It was the final conference of a project I have been involved in over the past four years on zoonoses, ecosystems and wellbeing in Africa. The conference highlighted the idea of â€˜One Healthâ€™, a movement aimed at linking human, livestock and ecosystem health. The focus was on how to make this happen in the â€˜real worldâ€™, so that both emerging and endemic zoonotic diseases can be tackled effectively.
Over the last few years, influenza, Ebola and now Zika have struck in different parts of the world, often with devastating consequences. The argument of those at the conference â€“ and indeed of our project, the Dynamic Drivers or Disease in Africa Consortium (DDDAC) â€“ was that better integration, and more interdisciplinary collaboration will make a big difference to the effectiveness of responses to disease, and focus on ecosystems, poverty and wellbeing need to be central.
There was certainly a great buzz at the conference, and beyond (#OneHealth2016 was one of the top trending topics on Twitter in the UK on the opening day!). We had some very high level speakers, from the head of the Wellcome Trust, Jeremy Farrar, to the Chief Scientist at the UKâ€™s Department for International Development, Charlotte Watts, as well as excellent participation from a range of stellar researchers and students working on One Health issues.
One of the recurrent themes was that making a â€˜One Healthâ€™ approach, rooted in interdisciplinary science, is really tough. And perhaps even more so, when we move to a transdisciplinary approach, working with practitioners and policy makers to â€˜co-constructâ€™ knowledge and action.
There is a lot of talk of inter- and transdisciplinary research these days. Everyone wants cutting edge research that makes a difference. So whether itâ€™s the Gates Foundation, the Wellcome Trust, the European Commissionâ€™s Horizon 2020 programme, or the new UK research council strategy, or umbrella programmes such as Future Earth, all want such problem focused research to tackle the big global issues of our time. And the themes of our conference, and our project, linking environmental change with disease with policy impacts certainly fit into this category.
Our project was supported by the UK Ecosystem Services and Poverty Alleviation Programme, funded by DFID, the UK Natural Environmental Research Council and the Economic and Social Research Council, and was hosted by the ESRC STEPS Centre based at Sussex University. It involved five countries in Africa (Zimbabwe, Zambia, Kenya, Sierra Leone and Ghana), four diseases (trypanosomiasis, Rift Valley Fever, Lassa Fever and Henipah). Each country study was focused on a puzzle, focusing on how diseases emerge, get transmitted, and who they affect different groups of people. The overall Consortium involved 19 institutions, ranging from diverse research groups in multiple universities in Africa, Europe and the US to veterinary, public health and wildlife departments in Africa. At last count there were more than 50 researchers involved in various ways. It was massively ambitious, and premised on a commitment to transdisciplinary working,
Â Unpacking the process of transdisciplinary research
Â Here I want to focus on the challenges and opportunities of the research process, rather than the results (more on those soon on this blog). The work has aimed to seek answers to on-the-ground problems, aiming at producing top-level research and generating an impact. But this is easier said (or written glibly into a proposal) than done. Building the ways of working in a transdisciplinary team is not easy. Much of it is about building trust, creating relationships, and finding new languages for interacting. These do not come easily. We had four all-team workshops during the project. Their tenor followed almost exactly the phases of group formation proposed by the psychologist, Bruce Tuckman.
The first was about â€˜formingâ€™ â€“ finding out what the Consortium was about â€“ which we held at ILRI in Nairobi. We didnâ€™t know each other then. There was a nervousness, and not a little scepticism. The next workshop at Sussex focused on setting up the research and methodology. This was the â€˜stormingâ€™ phase. Here we had to negotiate our roles, and define our stance â€“ in a potentially threatening and confusing setting. There were a few arguments, and some misunderstandings â€“ and some storming. We got through this, and got on with the work, but it took us a while to reach the â€˜normingâ€™ phase. This was alreadyÂ three years into the project at a workshop in Naivasha, Kenya. We had found a way of working, but we were only just beginning to build the relationships that really deliver transdisciplinary work. This really only happened in the final period, and at our last workshop â€“ last week at London zoo â€“ we could really say that we were â€˜performingâ€™. This final stage, where groups genuinely work together, came too late. We already had a nine-month no-cost extension ending next month, and the money had run out.
What lessons have we learned from this journey?
Central is the importance of time. It takes a while for any group to go through these stages. With a large, complex, international group, it takes longer. There are no real short-cuts.
Time is also important when studying dynamic complex systems, as there will be events that cannot be planned for that reframe the way we think, and the way we work. Ebola was the big one in our project, coming in 2014, right in the middle of the Sierra Leone fieldwork, which was in the epicentre of the outbreak. This made us rethink and restructure the work. But, despite the horrors, the experience helped us focus on new issues, and appreciate the value of cross-disciplinary working; something that of course proved to be vital to the Ebola response more generally.
Time is also important as the last pieces of the puzzle may be difficult to find. The whole story of the Zimbabwe work looking at trypanosomiasis only fell into place last week, when we were able to sit together and discuss the results of the livestock blood sampling. Mapped onto our GIS information from the geographers, and combined with the participatory analysis done in the field in Hurungwe the story became much clearer (more on this on this blog soon).
Linking different disciplinary approaches is not easy. There are different languages (from complex mathematics to complex words), and different styles of collecting, analysing and writing up data. Fieldwork means different things to different disciplines; as does paper writing, policy engagement, and so on. All these have to be negotiated. To work together we have to learn both new languages and cultures, and be patient and respectful.
But we also need frameworks that help make the connections that create the new insights. The DDDAC project had a simple framework that helped our earlier â€˜formingâ€™ and â€˜normingâ€™ stages, but we really got to â€˜performingâ€™ when we were able to link analytical approaches. This particularly focused on connecting different types of â€˜modellingâ€™. Everyone models the world â€“ itâ€™s just a framework for understanding expressed in different ways â€“ but what the assumptions, frames and data requirements are will depend on who is modelling, and posing the questions.
We had various modelling efforts looking at diseases, emergence, spread and impact, from mechanistic Process based models, to statistical, macro ecological Pattern models to a diversity of Participatory modelling approaches, rooted in field analysis. Our 3P approach allowed conversations to happen and new results to begin to emerge, in this final period.
In other cross-disciplinary experiences â€“ whether around the sustainable livelihoods framework or the STEPS pathways approach â€“ my experience has been that, for all their limitations (there are many, for sure), these frameworks (â€˜modelsâ€™) allow new conversations to happen, and new insights to emerge. So it has been in our integrative modelling, although only just touching the surface, due to our curtailed â€˜performingâ€™ phase. Four years in,Â new insights on disease emergence, transmission and effect were just beginning to emerge.
But itâ€™s not just the frameworks that are important, itâ€™s the people who are able to make the links â€“ creating the basis for joint work. There are many different people with different roles in a successful team, as group psychologists, such as Meredith Belbin, have long known. We had very high-powered people in our team, many topÂ researchers in their disciplines. But getting researchers and other project participantsÂ to work together required some unusual and new skills.
Research brokers, facilitators and leaders are rarely recognised, but essential for cross-disciplinary work. We had a number of such people luckily, but I donâ€™t think we knew enough about their importance at the beginning to give them well thought through roles, or even identify such skills in advance. Leadership in transdisciplinary working is a very special skill and a vital, usually unrecognised, and poorly rewarded, role.
Our four team workshops moved the approach to working together forward incrementally. But between our four workshops, the team dispersed, fragmented, and often went back to silo working. Sustaining a continuous process of interaction is difficult, and expensive in an international project. Students can be key, as they are not subject to the same institutional strictures, and set professional behaviours and practices. Yet in our project, studentships were not encouraged, and we had only selective engagements, often from outside the project. This undermined coherence and continuity, and constrained genuine opportunities for transdisciplinary working.
As so many large projects, the temptation is to break things down into â€˜work packagesâ€™; manageable units, associated with certain deliverables, with devolved leadership roles. This makes sense from an ease of management point of view, and indeed was encouraged in our project by the funding going to four separate Principal Investigators in four institutions. But integration then becomes incredibly difficult, as making links between activities, and making use of budgets to make this happen is impossible, as they are held multiply in protected silos.
Breaking out of existing institutional cultures, structured around disciplines and sectors, is incredibly difficult. And any project must know its limits. People have to be rewarded in their own systems, as well as gaining benefits from new collaborations. Itâ€™s not an easy balancing act. Ultimately people get promoted in their own institutions/disciplines, not in a project. And different people in such a project have very different reward systems, styles of publishing, forms of authorship and so on. Developing ways of working that take these into account, but move people to work in new ways is important, but not easy.
As so many projects formulated in a highly competitive funding environment, the earth was promised. But inevitably it could not be delivered inÂ three Â years. It would be absurd to expect it to have been despite the generous budget. The pressure was on from the beginning â€“ high end, international science delivering impact. Anyone involved in research projects these days will know the routine. Impact, engagement, communications are central. This is all good, but forcing it may not make sense. Impacts emerge over time through relationships, and based on results that may not emerge easily. These are complex, difficult, challenging puzzles.
So the formulaic model of impact may not be appropriate, and we perhaps should be more sanguine about what is possible. Of course in our â€˜pathways to impactâ€™ assessments we over-promise (sometimes even lie), so the audit culture of project management kicks in to assess why we havenâ€™t met the targets. And changing course, being flexible and reinventing projects to fit the moment is regarded with horror by research managers.
There is a dangerous culture of control in much research funding. Yes, linked to accountability, and assuring â€˜value for moneyâ€™, but pushing an inflexible audit approach can too often undermine creative, innovative research. There were moments in this project where overbearing centralised funder management constrained operations, and undermined partnerships.
At the end of our project last week, we felt weâ€™d only just started. We had done some good work, we had struck up excellent new transdisciplinary relationships, but we had only just started â€˜performingâ€™ when the money had run out.
All large group based projects (a common feature of funding modalities these days) go through the four group formation phases. So why not fund and manage in relation to this? Fund the forming, norming and storming, and performing separately in a phased approach.
There can be an expectation that some projects never get past forming, some never generate norms, and some fall apart during the storming (I have been in projects of all these types over the last 30 years!). But if you get to performing, often after quite a while, then you need proper funding for really generating the value from the funding. In our case much of the investment is sunk in a set of relationships that sadly will not be fully utilised as the funds have finished.
One route to this is through such a phased â€˜challengeâ€™ approach (Gates follows something similar, in the language of proof of concept to final project, although the argument is a bit different here). Another is to establish long-term, well-funded Centres around successful groups that have begun â€˜performingâ€™. This is the approach of UK research councils, Wellcome Trust and others. Centres with 10-20 years of funding can really make a difference. They can provide the home (real and virtual) for the type of interactions that are required to create real transdisciplinary work.
Only as part of Centres can the â€˜constructive conflictâ€™ between disciplines be generated andÂ the type of frameworks that allow integrative, joint working encouraged. And only in such settings can the new norms and cultures that transdisciplinary work requires be fostered â€“ and across generations of researchers and practitioners, this is a long-haul job.
Such efforts are of course not cheap, but the investment can be very worthwhile (and great value for money), as the sunk costs can genuinely be capitalised upon for really change-making work. Too often the money is pulled just as things get going, and exciting. The costs need to be focused on the relation-building that generate impact, rather than formulaic approaches, and invested in leadership, brokerage and facilitation that allow creative partnerships to be nurtured and allowed to work. This is difficult to programme and plan, and even more difficult to fit into the audit systems that dominate funding agenciesâ€™ obsessions.
Interdisciplinary and transdisciplinary collaboration is really hard, and involves a long slog that can be conflictual and challenging. But in the big issues that confront us today â€“ whether climate change, sustainable development, zoonotic disease emergence, or indeed any area where multiple perspectives on a complex, dynamic problem are required â€“ such approaches are imperative, and in my view a good investment. In our DDDAC project we made a creditable start, but are only at the beginning.Environment