2]. This is occurring when most African countries are still struggling to control infectious diseases (such as HIV and TB) due to weak and overburdened health systems[3]; inadequate resources for scaling up proven interventions; poor management of human resources for health; and recurrent natural and man-made disasters and emergencies [4]. Other contributors to heavy disease burden on the continent include food insecurity, poor access to safe sanitation, the prevalence of indoor pollutants, high unemployment, and is characterised by high exposure to various types of violence and forced migration and access to cheap but unhealthy foods[5]. Tackling these challenges and coming up with pragmatic solutions requires robust research [6, 7].
This need for local research is occurring when Africa has in the recent past been reported to lag behind other regions in research output – producing less than 1% of the world’s research [8], including research in the fields of population and health [9, 10]. The under-performance in research in Africa is due in-part to inadequate research funding by African governments [11, 12]. During the first African Ministerial Conference on Science and Technology in 2003, participating countries committed to spending at least 1% of their gross domestic product on research and development by 2010 [12, 13]. Three countries, Malawi, Uganda, and South Africa, had honoured this commitment five years down the line, in 2015 [14]. Other reasons for under-performance include inadequate access to research training [9], poor research infrastructure and technology such as laboratories and computers, insufficient mentorship for junior researchers [11], and limited collaboration or partnerships among research institutions within Africa [10].
There has however been a substantial improvement in the output of researchers in the field of public and population health in many African universities during the past decade [15, 16], a development attributed to advancement in the faculties of public and population health in higher education institutions [16, 17]. Nachega and colleagues [16] reported that between 1991 and 2010, epidemiology and public health research output in the WHO/AFRO region increased from 172 to 1086 peer-reviewed articles per annum, which is a 531% increase over nineteen years. During this period, the most commonly research topics published by researchers from African institutions were on HIV/AIDS (11%), malaria (9%), and tuberculosis (7%), which may be motivated by the articulation of the Millennium Development Goals (MDGs) and increased donor funding in specific disease areas [18].
There have been a number of contributions to the development of research capacity on the continent. While not yet adequate, there has been both national and international investment in higher education in general [19, 20]. There has also been a commitment to health-related research. The New African Region Health Research Strategy adopted by the African Union Health ministers in 2015, has prioritised research on public and population health [21]. Significant investment in health related research capacity building has also taken place including the African Institutions Initiative [22], and investments made through the DELTAS programme [23], as well as the establishment of the Centre for Disease Control (Africa CDC) by the African Union General Assembly in 2015 [24] which has also promoted health and security and prompted response to emergencies using empirical data, to inform decision making.
As the disease burden changes on the continent, a comprehensive approach is needed to guide health research capacity in the region, and policies and interventions need to be appropriate to local conditions. The conduct and dissemination of good quality research undertaken by African scientists is central to this [25]. We investigated the research output of a cohort of African scholars to assess the degree to which their research was related to identified African health priorities.
We focused on one initiative for which we had comprehensive data, the Consortium for Advanced Research Training in Africa (CARTA) [26]. Launched in 2009, CARTA initially brought together nine academic and four research institutions from seven countries in Africa, in partnership with selected northern universities and training institutes. CARTA aims to develop sustainable health research capacity in Africa through training of PhD fellows in public and population health and promoting research supportive environments. Part of CARTA’s strategy for long term sustainability is that only staff of participating African consortium institutions are admitted as PhD fellows [26]. This study describes the publications authored by CARTA supported PhD fellows and compared them to published consensus African public and population health research agendas as defined by the sustainable development goals (SDGs), World Bank (WB) and Africa Development Bank (AfDB) priorities.