Adetokunbo O. Lucas, MD
TDR Director 1976–1986
Currently, Adjunct Professor
Harvard University, Cambridge, Massachusetts, USA
The Special Programme for Research and Training in Tropical Diseases (TDR) was created in response to a World Health Assembly resolution that urged the Director General to intensify WHO’s research on tropical diseases. The idea was widely welcomed but there was much debate and dispute about the design and implementation of the programme. Some of the controversies threatened to abort the programme in its incubatory phase. It seemed that the difficult birth would produce a stillbirth or an early neonatal death.
Three agencies had agreed in principle to cosponsor TDR, but in the initial phase the World Bank withheld its commitment to join WHO and UNDP in the venture. Robert McNamara, the head of the Bank, had reservations on two issues:
- TDR’s design to use networks of collaborating scientists instead of the traditional dedicated research institutes;
- the qualifications of the Director of TDR.
The ultimatum was clear and uncompromising but eventually, the Bank relented and became a strong and loyal member of the team.
Five pillars of strength
The features that enabled TDR to achieve its outstanding success can be briefly summarized as follows:
- Strong leadership at the top – notably the personal commitment of Dr Halfdan Mahler, the Director General of WHO, and his deputy, Professor T. Adeoye Lambo, as well as leaders among the cosponsors.
- Eminent scientists and managers on the staff of TDR and other relevant units in WHO.
- Networks of scientists who served as advisers and researchers.
- Pharmaceutical industry – fruitful partnerships.
- Donors and fund raisers: generous donations enabling TDR to achieve its goals.
TDR’s contribution must not be viewed narrowly as an isolated venture. Rather, it should be recognized as one of the important building blocks of global health. In addition to its specific contributions to the control and elimination of tropical diseases, TDR has generated useful lessons in the context of global health.
Five pillars of wisdom
TDR illustrates important features which characterize the modern concepts of global health. Over the past four decades, TDR has learnt and taught five essential features that constitute the current concept of global health.
- Ethical standards based on equity and social justice.
- Health research – multidisciplinary – biomedical and social sciences.
- Strategic design and management of disease control programmes with effective monitoring and evaluation.
- Collaboration – national, regional and global.
- Setting global priorities for disease control, elimination, and if feasible, eradication.