The COVID-19 pandemic has demonstrated how health shocks impact all aspects of a globalized society, rippling across national economies, diverse industries, and national-level supply chains. While no country has been immune to the impacts of COVID-19, low- and middle-income countries (LMICs) have been especially vulnerable. Yet even as the novel coronavirus has spread around the globe, with cases still rising,¹ many LMICs have shown resilience in their ability to respond quickly and proactively by deploying virus surveillance networks and leveraging local research and innovation capacity. Higher education institutions (HEIs) have emerged as engines of global collaboration and pandemic response and recovery. The contribution of higher education systems to resilience in LMICs over the past year should serve as a lesson for future investors looking to increase resilience against the next shock.²

Although they are often overlooked as a humanitarian and development assistance actor, HEIs have a long history as development partners and can play an outsized role during crises. Indeed, HEIs occupy a unique position in international issues. Many are able to transcend political impasses through academic diplomacy and collaborative mechanisms that promote transboundary cooperation. The United States Agency for International Development (USAID) and many development organizations have partnered with international HEIs for decades. Early development efforts focused on building local institutional capacity. In parallel, exchange programs and visas enabled professors and research scholars, short-term visitors, and students from all over the world to study and conduct research in the U.S. These exchanges seeded enduring research partnerships. As institutions became more self-reliant and/or existing capacity was recognized, efforts shifted towards local ownership with international partners playing a more supportive role.³

A collection of initiatives and policies have laid the foundation for science and technology diplomacy in international development. Binding bilateral and multilateral agreements have set the stage for U.S.-funded science and technology programs by facilitating the exchange of scientific results, allocating and protecting intellectual property rights and benefit sharing, facilitating access for researchers, and addressing taxation issues. These agreements have provided a foundation for confronting the complex set of issues related to cross-border scientific exchange.⁴

U.S. government research funders like the National Institutes of Health (NIH) and the Centers for Disease Control (CDC) have facilitated partnerships through funding opportunities that focus on building alliances around global expertise in medicine and public health, which have contributed to the development of LMIC HEIs’ capacity. These partnerships, and the capacity they have built can be leveraged for subsequent opportunities.⁵ Within USAID, initiatives that sought to disrupt the historic donor/recipient model such as Partnership for Growth,⁶ the Journey to Self-Reliance,⁷ and the New Partnership Initiative⁸ have contributed to intergovernmental policy shifts with country governments taking increased ownership. Finally, dedicated annual funding for HEIs and research collaborations have ensured continuity and enabled other long-term investments. These advances in local university systems have contributed to the robust response to COVID-19.

This paper presents examples of HEI-based responses to the COVID-19 pandemic, demonstrating the importance of developing, supporting, and maintaining HEI networks in LMICs. These examples were drawn from a recent in-depth analysis of publicly available accounting of HEI responses and from USAID HEI implementing partners in the Higher Education Solutions Network (HESN),⁹ Partnerships for Enhanced Engagement in Research (PEER),¹⁰ and the Accelerating Local Potential program (ALP).¹¹ They highlight that HEIs can have an outsized impact locally, nationally, and internationally during crises and can rapidly develop and mobilize tailored solutions to critical challenges. Moving forward, governments, donors, and the next generation of science diplomats must increase investment in and draw attention to HEI systems around the globe so HEIs can sustain their vital role in responding to social impacts of COVID-19.

HEIs  link  many elements of society; are able to rapidly mobilize people and resources at community, national, and international levels; can sometimes transmit information and data faster than larger international bodies; and often offer greater institutional stability and closer governmental connections than the non-governmental organizations with whom aid organizations typically partner.¹² In this article, we showcase how science diplomacy investments that strengthen HEI systems yield stabilizing dividends for countries during times of crisis. Thus, we recommend that international foreign assistance providers create flexible, open funding mechanisms to identify and invest in indigenous HEI capacity. These vital institutions can then be leveraged to channel South-South and South-North collaborations.

Investments in university-driven collaboration helped prepare for the COVID-19 response

Science diplomacy-focused responses to previous infectious disease epidemics laid the groundwork for HEI-led responses to COVID-19. In the 2013-2016 Ebola epidemic in West Africa, international teams, partnering with local institutions, were critical in the effective response.¹³ At the beginning of the epidemic, international health organizations deployed staff with broad expertise including medical anthropology, risk communication, and social mobilization.¹⁴ As the Ebola epidemic grew, higher education systems served an important role in supporting a coordinated, multidisciplinary response. However, the social return on investments in higher education partnerships was not limited to the Ebola response. After the Ebola epidemic, the United States Agency for International Development (USAID) created two programs, Partnerships for Enhanced Engagement in Research Liberia (PEER/Liberia) and One Health Workforce Programs (OHW), which have provided infrastructure and expanded the capacity built during the Ebola crisis to mitigate the COVID-19 pandemic.¹⁵

In some LMICs, the COVID-19 pandemic has revealed numerous operational, reporting, and rapid communication challenges, challenges that were also highlighted during the Ebola epidemic. The global rather than regional nature of the COVID-19 pandemic meant that large international response organizations struggled at first to meet individual country needs, as often each country-government-member had to focus inward to address its own emerging domestic disaster.¹⁶ But even as the pandemic paralyzed the globe, many universities in LMICs leveraged and continued to strengthen inter-university ties, offering digital training opportunities to support students and staff, purchasing laptops and data plans to facilitate remote learning, and building platforms for sharing COVID-19-related data. HEIs worked quickly, often in partnership with local disease control agencies, in creating public-facing disease tracking dashboards and releasing best-practice recommendations.¹⁷ The dynamic channels of communication that were already established, among HEI researchers allowed them to quickly collaborate, and share data and ideas during outbreaks.

Example: One Health Workforce

Partners: University of Minnesota, Tufts University, One Health Central and Eastern Africa, Southeast Asia One Health University Network, Indonesia One Health University Network, Malaysia One Health University Network, Thailand One Health University Network, Vietnam One Health University Network, funded by USAID as part of the OHW program

The OHW program was developed in the aftermath of several recent and notable zoonotic epidemics – Ebola, the African swine fever, and SARS – that helped pave its inception. The program brought together HEIs through two regional and four national networks in Africa and Southeast Asia and from across multiple disciplines including human and animal health, environment, epidemiology, and agriculture. It called attention to the need for competency domains in the areas of management, culture and beliefs, communications, informatics, leadership, policy and advocacy, teamwork, and systems thinking, and applied these principles to classroom and field-based training. In this way, OHW was designed to change the way health researchers and practitioners saw their work, moving from just disease observation and tracking, to include communication and prevention. Using a One Health approach, it targeted the capacity of country workforces to respond to threats by enhancing coordination across sectors through hard and soft skills training. OHW’s success has been based on regional and global cooperation and coordination for advanced skills, networks, and expedited action.¹⁸ The follow-on program, One Health Workforce - Next Generation, is expanding on OHW and building human resources capacity for more effective disease surveillance and control.¹⁹ In response to COVID-19, OHW institutions have actively surveyed and educated communities and government staff, developed tailor-made public messaging platforms with infographics, and shifted resources to increase testing and contact tracing. OHW and OHW Next Generation have contributed to new methodologies for multisectoral coordination and workforce training, which have led to improved outreach, more rapid response times, and a more professional health workforce around the globe.

Example: Partnerships for Enhanced Engagement in Research Liberia (PEER/Liberia)

Partners: University of Liberia A.M. Dogliotti College of Medicine, Mother Patern College of Health Sciences, Yale University, Vanderbilt University Medical Center, University of Massachusetts Medical School, funded by USAID as part of the PEER program

In response to the Ebola outbreak in Liberia in 2014, USAID’s PEER program awarded a consortium of U.S. universities funds to develop and implement medical student training courses, faculty development, and an infectious diseases fellowship program from the ground up at A.M. Dogliotti College of Medicine (AMD).²⁰ For the faculty development program, PEER/Liberia’s U.S. faculty initially planned to train the first cohort of AMD faculty. However, early in the process, they learned about a similar USAID program at Mother Patern College of Health Sciences (MP), a nursing school in Liberia. Rather than rely on U.S. faculty, PEER/Liberia decided to partner with MP faculty, adapting the curriculum to better suit their faculty, and leveraging MP’s existing network of trained facilitators. MP faculty led the training in the fall of 2019, MP and AMD faculty split responsibilities in the fall of 2020, and AMD faculty are planning to lead independently in the fall of 2021. U.S. faculty planned to be present during all three trainings to contribute additional technical assistance. When the program began, the partnership with MP was useful for leveraging in-country expertise and previous USAID investments, but it became indispensable with COVID-19. The two HEIs are located in the same city, and with low numbers of COVID-19 cases in Liberia, faculty training has been able to continue almost entirely as planned, with small modifications to allow for physical distancing. By investing in local, indigenous capabilities, PEER/Liberia strengthened HEI networks and enabled an adaptive response to the COVID-19 pandemic that allowed essential medical training to continue.

Additionally, while the conduits between HEIs tend to be  apolitical, they often extend beyond the university system and into the halls of government through well-connected HEI leadership. For example, the lead Liberian health practitioner in the PEER/Liberia program and current Vice President for Health Sciences at the University of Liberia and is also the former Minister of Health for the Republic of Liberia. In many LMICs, faculty positions at the country’s top HEIs are direct pipelines to and from policy posts, which facilitates open communication and collaboration between universities and policymakers. These important scholarly and diplomatic connections provide an opening for discussions about the reliability of data coming out of research institutions, how that data can shape a locally driven response, and what evidence-based policies or frameworks should be developed during a fast-moving crisis.

Example: Science, Technology, Research and Innovation for Development (STRIDE) Program

Partners: Government of the Philippines, Philippine higher education institutions (HEIs), local private sector, implemented by RTI International, funded by USAID

Partnership for Growth (PFG) is a partnership between the United States and a select group of countries to accelerate and sustain broad-based economic growth by putting into practice the principles of former President Obama’s September 2010 Presidential Policy Directive on Global Development.²¹ The U.S.-Philippines Partnership for Growth initiative created a strong foundation that enabled an innovation-driven, Filipino-led response to COVID-19. USAID’s Science, Technology, Research and Innovation for Development (STRIDE) program²² began as part of the Partnership for Growth. STRIDE focused on private sector engagement, science and technology innovation capacity development, and enhancing policy and management capacity at HEIs across the Philippines—all in partnership with the national government. Program results include the creation of the office of Competitiveness and Innovation Group at the Department of Trade and Industry (DTI), the establishment of Regional Inclusive Innovation Centers across the country,²³ the implementation of an innovation roadmap for public universities in collaboration with the Philippine Association of State Universities and Colleges,²⁴ and the establishment of Knowledge and Technology Transfer Offices at 56 Philippine HEIs. These advances correlated with the Philippines rising in the overall Global Innovation Index from 95th in 2012 to 50th in 2020.²⁵

STRIDE’s investments in improving the science and innovation ecosystem, including improving the process of procuring scientific supplies and equipment, made it possible for HEIs in the Philippines to respond quickly to COVID-19. Advances include the university-led rapid manufacture of low-cost medical and personal protective equipment, the production of locally sourced bioethanol disinfectants, and capacity building to perform advanced molecular biology techniques using polymerase chain reaction (PCR).

Higher education systems provide a bridge between communities, industry, and government

HEIs are deeply rooted in their local communities, drawing students, leadership, and research projects to address the challenges those communities face. Each community needed to respond to COVID-19 differently and policies or programming that work through HEIs can lead to a sustained  impact that outlives news cycles. Nearly every country saw their HEIs quickly repurpose research lab space and expertise to address the pandemic and share results through pre-publications or university websites. Through their transparency and nimble actions, HEIs allowed countries to learn and respond more quickly.²⁶ These examples demonstrate how HEIs have the unique ability to receive and disseminate knowledge from international scientific networks and then craft interventions that are responsive to local needs.

Example: Malawi Innovation Scholars Program

Partners: Malawi University of Science & Technology (MUST), Lilongwe University of Natural Resources and Agriculture, Michigan State University, funded by USAID as part of the Accelerating Local Potential (ALP) program

The Malawi Innovation Scholars Program, launched in 2016 with support from USAID, helps to train university faculty and staff in innovation and design thinking. In response to the COVID-19 crisis, MUST invited proposals related to preventing the spread of the virus as well as tracking infections. These proposals take a human-centered design approach, requiring applicants to define their problem and identify potential end-users. Each accepted proposal was then supported by a coaching team as well as a customized packet of materials to assist with gathering insights from end-users about the problem, prototyping, testing, and planning to pass on data or technologies to health institutions for further development or scaling.

One of the supported ideas includes mobile handwashing stations that can run on three sources of power (electrical grid solar panels, and batteries) and are adaptable to a variety of urban and rural settings.²⁷ The team leveraged a partnership with Michigan State University to rapidly develop a research instrument to gather end-user insights at financial and health institutions. Following testing, the mobile hand-washing stations caught the attention of the United Nations Development Program (UNDP) in Malawi as well as Malawi’s Revenue Authority and multiple prototypes (>40) are being developed and distributed across the country. Another supported idea was the Student COVID-19 Mobile App, an integrated platform for preventing, and containing the spread of the virus. The proposal was submitted by a group of MUST students who agreed to be advised by an Independent Study Project member. The app provides a central repository for users to access reliable information on COVID-19 from organizations such as the World Health Organization (WHO) and the Malawi Ministry of Health. The app encourages self-reporting of symptoms or those of other citizens, providing an avenue to conduct diagnoses remotely and connect these individuals to health workers. Data generated by the app also gave the Ministry of Health a mechanism to trace cases and identify emerging hotspots.

Example: 100,000 Students Against COVID-19

Partners: Virtual University of Senegal, Cheikh Anta Diop University of Dakar, Gaston-Berger University of Saint-Louis, Alioune Diop University of Bambey, University of Thiès, Assane Seck University of Ziguincho, University of Sine Saloum El-Hadj Ibrahima Niass, Amadou Mahtar Mbow University, Health Emergencies Operations Center (COUS) of the Ministry of Health and Social Action

In Senegal, the “100,000 Students Against COVID-19” organization was founded through a consortium of eight public Senegalese universities, and helped mobilize youth to reduce the spread of COVID-19.²⁸ The organization collaborated closely with the Health Emergency Operation Center (COUS), a government agency created in response to the Ebola crisis and supported by USAID and the WHO. The existing relationship between COUS and universities was instrumental for rapidly responding to COVID-19, allowing the new organization to easily reach students specializing in relevant fields such as medicine, public health, and epidemiology. Those students in turn helped develop locally relevant COVID-19 awareness campaigns, initiate community surveillance campaigns in coordination with local health authorities and identify leaders that could effectively communicate risks to the community. 

Example: Innovative research on therapeutic equine antibodies against SARS-CoV2: University of Costa Rica Research Center, Costa Rica Social Security Fund, George Mason University, Central American Bank for Economic Integration

The Costa Rican Social Security Fund, which runs Costa Rica’s public hospitals and clinics, identified and leveraged the expertise of the research community of the Clodomiro Picado Institute in the fight against the pandemic.²⁹ The Institute, a research unit at the University of Costa Rica, produces equine antibodies for snakebites that save hundreds of lives in Costa Rica and thousands more worldwide each year. Researchers were able to use their technology platforms and experience to produce safe and effective COVID-19 equine immunoglobulins for patients whose immune systems do not produce enough antibodies to fully clear viral particles. In August 2020, after the equine antibodies were purified, vials were sent to George Mason University, where the horse-produced polyclonal antibodies were tested against lab-grown SARS-CoV-2 viral particles and shown to neutralize  the virus. Currently, the equine antibodies are in an accelerated clinical trial and will move to large-scale production depending on the results. The institute received a $500,000 grant in August from the Central American Bank for Economic Integration to support its work. 

Example: Makerere University

Partners: Various

Ugandan universities and research centers are playing a critical role in both the local and global response to COVID-19. Makerere University, a world-class research institution and leader of the Resilient Africa Network (RAN) part of the USAID-funded HESN, is driving critical COVID-19-related research and innovation. For example, Makerere is leading an international, multi-sector consortium in a clinical trial to test the efficiency of plasma from people who have recovered from COVID-19 in treating COVID-19.³⁰ This study has the added benefit of also building the capacity of the Uganda Blood Transfusion Service (UBTS) to collect and process this convalescent plasma. The study is leveraging UBTS’s immunology lab to test the immunological properties of the plasma and working with epidemiological and clinical teams to set up the trial. Similarly, the Uganda Virus Research Institute (UVRI) along with researchers from the London School of Hygiene and Tropical Medicine, Makerere University, the Uganda Ministry of Health, and the UK Research and Innovation Medical Research Council are conducting rapid local sequencing of the coronavirus and have generated the first Ugandan SARS-CoV-2 full genome. Through such research, Ugandan scientists have been better able to understand how the virus is circulating in the region and mount an appropriate local response.³¹

Makerere University’s expansive networks and close government ties have been critical to Uganda’s response. The university organized public dialogues on COVID-19 in collaboration with Uganda's Ministry of Health and the WHO to disseminate public health advice to communities.³² The university also developed a Coronavirus Resource Center that integrates national data from Uganda’s Ministry of Health with global data from Johns Hopkins University.³³ At the same time, Makerere is leveraging partnerships to address the socio-economic impacts of COVID-19 by rolling out innovations to address gender-based violence and, together with the QED Group, supporting USAID Uganda to adapt existing programs to address emerging social challenges.

According to Dr. Roy Mayega, Deputy Chief of Party for the USAID-funded RAN and Lecturer at the Makerere University School of Public Health: “The impact we see from these initiatives is that the national response has been strongly supported by evidence and science and Makerere University has been at the center of providing the scientific support to the response.” The sustainability of these advances is bolstered by the recent establishment of the Uganda Research and Innovation Fund, an $18M investment by the Ugandan government to support local research and innovation for development.³⁴

Conclusion

HEI responses to COVID-19 demonstrate how they can serve a critical and outsized function in understanding and responding to shocks, as well as contributing to collective resilience against future shocks. Owing to their culture of adherence to the scientific method, international collaboration, and apolitical open channels of dialogue amongst academics, higher education is uniquely situated to be a lever for science diplomacy. HEIs can, and have, played a key role in the process of gathering, translating, and disseminating evidence nationally and internationally, oftentimes with advanced knowledge of newly emerging information. HEI networks rapidly created sharing platforms that provided local, then national and even international constituents with critical information that was more robust and faster to respond than had been anticipated.

Relative to other development priorities, fairly minimal emphasis has been placed on strengthening higher education institutions in development assistance strategies. However, the results achieved as a consequence of these initial investments suggest that continued strengthening of the higher education system globally will yield even greater benefit in the long run. While it is difficult to predict how HEIs will react to future shocks, designing strategic diplomatic ties between civil society, governments, and international HEIs will cement the networks needed to leverage HEIs for rapid responses.

Government funding agencies and donors should recognize the role of HEIs as central actors in locally led development—conducting and applying research, delivering quality education, and engaging communities.³⁵ Through creating multiple nodes of connection to rigorous HEI-driven research and data, governments and decision makers can leverage channels of discussion, and rapid routes of dissemination to communities in need. In parallel, funding organizations should identify appropriate indicators to track these partnerships in order to guarantee that indicator data can be quickly used for decision-making, while leaving room for both discovery science (directed by HEIs) and decisional science (directed by funders) which operate on different time scales.

At the individual and institutional level, new approaches are needed to train the next generation of science diplomats to foster international teams. Universities should make a point of supporting knowledge exchange and technology transfer through cross-border collaborations, mentorship programs, and extended technical exchanges in partners’ labs. Appropriate laboratory funding is critical so that these partners have the equipment necessary for research. Organizations like Seeding Labs³⁶ and The World Academy of Scientists³⁷ are starting to fill this gap, but significantly more investments are merited. Similarly, the Science and Technology Joint Commission Meetings led by the U.S. Department of State have been instrumental in forging bilateral science and technology partnerships and agreements.³⁸

The COVID-19 pandemic is a crisis without comparison in modern history, yet it provides an opportunity to recognize and leverage previously overlooked leaders, such as LMIC higher education institutions, in preparation for future shocks and stresses. As the global scientific enterprise evolves and recovers in the coming months and years, governments, communities, non-profit organizations, and universities should continue to internationalize and deepen connections between scientists. Higher education systems around the world have shown that their institutions can provide stability, foster innovation, and quickly mobilize resources for their communities during times of crisis. However, higher education systems will require strategic long-term investments to build academic infrastructure and create sustainable networks.

The world as we knew it no longer exists. The time to re-imagine collaborative and communal relationships in higher education and research, and put financial and operational weight behind them, is now. Ultimately, increased and diversified investments in HEIs and research platforms—both in their technical and research capacity and their operational and management capacity—should be a critical part of the recovery effort. Governments, donors, philanthropic institutions, and others that fund science across the globe must take action to support HEIs in the recovery effort—particularly because some institutions will be struggling with lower enrollment which will reduce their ability to respond to crises at the local level. This paper describes several existing vehicles and platforms for collaborative HEI capacity building around science and technology. In addition, as institutions evaluate their own assets, performance, and societal impact with respect to their responses to COVID-19, mechanisms that have emerged during the last year for collaborating quickly across departments, institutions, and with communities should receive additional support. Higher education institutions have a remarkable ability to learn and adapt, and many are already leading the way.

Disclaimer

The views and opinions expressed in this paper are those of the authors and not necessarily the views and opinions of the United States Agency for International Development (USAID). This activity, in part, was supported by an AAAS Science & Technology Policy Fellowship served at USAID.

Endnotes

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