South-South Partnerships Research Articles

Establishment of a Mesoamerican-Caribbean south-south research platform: Challenges in the Meriva (curcuminoids) Gastric Cancer Chemoprevention Trial.

Gastric adenocarcinoma (GAC) is the fourth-leading global cause of cancer mortality and leading infection-associated cancer. High incidence regions include Latin America and Eastern Asia. Immigrants from high incidence regions maintain their GAC risk. GAC is a major U.S. cancer disparity, incidence rates are 2-10 time higher in non-white populations. Emerging guidelines recommend 3-year surveillance endoscopy for patients with high-risk gastric premalignant conditions (GPMCs). Clinical trials of GPMC chemoprevention agents are lacking. We conducted an NCI Division of Cancer Prevention-funded, phase II placebo-controlled chemoprevention trial in patients with GPMCs (atrophic gastritis, intestinal metaplasia) with a highly bioavailable preparation of curcuminoids (Meriva®). The trial sites in Puerto Rico and rural Honduras had important characteristics: (1) representative Caribbean and Mesoamerican populations, linked to large U.S. immigrant populations; (2) high prevalence of H. pylori infection and GPMCs; (3) absence of turmeric and curcuminoids in the local diets; (4) proven bidirectional collaboration with U.S. academic institutions. H. pylori-negative GPMC patients were randomized to study drug (500 mg po bid) or placebo for 180 days (NCT02782949), with primary outcomes based upon histologic parameters. Principal study challenges included: (1) international regulatory environment; (2) research infrastructure strengthening, particularly in Central America; (3) participant recruitment in Honduras wherein only 10-15% are H. pylori negative; (4) the Covid-19 pandemic; and (5) natural disasters (3 hurricanes). There were no losses to follow-up related to the pandemic or natural disasters. In conclusion, the south-south partnership provides a model for chemoprevention and translational studies in Latino populations with prevalent cancers such as GAC.

Culture as a Dimension of Interweaving Reinvented South-South Partnership in Africa

Culture as a Dimension of Interweaving Reinvented South-South Partnership in Africa

Affective relatedness, temporalities, and the politics of care in a medical South-South partnership

Abstract For more than 50 years, Cuba has been one of the most important players in the field of international medical care in the Global South. Between 2013 and 2018, Cuba sent nearly 18,000 Cuban health professionals to Brazil within the framework of the More Doctors Program to assist during the Brazilian public health care system's state of emergency. This article focuses on local encounters and emergent socialities between Cuban physicians and Brazilian patients and medical staff. Their sensitive moments of interaction—with their embodied, emplaced, and political dimensions of past and present—hold the possibility of a fragile intersubjectivity that creates its own temporal and affective dynamics, undermining, for a moment, the prevalent care regimes.

The role of International Society of Paediatric Oncology (SIOP) in advancing global childhood cancer care.

The Société Internationale d'Oncologie Pédiatrique [International Society of Paediatric Oncology] (SIOP), founded in 1969, aims to improve the lives of children and adolescents with cancer through global collaboration, education, training, research and advocacy. The annual congress provides the opportunity to share late-breaking research, clinical experiences and debate, with experts worldwide. SIOP's six Continental Branches represent their constituent members in North America, Oceania, Latin America, Africa, Europe and Asia and bring best practices and recent research findings of value to their specific patient populations. In 1990, the SIOP Board of Directors addressed the formerly predominantly European/North American society transforming into a global association by establishing a scholarship program to bring low- and middle-income country (LMIC) paediatric oncologists and nurses to SIOP meetings. A major achievement was SIOP's acceptance as a World Health Organisation (WHO) non-state actor in official relations in 2018, joining 220 non-governmental organisations, international business associations and philanthropic foundations with this privilege. SIOP supports advocacy with WHO member states and civil society to highlight the specific needs of cancer in this age-group through key programs especially supporting the WHO Global Initiative for Childhood Cancer. Sustained improvement in childhood cancer outcomes has paralleled the integration of research with care; thus, SIOP launched a Programme for Advancing Research Capacity for funding selected clinical trial groups in LMICs. SIOP supports south-south partnerships, and the principles elegantly expressed in SIOP Africa's checklist for co-branding projects, that include the prioritisation of local needs, cultivation of local expertise and commitment to equitable partnerships. SIOP now counts approximately 3,000 members from over 128 countries; 39% are from more than 60 LMICs. SIOP members have multidisciplinary expertise on all aspects of childhood cancer care working in collaboration with key stakeholders including governments, civil society organisations and funders to improve the lives of children/adolescents with cancer everywhere in all ways.

Commit to the Global South

Vulnerabilities of the world’s least developed countries to health, economic, and environmental crises were recently in the spotlight at a United Nations (UN) conference in Qatar. In March, the Doha Programme of Action was announced as a call for the developed world to renew commitments to support low- and middle-income countries in overcoming major challenges. UN Secretary General António Guterres aptly stated there are “no more excuses.” Such a commitment requires Global North-South and South-South partnerships that harness science and technology and that also empower the South to sustain progress. As a scientist from the Global South who can attest to science’s transformative role in this region of the world, individuals and organizations across sectors and society can play a strong role in supporting such a commitment.

Editorial introductions.

Editorial introductions.

Development of a South-South Clinical Research Capacity Strengthening: Institutional Partnership Platform between Cameroon and South Africa

Collaborative partnerships are key components to reinforce biomedical and clinical research capacity and are characterized by enormous challenges though important in promoting the institutional exchange of ideas and capacities that potentially fill knowledge and research gaps. An observational analysis was conducted from 2014 to 2022 between the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa, and the Centre for the Study of Communicable Diseases (CSCCD), Faculty of Medicine and Biomedical Science, University of Yaoundé I, Cameroon. Despite constraints, affiliations with institutes from developed economies are often established within the framework of North-South collaborations. Since 2014, a strong bilateral South-South research partnership between the two institutions has been developed and consolidated for sustainable coexistence. In this paper, we report on qualitative research within our leading collaborative scientists involved in major institutional research, our views on South-South collaboration, and the factors that consolidate our decision-making about joining and participating actively in research networks. Keywords South-South collaboration, Stellenbosch University, South Africa, University of Yaoundé 1, Cameroon.

The Imperatives of Academic Collaboration in Africa, Asia and Latin America

A multitude of intentions drives institutions to engage in academic collaborations, mainly dictated by necessity. The imperatives of academic collaboration are many and varied and include generating resources, developing academic capacity, exchanging experiences, and enhancing the institutional profile. Institutions also engage in collaboration to pursue mega initiatives (such as human genome projects) and tackle major global challenges (like climate change and diseases such as COVID-19). Such endeavours mainly take place within the framework of North-North and, to certain extent, North-South collaboration. South-South collaboration has been less evident, although this trend appears to be changing steadily with growing interest, focus and drive in these regions. For decades, academic collaboration has been touted as a positive force in knowledge creation and capacity building, particularly in the South. However, this conception has largely been framed in the context and perspective of the North. Given growing calls for a shift from traditional North-South collaborations, this article explores the imperatives of academic collaboration in the context of South-South partnerships and examines the critical factors that shape such collaboration in Africa, Asia and Latin America. It explores the intention, nature, scope and modalities of academic collaborations in the context of academic exchange, joint research/projects, joint programmes, capacity building and other relevant engagements on these continents in the post-COVID-19 era.

Abstract A016: Successful design and execution of two gastric cancer chemoprevention trials in Central America and Puerto Rico

Abstract Gastric adenocarcinoma (GAC) is the third leading global cause of cancer mortality and leading infection-associated cancer. The high incidence regions are Latin America, East Asia, and Eastern Europe. In the U.S., GAC represents a major cancer disparity, double the incidence rates in all non-white populations, the opposite of Barrett’s Esophagus and EAC. Immigrants from high incidence regions maintain the risk profile of their nations of origin. In a paradigm shift, recent guidelines now recommend surveillance endoscopy (eg, 3 years) for patients with high-risk gastric premalignant conditions (GPMCs). Clinical trials of chemoprevention agents for patients with GPMCs are lacking. We conducted two independent, NCI DCP funded, phase II placebo-controlled chemoprevention trials in patients with GPMCs (intestinal metaplasia, atrophic gastritis). The oral agents were curcumin and eflornithine (DFMO). A highly bioavailable preparation of curcumin was used. The RCTs were conducted in Puerto Rico and rural Honduras, with important characteristics: (1) representative of Caribbean and Mesoamerican populations and linked to large U.S. immigrant populations; (2) high prevalence of H. pylori infection and GPMCs; (3) absence of turmeric and curcuminoids in the local diets; (4) proven bidirectional collaboration with academic institutions in the U.S. In the curcumin trial (NCT02782949) H. pylori negative patients were randomized to study drug or placebo for 6 months. In the eflornithine study (NCT02794428), H. pylori positive and negative subjects were randomized to study drug or placebo for 18 months, with endoscopy at baseline, and 6. 18, and 24 months. The primary outcomes were based upon changes in histologic parameters at 6 months. Principal study challenges included: (1) International and bilingual regulatory environment; (2) Strengthening of the research infrastructure, particularly in Central America; (3) Participant recruitment, eg, in the curcumin RCT in Honduras wherein only 10-15% are H. pylori negative; (4) The Covid-19 pandemic; (5) Natural disasters (3 hurricanes). In Conclusion: Eflornithine and curcumin RCTs have been successfully completed, despite important challenges in implementation and execution. No losses to follow-up were encountered related to the pandemic or natural disasters. The south-south partnership may provide a model for chemoprevention and translational studies in Latino populations with prevalent cancers such as GAC. Citation Format: Eleazar Montalvan-Sanchez, Maria Gonzalez-Pons, Dalton Norwood, Ricardo Dominguez, Keith Wilson, Marcia Cruz-Correa, Douglas Morgan. Successful design and execution of two gastric cancer chemoprevention trials in Central America and Puerto Rico [abstract]. In: Proceedings of the Second Biennial NCI Meeting: Translational Advances in Cancer Prevention Agent Development (TACPAD); 2022 Sep 7-9. Philadelphia (PA): AACR; Can Prev Res 2022;15(12 Suppl_2): Abstract nr A016.

Smart Partnership in The South: The History of Tanzania-Malaysia Economic Engagements, 1960-2015

The history of Tanzania's and Malaysia's economic interactions and engagements is explored and examined in this paper. It is a qualitative study that examines Tanzania's historical contacts and relationships with Malaysia from 1960 to 2015. It does so using a descriptive and historical-analytical method. Tanzania and Malaysia had historically established very close commercial and cultural relationships with significant Southeast Asian maritime traders before connecting with European international trade from the 15th century onwards. However, the formal political relations between the two countries did not begin to exist until after they had gained their independence and had been successful in forging bonds and reciprocal ties in several political settings and possibilities within the South-South partnership. Between 1980 and 2015, the two countries' relations did, however, shift from a political posture to more economic collaboration. This came about because of Tun Mahathir Muhamad and Mwalimu Julius Nyerere's attempts to commission a South-South commission, which was charged with tackling the economic problems affecting the countries of the southern hemisphere. This example of the growing relations between Tanzania and Malaysia shows how similar ties between and among other southern nations may be beneficial for stronger regional cohesion

Health policy and systems research capacity development to support maternal, new-born, child and adolescent health in West and Central Africa.

To examine how and why a South-South capacity development and networking program for leadership, research, practice and advocacy on maternal new-born, child and adolescent health and health policy and systems strengthening in West Africa and Cameroon worked and identify lessons for low- and middle-income countries. Single qualitative case study drawing on data from document review, observations, key informant interviews and a deliberative workshop. Ethics approval for primary data collection was obtained from the Ghana Health Service Ethical Review Committee (GHS-ERC 012/10/18). West Africa and Cameroon. Researchers, policy and programme managers and frontline health workers. Networking and capacity development. The programme made good progress in implementing many but not all planned capacity development and networking activities. The opportunity to network with other organisations and individuals and across countries, disciplines, and languages as well as to learn, to develop skills, and obtain mentorship support, were considered valuable benefits of the partnership. Human and financial resource constraints meant that not all planned interventions could be implemented. Lessons for health policy and systems research capacity building in LMIC include the potential of South-South partnerships, the need for dedicated resources, the potential of Sub-regional health organizations to support capacity building and recognition that each effort builds on preceding efforts of others, and that it is important to explore and understand where the energy and momentum for change lies. The work described here has been funded by IDRC Canada under research grant # 108237 "West and Central African partnership for maternal, new-born, child and adolescent health research."

Foreign aid, China’s aid and Africa’s Development: Interrogating the Dynamics

The distinctiveness of aid to economic growth and development of developing countries has stirred up discussions over the years. The conventional arguments have sought to evince both optimistic and pessimistic views about aid to development in Africa while at the same time studies are copiously emerging around Chinese aid to Africa’s development within the broader China-Africa engagements. This article interrogates the dynamics surrounding the subject to examine foreign aid, China’s aid practice toward Africa and the possible implications for Africa’s development. Probing into the general perspective in literature and other primary sources, the study submits that China’s active aid practice has heightened the uncertainties around foreign aid to Africa’s development. Notwithstanding the verity of China’s aid policies and principles being germane to Africa’s development, the practical implementation maintains certain attributes that provoke divided thoughts. Hence, the requisite platform of action should be bolstered to consider both the Chinese interests and the African needs for a well-balanced development in the acclaimed South-South cooperation partnership.

Long Term Followup of Sickle Cell Disease Post Hematopoietic Stem Cell Transplant from Uganda

Introduction: Sickle cell disease (SCD) remains associated with high risk of morbidity and early death. Many patients in sub-Saharan Africa continue to experience severe complications despite best supportive care. Hematopoietic stem cell transplant (HSCT) can be considered for a select group of patients. When successful, HSCT is economical and improves quality of life. We report the experience from our south-south partnership whereby Ugandan patients with SCD have undergone HSCT at the Bone Marrow Transplant Center in Gurgaon, IndiaMaterial and methods: 23 consecutive patients suffering from SCD who underwent HSCT between June 2014 and July 2017 were included in the study. Eleven underwent matched sibling donor bone marrow transplant (BMT) using busulfan 3.2 mg/kg/day for 4 days, cyclophosphamid 50mg/kg/day for 4 days, and hATG (PfizerATGAM) 30mg/kg/day for 3 days. Two adult patients underwent matched sibling donor HSCT using reduced intensity conditioning with busulfan 3.2 mg/kg/day for 4 days, cyclophosphamid 60mg/kg/day for 2 days, and ATG (PfizerATGAM) 30mg/kg/day x 3 days. Immune suppression for for HSCT patients was cyclosporine 3mg/kg/day in 2 divided doses starting D-4 and methotrexate 10mg/m2 on D+1 followed by 7mg/m2 on day 3, 6 and 11 post HSCT. Ten patients underwent haploidentical HSCT using hypertransfusion (target Hb 11-13gm/dl), hydroxyurea (20mg/kg/day) and azathioprine (2mg/kg/day) from day -45, conditioned with Thiotepa 10mg/kg in two divided doses (D-7), fludarabine 30mg/m2 (D-6 to D-2), cyclophosphamide 14.5 mg/kg (D-5, D-4), TBI 2Gy with thymic shielding (D-1), rATG (Genzyme Thymoglobulin) 1.5 mg/kg (D-9 to D-7). GVHD prophylaxis included PTCy 50 mg/kg/day on D3 and 4, tacrolimus (target level 5-15 ng/ml) or sirolimus (target levels 10-15ng/ml) (till 6 months post HSCT) and MMF (till D35) starting from D5.Results: The median patient age was 8 years (range 10 months-31 years). Before transplantation all patients had repeated episodes of SCD complications warranting a transplant. All were non-responsive to hydroxyurea. Of the 23 patients, 18 survived without sickle cell disease with Lansky/Karnofsky scores of 100. One had a primary graft failure another secondary graft failure with recurrence of disease. At median follow up of 479 days (range 51-1204) the probabilities of survival, SCD-free survival, and transplant-related mortality after transplant were 87%, 78%, and 13%, respectively. Three children who underwent haploidentical HSCT died. One died due to PRES with intracranial hemorrhage at day 86 post BMT, another one due to primary graft failure with Klebsiella sepsis with shock. The third child died due to complicated falciparum malaria and possible invasive fungal infection at day 24 post HSCT. He had full donor chimerism.Conclusion: Outcomes of HSCT in SCD have improved significantly. With better conditioning regimens and improved supportive care, alternative donor transplant and adult HSCT have become viable therapeutic options. HSCT should be strongly considered as a curative modality for selected patients suffering from SCD. DisclosuresNo relevant conflicts of interest to declare.

Regionalism and bilateral counter-terrorism cooperation: the case of India and Thailand

ABSTRACT After major terrorist attacks in the United States on September 11, 2001, Bali, Indonesia in 2002, and Mumbai, India in 2008, India and Thailand responded in disparate ways. Thailand was slow to respond out of fear of alienating the large Muslim population in its restive south. India, after Mumbai, moved to create and strengthen domestic institutions that would hasten counter-terrorism measures, with limited success. In the years that followed these seminal events, both Bangkok and New Delhi have, like other South Asian and ASEAN states, moved toward bilateral and multilateral counter-terrorism partnerships. This paper surveys the history of terrorism in both countries and their domestic responses, persistent domestic and regional challenges, and documents a growing India-Thailand bilateral counter-terrorism partnership – particularly in the sectors of maritime security, intelligence sharing, extradition, and joint security cooperation. This paper contributes to a growing body of literature on emerging South-South partnerships by evaluating India-Thailand counter-terrorism cooperation and explores avenues for future bilateral exchanges and multilateral opportunities within institutional bodies, such as ASEAN and BIMSTEC.

India and China in Africa: Rivalry or catching up?

The South-South cooperation has been experiencing a second youth with the deepening of Sino-Africa and Indo-Africa relations. In order to secure an important part of the Black continent’s enormous natural resources, China and India have pledged to build mutual beneficial partnerships with Africa. In the process, both Asian growing economies are infusing the continent with capital, infrastructure and jobs. If the two Asian drivers’ safaris in Africa mark the resurgence of Africa in international affairs after more than a decade of negligence by its traditional Western partners, the emerging South-South partnership being forged by both countries brand themselves as ‘win-win’ as compared to Western countries relationship with Africa. More, the Indian version, while refuting the idea of being engaged in a strategic rivalry with Beijing, stresses even more to distance itself from the Chinese type that is accused to be solely replicating the old colonial paradigm of the scramble of Africa’s raw material resources. This paper assesses the veracity of this assumption by confronting the Indian’s project main features to their Chinese counterpart through a cross-examination of key dimensions of both countries’ African project and highlights significant similarities as well as notable differences between these two approaches. Key words: Rivalry, competition strategic partnership, south-south cooperation, China-Africa, India- Africa.

Multisector Collaborations and Global Oncology: The Only Way Forward

PURPOSEAt the 12th meeting of AORTIC (African Organization for Research and Training in Cancer) in Maputo, Mozambique, held between November 5 and November 8, 2019, a special workshop was organized to focus on the need for collaboration and coordination between governments and health systems in Africa with academic, industry, association, and other nongovernmental organizations to effect sustainable positive change for the care of patients with cancer.METHODSRepresentatives from seven different projects in Africa presented implementation science and demonstration projects of their to date efforts in cancer system improvement including patient access, South-South partnerships, in-country specialized training, palliative care consortium, treatment outcomes, and focused pathology and diagnostic capacity building. Key partners of the various projects served as moderators and commentators during the session.RESULTSFrom across all the presentations, lessons learned and exemplary evidence of the value of partnerships were gathered and summarized.CONCLUSIONThe concluding synthesis of the presentations determined that with the broad needs across cancer requiring in-depth expertise at each point on a patient’s journey, no single organization can effect change alone. Multipartner collaborations not only should be the norm but should also be coordinated so that efforts are not duplicated and maximum patient access to cancer diagnosis and care is achieved.

Internationalisation of Higher Education: Building South-South Partnerships between China and Mexico

As an important emerging economy, Mexico is significant to China for promoting world multipolarisation as well as an important partner in jointly building a community of shared future for mankind. Educational exchanges and co-operation are an indispensable part of friendly transactions between China and Mexico. Both countries have made many advancements in the fields of personnel turnover, the establishment of overseas co-operation centres, language promotion, and vocational and technical training. Both China and Mexico regard the other as an important education partner. In future co-operation, the two countries should continue to promote vocational education, improve the degree system, and pay attention to hidden safety issues.

Strengthening capacity for natural sciences research: A qualitative assessment to identify good practices, capacity gaps and investment priorities in African research institutions.

BackgroundStrengthening research capacity in low-and-middle-income countries is essential to drive socioeconomic development and to achieve the Sustainable Development Goals. Understanding strengths and weaknesses in institutions’ research capacity can guide effective targeting of investments and resources. This study assessed the capacity of institutions undertaking research in natural science topics in Africa to identify priority capacity gaps for future investment.MethodsAssessments were conducted in eight African institutions that were partners in a UK-Africa programme to strengthen research capacity in renewable energy, soil-related science, and water and sanitation. Assessments involved eighty-six interviews and three focus group discussions to identify institutions’ research capacity strengths and gaps against an evidence-informed benchmark. Use of the same interview guides and data collection processes across all institutions meant that findings could be compared.ResultsCommon research capacity gaps were: lack of, or poorly maintained, equipment; unreliable, slow procurement systems; insufficient opportunities for developing the skills of research support staff such as administrators and technicians; dysfunctional institutional email communication systems; insufficient focus on the development of ‘soft’ researcher skills such as ethics, academic writing and, in non-Anglophone countries, English language. Programme strengths were the South-South and South-North partnerships for sharing and cascading expertise and resources, joint writing of proposals and publications, and improved individual and institutional visibility.ConclusionThere were many similarities in research capacity gaps irrespective of the institutions’ natural sciences research focus, and these were similar to those reported in the health sector. Common capacity needs are improving the skills of technicians and administrators to support research activities, soft skills training for researchers, and more effective pan-institutional e-communication systems. These could be strategic investment targets for the joint efforts of national governments and international organisations that fund programmes for strengthening research capacity in low- and middle-income countries.

Global Health: A Review of Concepts, Players, and Publications

Introduction: The increasing number of global health initiatives have contributed to improving access to health services and building knowledge platforms. However, the distribution of activities and knowledge produced has been uneven. To scope the scientific output in global health, publications from 2008-2017 were reviewed to identify major players, assess the extent of involvement of low- and middleincome countries (LMIC), and map areas of research interest. Methods: A total of 3153 Web of Science (WoS) publications were retrieved, of which 2423 were selected for this review. The country of origin, institutions involved, types of documents, language of publication, journal titles, content categories, authorship, themes, and characteristics of collaboration were examined. Results: Over the years, the number of global health publications from both high-income countries (HIC) and LMIC has increased. Authors from LMIC were engaged in 19.3% of the publications, representing 10.3% of first authors and 9.7% of single-author articles. Collaboration across World Health Organization (WHO) regions ranged from 29.6% to 64.6%. Themes of greatest research interest were capacity development, health policy and systems, and disease control. Conclusion: Global health research is experiencing rapid expansion, but LMIC authors continue to have limited involvement. The current study revealed diversity in publications, journals, and actors with a marked influence from developed countries. As north-south and southsouth research partnerships are increasing across the world, it is important to ensure open collaboration between partners and alignment with public health research priorities and needs.

Social processes in post-crisis municipal solid waste management innovations: A proposal for research and knowledge exchange in South Asia

Municipal solid waste management (MSWM) has become one of the most pressing environmental issues in South Asian cities, the more so as it is closely linked to drinking water quality, sanitation and human health affecting mostly the urban poor, as well as to global climate change. Looking at recent governance initiatives in three South Asian cities developed in the wake of natural or human-induced crises, the project will focus on how to render MSWM improvements politically feasible and socially acceptable, which is a pre-requisites for functioning SWM systems, and thus for (environmental and social) sustainability more generally. The goal of this project, therefore, is to identify, analyze and promote the political and sociocultural processes that are necessary to enable the functioning of MSWM systems. In particular, alternative practices and systems are promoted, whereby institutional hierarchies are decentralized, favoring horizontal accountabilities and whereby waste chains are shortened and transformed into closed loops implying a more circular waste economy in which both environmental and local livelihood benefits would accrue. The project puts emphasis on mutual learning through horizontal South-South partnerships between local authorities, civil society actors and researchers across South Asia.