Fostering a spirit of collaboration: insights from the inner workings of an international research consortium

What is RESPIRE?

The National Institute for Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE) is an NIHR-funded research unit based at Edinburgh University that aims to reduce morbidity and mortality of both acute and chronic respiratory diseases in four initial target countries in Asia: Bangladesh, Pakistan, India and Malaysia. To achieve this, we are using evidence-based research to help health systems support respiratory health needs across a lifetime and assess the role of key actors to ensure locally-relevant solutions.

Professor Devi Sridhar, GHGP Director and my PhD supervisor, co-leads the Stakeholder Engagement and Governance Platform. Meanwhile, RESPIRE is directed by the Usher Institute’s director Professor Aziz Sheikh, and co-directed by Professor Harry Campbell, a leader in global child health also within the Institute.

RESPIRE hosts an Annual Scientific Meeting (ASM) in which all its research partners gather to review progress and plans for the coming year; this year, RESPIRE’s ASM was hosted in Kuala Lumpur for three days in September. Before arriving in Malaysia, I had determined to get to know all the various research partners – over 80 from Edinburgh and Asia – to gain a clearer sense of direction for my own PhD project. However, I gained much more than just academic clarity: I was able to receive first-hand experience of collaborative efforts among an international cohort with a shared vision.

Day 1: External Showcase and Partner Presentations

Day 1 set the pace for the entire ASM: main themes covered were the challenges, success and future plans of RESPIRE’s various projects regarding the impact of targeted interventions, diagnosis and respiratory disease management. Whilst high profile guests such as Malaysia’s Deputy Minister of Health Dr. Lee Boon Chye were in attendance during the external showcase for VIP guests, it was clear that the themes addressed by RESPIRE are timely and were well-received by everyone in attendance. A stark representation of this was the heavy shroud of air pollution in the city throughout the trip, locally referred to as haze; after all, air pollution is a significant risk factor for respiratory conditions such as chronic obstructive pulmonary disease (COPD) and pneumonia.

The showcase was followed by partner presentations of country leads as well as PhD students and research fellows’ progress in their individual projects. I was inspired by the scope of research opportunities available within RESPIRE and the freedom with which country teams developed and adapted their projects to tailor them to local solutions.

Day 2: Sustainability Workshop, Keynote Speech and External Feedback

Day 2 involved in-depth discussions of the applicability of sustainable impact, facilitated by Asthma UK Centre for Applied Research’s Knowledge Exchange Lead, Monica Fletcher and Siân Williams, Chief Executive Officer of the International Primary Care Respiratory Group (IPCRG). IPCRG is an instrumental partner with RESPIRE, ensuring cohesion with the other relevant NIHR research units for more effective collaborative efforts; one such is ASTRA, which focuses on reducing use of smokeless tobacco in South Asia, another significant risk factor for respiratory diseases.

The sustainability workshop dealt with the delivery of pulmonary rehabilitation, an evidence-based technique to improve lung capacity in COPD patients through exercise and training. Dr Monsur Habib, President of the Bangladesh Primary Care Respiratory Society and champion for the intervention, shared his personal experiences in scaling up for national service delivery. Dr Habib emphasised the need for patient involvement and engagement to direct self-management as this was crucial for sustainable uptake and subsequent health benefits.

This workshop was followed by the keynote speech by Celina Gorre, CEO of WomenHeart, who aptly examined the relevance of non-communicable disease priority-setting in the Sustainable Development Goals. Ms Gorre is one of RESPIRE’s International Steering Committee members, also comprising of Dr Shamim Qazi, Dr Mandeep Chadha and chaired by Professor Zulfiqar Bhutta, a global leader in child health and nutrition. The committee’s feedback provided a sense of how well RESPIRE’s targets were being met and areas of potential improvement.

As an early career researcher myself, it was heart-warming to be welcomed into a group of humble-yet-high-achieving researchers and clinicians, who all demonstrated a tireless passion for improving health across their countries. There was very much a sense of eager collaboration, such as through the demonstration of knowledge exchange between country leads at the lunch table that afternoon. It was at this point of the trip that I found some answers of questions I initially had by deciding on examining governance of childhood pneumonia in Bangladesh. However, more questions were formulating: how could my PhD complement RESPIRE’s wider aims and objectives? And how would my findings create a lasting impact in my area of focus?

Day 3: Health Clinic Visits and Skills Sharing Sessions

The final day of the ASM allowed the research partners to visit a range of health clinics in the coastal district of Klang, south west of Kuala Lumpur. It was eye-opening to see comparisons between Malaysia’s primary care facilities and those in the UK, for instance the range of specialised services available and how the referral system operates. Whilst the difference in capacity, size and specialised facilities were stark between the two clinics I visited, there was a sense of pride among the medical teams in their work, yet great humility and willingness to help. This was further demonstrated by the hospitality shown to the RESPIRE group despite the hustle and bustle of care-seekers. This is a trait I witnessed throughout my time in the country, not only in Klang but among everyday Malaysians: a warmth and friendliness that made you feel right at home.

Following this, skills sharing sessions were conducted in small break-out workshops, such as how to effectively communicate your research to the public and how to demonstrate impact. As everyone came from a range of academic backgrounds, varied experiences and insights led to rich discussions. The ASM was then concluded by its co-directors as everyone parted ways.

The ASM was a hugely beneficial experience to have participated in. Whilst we as a collective try to reduce our carbon footprint by limiting travel, it is hugely important for such meetings to occur to build rapport among such a large research unit. Furthermore, it was through these discussions that I was able to grasp the bigger picture of REPSIRE’s vision for respiratory health and thus help determine the direction of my own research to complement the larger findings. Such gains are difficult to find among the pages of journal articles, particularly when written by researchers halfway across the world. Thus, the experience was a fitting reminder that effective research in global health cannot be done in isolation and impact is sustained through such international collaborative efforts.

 

By Lois King

 

Find out more about Lois' PhD with RESPIRE