AUTHOR=Donna María Lucila Gonzalez , León María Luisa Cabañas , Colas Cinthia Gauna , Gunsett Alicia Pomata , Maniero Silvia Ferreira , Osuna David Olivares , Klimovsky Ezequiel , Coradini Lucas , Enrico Diego , Chacón Matías , Waisberg Federico TITLE=Breaking the unvirtuous cycle: barriers and opportunities for research and development in Paraguay. A case study JOURNAL=Frontiers in Medicine VOLUME=Volume 10 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1266246 DOI=10.3389/fmed.2023.1266246 ISSN=2296-858X ABSTRACT=Coordinated efforts are needed to break an unvirtuous cycle consolidated by low budget allocation for research and development, an insufficient number of clinical investigators and publications, and scarce private investment. There is an increasing interest in enhancing health research in Paraguay, materialized in the creation of specific programs that encourage the collaborative work of healthcare providers, basic scientists, and private investors. Nonetheless, a comprehensive approach is needed also to strengthen regulatory agencies and attract external sponsorship. While modern and currently popular topics, including artificial intelligence, real-world data, and translational research may represent key opportunities to seek investment, special policies should be adopted to prioritize research on the determinants of health in the Paraguayan population.This case study involved two main components: A literature review to analyze the regulatory framework, and the characteristics of past and ongoing research projects, and a semistructured survey to identify barriers and facilitators to promote clinical investigation in Paraguay.