Biomedical Research in Latin America

Biomedical research has historically been centered in Western Europe and North America, and has more recently expanded into east Asia. This is the result of a wide range of influences, including distribution of funding, prioritization of research within governmental budgets, reliance on existing scientific structures and resources, and geographical and institutional biases within the publishing fields. Scientists in Latin America have been active in medical research since the nineteenth century, but research has failed to expand at the rates seen in other countries, and the region has received little global recognition for key contributions to medical knowledge.

Medical and scientific publications from the the US alone outnumbers publications from Latin American scientists by about 20:1 (Benedetti, 2016). This disparity in research production is reflected in the disparity of funding allocation: in 2017, the U.S. spent 2.8 percent of their GDP on scientific research, Japan contributed 3.3 percent of their GDP, and Germany 2.9 percent. Only one country in Latin America, Brazil, allocated more than 1 percent of their government funding towards research, spending 1.1 percent in 2017 (Benedetti, 2016). 54 percent of Latin American economies are classified as upper-middle income, and yet investment in research and development has not been, and is not, a priority (Estenssoro, 2016).

The reasons for this are complex and often somewhat circular. Because there is so little funding in research, few students in Latin American countries are encouraged to enter scientific research fields. Those that do are often confronted with limited educational and post-doctoral research opportunities, resulting in the “best and the brightest” often leaving for better positions in countries like the U.S. and China (Ciocca, 2017). Dubbed “brain drain,” this loss of talented scientists exacerbates the pre-existing issue of a lack of local leaders in biomedical fields, that then in turn further drives students to travel to other countries to pursue research. Lack of funding also often has significant practical consequences. Particularly in biomedicine, expensive equipment, reagents, and machinery are often essential for basic laboratory processes. A government research grant in Latin America typically falls between $5,000-$40,000 annually; for comparison, the average grant awarded for RPGs (Research Proposal Grants, which are typically multi-year) by the U.S. NIH was $488,000 in 2017 (Ciocca, 2017).

Another element to consider that is directly tied to funding capacity is the already-existing infrastructure in well-established research institutions in the U.S. that make it possible to allocate grant money more directly towards specific projects rather than towards basic equipment or stock solutions. Most scientific supplies must also be imported, often from the U.S, and therefore face a heavy and debilitating import tax on top of the already expensive baseline price tag (Zenteno-Savin, 2007). Finally, most high-impact scientific journals charge publication fees of around $4,000-$5,000 per article, resulting in many Latin American researchers with tight budgets opting to publish in lower-impact, less well-known scientific journals that may not accurately reflect the import of their findings and discoveries (Ciocca, 2017). All of these things together hugely limits the scope and speed of research that is possible in Latin American laboratories, and further drives the exportation of Latin American scientific talent to other countries.

Lack of cooperation and communication between scientists in different Latin American countries is a further confounding factor to the scientific productivity of the region. It has long been recognized that pooling of knowledge and resources is likely what is necessary to put Latin American science in the same sphere of ability as the U.S. or China; but different government guidelines, bureaucratic policies, and minor language barriers have slowed cooperation. Recently, however, new steps have been taken to push collaboration among researchers in different countries: in 2015, the Latin-American Research Network (LIVEN) was founded with the goal of fostering inter-regional research among scientists from Brazil, Chile, Argentina, Colombia, Ecuador, and Uruguay (Estenssoro, 2016). Research groups that spearheaded investigation into the Zika epidemic, as well as other endemic infectious diseases, are becoming more widely recognized in international circles (Diniz, 2016). Research budgets, while low, are on an upward trend across Latin America (Estenssoro, 2016). Currently, universities and institutions are working to emphasize and revitalize Latin American contributions to biomedicine, as it becomes more and more important in both disease control and the global marketplace. U.S-based philanthropies have been instrumental in supporting these endeavors; for example, the Rockefeller Institute has provided grants and scholarships specifically for biomedical and public health research to many Latin American institutions (Cueto, 1990).

Despite relatively low productivity as a whole region, there are certainly several examples of Latin American research institutions that are leaders in biomedical fields. Perhaps the most well known is the Oswaldo Cruz Foundation, also known as FIOCRUZ, in Rio de Janeiro, Brazil. One of its earliest and most notable achievements was the discovery of Chagas disease (by Carlos Chagas) at the beginning of the 20th century, and it has built upon this early success by focusing much of its energy and funding into tropical disease research and virology (Kropf, 2009). FIOCRUZ is especially well-regarded for its research into vaccines to defend against viral infections that are endemic and often devastating in different areas of Brazil (Coura, 2002; Martins, 2015).

René Favaloro, an Argentinean surgeon, has also been recognized as one of the leaders of Latin American representation in medicine; he was instrumental to the development of coronary artery bypass surgery at the Cleveland Clinic in Ohio. He returned to Argentina later in life and founded the Instituto de Cardiología y Cirugía Cardiovascular de la Fundación Favaloro, as well as funding a medical center that included a teaching unit and cardiac research departments (Captur, 2004). Bernardo Houssay, an endocrinologist from Argentina, won the Nobel Prize in Medicine in 1947 for work on hormonal regulation of blood sugar -- work that has been fundamental to advances in the treatment of diabetes in the second half of the twentieth century (Tan & Ponstein, 2016). Understandably, a large portion of Latin American contributions to the medical sciences has been on the topic of infectious and vector-borne diseases; one of the first examples of this was Carlos Finlay, a Cuban scientist who, in 1881, was the first to propose that mosquitoes transmit yellow fever (Chaves-Carballo, 2005).

Currently, Latin American scientific talent is spread around the globe as a result of poor infrastructure in their home countries, but this also gives hope that if these underlying funding issues can be addressed and potentially resolved, there is a large pre-existing pool of Latin American researchers able to contribute significantly to their countries’ research efforts if sufficient grants and opportunities can be secured. Latin American medical research has recently garnered attention as the ideal environment in which to explore local medical customs and indigenous health traditions that show promise of bringing vital non-Western and non-colonial healing theories into medical science (Cueto & Palmer, 2015). Latin American researchers occupy a unique space in coming from environments that blend technology and tradition, science and culture; they are a group who, if provided with the means and freedom to conduct science, will be able to contribute significantly to the global biomedical field as a whole.

References

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