Foreign funding of health research in Nepal: Do externally funded projects support national health system and policy goals?

Purpose: Evidence-based national health sector planning requires high-quality, relevant research findings. In resource-limited settings such as Nepal, research depends heavily on external funds. The current study assessed externally-funded health research proposals to better understand the contribution of foreign funders.

Methods: A team at the Nepal Health Research Council (NHRC) reviewed research proposals for all studies approved by their Ethical Review Board (ERB) between 2010 and 2014. Data on funding, investigators, focus area, and report availability were extracted. Studies were assessed for quality. Studies with Nepali funding sources were removed prior to analysis.

Results: Of 308 externally-funded research proposals assessed, universities were the most frequent funders (31%) followed by multilateral agencies (16%). Excluding multilaterally-funded projects, funding originated primarily from the USA (30%) and the UK (21%), and ranged from US$200 to US$23 million. Over half of projects (67%) had a Nepalese Primary Investigator. Only 4 projects (1.3%) provided reports to the NHRC. In almost one-fifth of studies (18%), research subject area was coded as “miscellaneous”, indicating no alignment identified with government-stated priority research areas.

Policy Implications: Health research funding is both an important foreign policy and national planning tool. The results suggest that substantial external funds support health research in Nepal; however, externally-funded projects do not appear to focus on gaps identified by national policy-makers. Nepalese researchers are listed as leading the majority of research projects, suggesting capacity-building efforts. Research funding information should be regularly evaluated and used to ensure foreign funders and donors are accountable to local needs.