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POLICY: PUBLIC HEALTH RESEARCH Recommended strategic approaches to solve the problem: Global level: ➜ The setting of the global agenda should involve researchers from developing countries. ➜ Dialogue between northern and southern researchers should be formally conducted to make northern researchers understand the difficulties of southern researchers. ➜ Global legislation and regulations should be put in place, requiring compensation to developing countries whenever any of their scientists is taken up for employment in the developed world. ➜ Funding agencies should make it obligatory to have good capacity building in any research activity conducted in a developing country. ➜ Equal partnership in research should be emphasised and there should be equal treatment to northern and southern researchers when conducting collaborative research. ➜ The creation of strong and high quality laboratories in the south must be treated as a matter of urgency. ➜ Conditions should be put in place to encourage leadership and coordination by the south in collaborative research. ➜ Global funding mechanisms should network and create complementary funding programmes with long-term commitments to ensure adequate funding and integration into the health systems for sustainability. ➜ Negative competition should be discouraged. WHO has had a long-term, successful programme in Africa which has created good capacities. These efforts should be complemented by the creation of similar programmes targeting complementary capacities for other diseases and health conditions. Regional level: ➜ Regional public health research coordination and promotion mechanisms should be created in developing countries ➜ Research funding mechanisms at regional level should be set and be adequately supported by regional governments. ➜ Regional participation in global public health research should be enhanced. ➜ Regional networks should be created and coordinated by regional mechanisms for greater impact. ➜ The excellent and vast northern capacities for research should be harnessed to support capacity building in developing countries. National level: ➜ Research coordination, promotion and monitoring mechanisms should be strengthened and national governments should provide more funding for research. ➜ Capacity strengthening at national level should be given priority and be strategically planned to fill in the major glaring gaps. ➜ Active creation of facilities for training and centres of excellence must be created. Partnerships with developing countries should be encouraged but guided by national and regional regulations, which prevent exploitation (Swiss Commission, 2001). ➜ Creation of facilities run and owned by the northern institutions in the south should be discouraged and existing ones should be run in partnership or integrated into country-owned systems. ➜ In addition to putting emphasis on research, countries must put in place effective plans to improve their health services and increase their capacity to absorb new interventions and scale them up at national level. ➜ Twining of laboratories and research institutions allowing for exchange of students and faculties should be encouraged. ➜ Inter country networking should be encouraged to enhance south-south collaboration. Discussion The world has set for itself the Millennium Development Goals and achieving them will require good information, evidence-based guidance on the implementation of effective interventions and continuous monitoring of more activities. Without a good base of scientific resources, this will not be possible even if resources are available. This provides an opportunity, to press for increased efforts in support of capacity building for public health research, to improve health status and reduce poverty. The Millennium Development Goals demand country actions and the actions of partners to provide assistance to poor countries. The goals do not require rich countries to solve the problems of the poor for them, but to help them solve their own problems. Charity does not work and is not sustainable. Globalisation is another opportunity, for uniting the world against the global problems and threats by disease and ill health. As Dr Pascoal Mocumbi put it “Above all we need to think in radical new ways – ways that show we are more conscious of our common humanity in this third millennium. Ways that make the obligation to help our weakest members the rule and the priority, rather than the exception. And ways in which there is no longer any place for the ‘my problem versus your problem” attitude that is still too prevalent in today’s otherwise globalised world (Mocumbi, 2004). The United Nations should take upon itself the responsibility of changing the global order and it is encouraging that this has been emphasised recently by world leaders, “Global problems need global multilateral solutions and the United Nations is best equipped to lead us”. It should push for more debt relief and use of such relief to build national scientific capacities especially in public health research. It should urge rich countries to contribute generously to the Global Fund to Fight AIDS, TB and Malaria, which should be maintained and used not only for 16 | World Hospitals and Health Services | Vol. 41 No. 3
POLICY: PUBLIC HEALTH RESEARCH providing the goods but especially for enabling countries to generate knowledge, tools and capacities to utilise effectively the available public health goods. Emphasis should be on strengthening the weak health systems in poor countries so that they can introduce and scale up interventions effectively. The international community must recognise the inadequacy of public health research capacities especially in developing countries, to solve the increasing global disease burden. Hence funding for research affecting the majority of the world population who are poor must not only be increased but audited to ascertain that funds reach and are used in disease endemic countries. Direct channelling of funds to developing countries’ institutions, instead of using intermediaries, will enhance capacity building for research management, coordination and accountability. Current initiatives like the European-Developing Countries Clinical Research Partnership (EDCTP) should be encouraged. Governments and regional organisations should provide the enabling environment for research through the enactment of appropriate policies that are relevant to research and product development. The lack of public health training facilities in disease endemic countries must be corrected and while endemic countries should take the lead, developed countries should help in providing technical and financial support. ❑ Reprinted from Global Forum Update on research for Health 2005, © Global Forum for Health Research 2005. References Anderson J, Maclean M, and Davies C, 1996. Malaria Research. An audit of International activities. Unit for Policy Research in Science and Medicine. PRISM Report No. 7, September 1996.. Global Forum for Health Research, 2002. The 10/90 Report on Health Research 2001-2002. Global Forum for Health Research, Geneva . Michaud C, Murray CCJL, 1996. Resources for health research and development in 1992; a global overview. In: WHO Ad-Hoc Committee, 1996. Investing In Health Research and Development. Report of the Ad-Hoc Committee on Health Research Relating to Future Intervention options. WHO, Geneva. Mocumbi P, 2004. ‘Plague of my People’. Nature 430: 925. Nchinda TC, 2002. ‘Research Capacity Strengthening in the South’. Social Science and Medicine 54: 1699-1711. Swiss Commission for Research Partnerships with Developing Countries, 2001. Enhancing Research Capacity in Developing and Transition Countries. Experiences, discussions, strategies and tools for building research capacity and strengthening institutions in view of promoting research for sustainable development. Swiss Commission for Research Partnerships with Developing Countries KFPE 2001. WHO Ad-Hoc Committee, 1996. Investing In Health Research and Development. Report of the Ad-Hoc Committee on Health Research Relating to Future Intervention options. WHO, Geneva. Vol. 41 No. 3 | World Hospitals and Health Services | 17
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