If You Could Fund Just One Public Health Study in 2025: What Would It Be?

[Adam J. Mohamed, inspired by Prof. Ozayr Mahomed]

Prof. Mahomed's words echoed in my mind like a haunting melody:

"When the goal becomes the paper, not the problem or solution, we lose the point. Too much public health research is written to be cited, not applied."

The silent march of neglected tropical diseases (NTDS), the insidious creep of antimicrobial resistance (AMR). These weren't abstract concepts on a spread- sheet; they were the daily reality for millions in low and middle-income countries like Tanzania. If he could fund just one public health study in 2025, what would it be? The question had been posed, a rhetorical flourish before the inevitable dive into existing grants and predetermined agendas.

I thought of the research I had seen, the countless papers dissecting the prevalence of Lymphatic Filariasis, mapping the spread of drug-resistant microbial strains, analyzing the socio-economic determinants of Trachoma. All meticulously done, rigorously peer-reviewed, and often, ultimately, gathering dust in digital archives.

We chase journal metrics, H-indices, and publication counts while communities wait for solutions & health systems to wait for innovation.

I imagined a different kind of study, one that wouldn't chase metrics but would chase CHANGE. It wouldn’t just identify a problem; it would unravel the tangled threads that prevented solutions from reaching the people who needed them most.

My hypothetical study wouldn’t focus on what the NTDs burden was in rural Tanzanian villages, but why existing interventions weren’t consistently reaching every child. It wouldn’t simply report on the rising rates of AMR in local clinics, but would delve into the complex behavioral, systemic, and economic factors that fueled it, and crucially, what practical, community-led solutions could truly bend the curve.

If could fund just one study it would focus on the implementation science of integrated, community-led interventions for NTDs control and AMR stewardship in rural Tanzania settings, with specific emphasis on local resource optimization and sustainable scalability.

"This wouldn’t be a study to merely document the failure of existing programs. It would be a deep dive into the mechanisms of failure and, more importantly, the untapped potential for success. We would partner with local health workers, community leaders, and traditional healers – not as subjects, but as co-creators of knowledge. We would ask: What are the genuine barriers to widespread deworming campaigns reaching every child? Is it logistical? Cultural? A lack of trust? And how can we empower local women’s groups, youth associations, and religious leaders to become the frontline advocates for health, not just recipients of top-down directives?" I envisioned a multi-faceted approach. On the NTDs front, the study would explore how integrated campaigns – combining deworming with nutritional interventions, sanitation education, and access to clean water – could be sustainably implemented at the village level. It wouldn’t just measure prevalence reduction; it would quantify the empowerment of communities to maintain these gains. It would identify and celebrate indigenous solutions, the quiet innovations already happening at the grassroots, often overlooked by the grand narratives of global health.

And on AMR, the focus would shift from broad prescribing patterns to the micro-level decisions made by individuals and informal healthcare providers. "We would investigate the ‘why’ behind antibiotic misuse, the desperation that leads someone to share leftover drugs, the lack of accessible diagnostics that pushes prescribers towards broad-spectrum antibiotics, the influence of pharmaceutical marketing on informal drug vendors. Then, we would collaboratively design and test culturally appropriate interventions: peer education programs for responsible antibiotic use, simple diagnostic tools that can be utilized in remote clinics, and economic incentives for healthcare providers to prescribe judiciously."

The true innovation of this study, wouldn’t be in its findings, but in its process. It would embody Prof. Mahomed’s call to action: "Will it inform policy, shift practice, or empower people? Or is it just another line on a CV?" This research would be designed from the outset to directly inform district-level health policy, to empower village health committees to become agents of change, and to shift clinical practices away from a reactive, symptom-driven model towards a proactive, community-centric one.

A qualitative arm that captures the lived experiences of those battling NTDs, giving voice to their frustrations and their resilience. A quantitative arm that rigorously evaluates the impact of these community-led interventions, not just on disease metrics, but on health literacy, economic stability, and social cohesion. And crucially, a robust knowledge translation framework embedded from day one, ensuring that every finding, every insight, is immediately packaged and disseminated in accessible formats for policymakers, community leaders, and the general public." I thought of the generations yet to come, the children now playing in the dust. Their future health wouldn't be defined by the number of papers published on NTDs or AMR, but by the tangible improvements in their communities. "Our greatest contribution isn't a paper. It's a healthier community."

Not to chase metrics, but to outline a proposal that, if funded, would truly bring the "public" back into public health research, transforming not just lives, but the very definition of impact. Because for me, and for a growing number of researchers, the time for mere recognition was over. The time for tangible transformation had arrived.

Merci beaucoup