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Innovation Major classification Major infectious diseases Noncommunicable diseases and disabilities Mental health Nutrition Other infectious diseases Injuries ICT in health Disease/Intervention area HIV/AIDS TB Malaria Cancer Diabetes Hypertension/heart disease/stroke Mental health/nervous system disorders Respiratory infections, incl. COPD and asthma Endocrine and metabolic diseases Zoonoses, new and emerging diseases Diarrhoeal diseases Trauma, including burns Health informatics, telemedicine & e-health, Biostatistics and bio-informatics Research areas Vaccine development, Microbicides, Drug discovery and evaluation Drug discovery and evaluation, Diagnostics, Vaccine development Drug discovery and evaluation, Diagnostics, Clinical epidemiology, Vector interaction Diagnostics, Imaging, Drug discovery and evaluation Diagnostics, Drug discovery and evaluation, Medical devices and selfmanagement tools Diagnostics, Drug discovery and evaluation, Medical devices & selfmanagement tools Imaging, Drug discovery and evaluation, Medical devices and selfmanagement tools Food security research, Food supplementation Drug discovery and evaluation, Medical devices and self-management tools Drug discovery and evaluation, Diagnostics Diagnostics, Drug discovery and evaluation Diagnostics, Drug discovery and evaluation Imaging, Medical devices, Drug discovery and evaluation Table 2: Health areas identified as priority areas for the development of Department of Science and Technology interventions Research institutions with higher levels of expertise will be encouraged to partner with institutions with limited capacity in order to build research capacity at these institutions. Examples of these consortia are the South African Aids Vaccine Initiative, South African Malaria Initiative and the Brain and Behaviour Research Group. The progress with regards to the expected outcomes will be evaluated on an annual basis, with biennial conferences and workshops to showcase the progress and to re-align the research efforts. Existing and future trends in health research, development and innovation In their article, Morel et al 1 highlighted a number of determinants for Health Innovation Systems that will enable a developing country to maximize its ability to address diseases of the poor, namely: 1. creating capacity for and undertaking R&D. 2. creating and sustaining capabilities to manufacture products to appropriate standards. 3. promoting and sustaining domestic markets. 4. promoting and sustaining export markets. 5. creating and implementing systems for Intellectual Property (IP) management. 6. creating and implementing systems for drug, vaccine, diagnostic and device regulation. Currently the main focus of the Research, Development and Innovation Strategy of South Africa is on the strengthening of R&D capacity, as well IP management. The local manufacturing of products is also receiving more attention. The Medicines Control Council of South Africa is a well-established entity and falls under the jurisdiction of the national Department of Health. All new drugs and vaccines need to be approved by the Medicines Control Council before they can be introduced to the market in South Africa. It is noteworthy that a similar system for medical devices is also envisaged. Total South African R&D expenditure: 2005/06 The Department of Science and Technology conducts an annual Research and Development Survey, based on the Frascati Manual i of the Organisation for Economic Cooperation and Development (OECD). Data extracted from the 2005/06 Research and Development (R&D) Survey results database, indicated that in South Africa the total spend for R&D in 2005/06 was R 14 149 239, with reported direct health R&D expenditure approximately 10.6% at R 1523 billion (Figure 1). In 2005 the total South African Health Care System contributed approximately 8.1% to South Africa’s GDP 7 . As the GDP for 2005 8 was estimated at ZAR 1 539 billion, then the total South African Health Expenditure is estimated at R 125 billion. The Health R&D expenditure is then approximately 1.2% of the total South African Health Expenditure for 2005/06. This is, however, still below the 2% target that was set by the South African Government. The analysis of the 2005/06 R&D Survey indicated that private companies were responsible for approximately 44% of all Health R&D being conducted in South Africa, while Universities accounted for approximately 36% of the health research (Figure 2). However, the 2005/06 results reflect that 67% of all health researchers are working at universities (Figure 3). This discrepancy between the percentage R&D funds versus the Health Researchers per sector illustrates there is i. The Frascati Manual was developed by the Organisation for Economic Cooperation and Development and sets out the methodology for collecting and using statistics about research and development in countries that are members of the OECD. 078 ✜ Global Forum Update on Research for Health Volume 4
Innovation Natural sciences and environment 6.9% Health 10.8% Defence 6.4% Agriculture 7.1% Mining 8.2% Energy 5.0% Science councils & governmental research organizations 20% Social sciences and education 8.9% Private companies 44% Engineering, manufacturing and other 35.6% Financial services 11.1% Universities 36% Figure 1: Total South African R&D expenditure 2005/06 Science councils & Figure 2: Health research expenditure per broad sector 2005/06 (%) probably a large amount of intersectoral cooperation between the private sector and the universities. There is a tendency for private research organizations to contract university researchers to conduct their research. When analysing the research outputs of the universitybased researchers, there was a steady increase in publications during the past 15 years. This development is very encouraging. However the national trend of the “greying” of the scientists in South Africa is a worrying factor 9 . The specific fields of science in line with the definitions ii of the Global Forum for Health Research within Health R&D that the health researchers are specializing in are illustrated in Figure 4. The low percentage of research funding for clinical research and chemical sciences research is a worrying factor and would need specific interventions. The research funding with Private companies 15% Universities 67% Science councils & governmental research organizations 18% ii. Basic medicine – anatomy, cytology, physiology, genetics, pharmacy, pharmacology, toxicology, immunology and immunohaematology, clinical chemistry, clinical microbiology, pathology, biomedicine. Clinical medicine – anaesthesiology, paediatrics, obstetrics and gynaecology, internal medicine, surgery, dentistry, neurology, psychiatry, radiology, therapeutics, otorhinolaryngology, ophthalmology. Health sciences – public health services, social medicine, hygiene, nursing, epidemiology. Chemical sciences – chemistry, and other allied subjects. Biological sciences – biology, botany, bacteriology, microbiology, zoology, entomology, genetics, biotechnology, biochemistry, biophysics, other allied sciences, excluding clinical and veterinary sciences. Social sciences – economics, health economics, psychology, educational sciences, political science, sociology, anthropology, demography and geography. Agricultural sciences – agriculture, forestry, fisheries, horticulture and veterinary medicine. Statistical and other mathematical sciences – mathematics and other allied fields. Computer sciences – information and communication technology and software development (hardware development should be classified under engineering fields). Engineering and technology – civil engineering, electrical engineering, computer engineering (hardware only), and other engineering sciences (such as chemical, mechanical, and metallurgical and materials engineering, the science and technology of food production). Physical sciences, and earth and related environmental sciences – physics and other allied subjects, geology and other earth sciences, and meteorology and other atmospheric sciences such as climatic research and vulcanology. Figure 3: Health researchers per broad sector 2005/06 (%) Computer sciences 3.7% Statistical and mathematical sciences 2.2% Agricultural sciences 5.6% Engineering and technology 13.9% Social Sciences 19.7% Physical sciences 6.0% Basic medicine 6.8% Clinical medicine 3.3% Biological sciences 6.8% Health Sciences 29.6% Chemical sciences 2.5% Figure 4: Health R&D expenditure per field of science (%) Global Forum Update on Research for Health Volume 4 ✜ 079
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Global Forum Update on Research for
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Editorial Advisory Board: Luis Gabr
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Contents 096 Child immunization: ac
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Introduction Research contributions
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Introduction Type I Type II Type II
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Introduction making), takes account
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Access to health Strengthening heal
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Access to health raising public awa
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Access to health Recent trends in r
Page 19 and 20: Access to health districts with a p
Page 21 and 22: Access to health Understanding heal
Page 23 and 24: Access to health This study investi
Page 25 and 26: Access to health References continu
Page 27 and 28: Access to health combining particip
Page 29 and 30: Access to health 2002 2005 Diff. SU
Page 31 and 32: Access to health References continu
Page 33 and 34: Access to health Americans think th
Page 35 and 36: Access to health threatening and se
Page 37 and 38: Access to health References 1. Worl
Page 39 and 40: Access to health Open access to res
Page 41 and 42: Access to health References 1. Rose
Page 43 and 44: Access to health national and globa
Page 45 and 46: Access to health Senior Research Fe
Page 47 and 48: Access to health ✜ Rights alone a
Page 49 and 50: Access to health meaningful communi
Page 51 and 52: Access to health Inequality, margin
Page 53 and 54: Access to health questions, develop
Page 55 and 56: Access to health reasonable in abou
Page 57 and 58: Access to health References 1. Kohn
Page 59 and 60: Access to health The diverse pathwa
Page 61 and 62: Access to health 2001, WTO ruled th
Page 63 and 64: Access to health knowledge and educ
Page 65 and 66: Access to health References 1. Lee
Page 67 and 68: Innovation 076 Towards the developm
Page 69: Innovation ✜ Creating a viable va
Page 73 and 74: Innovation References 1. Morel C et
Page 75 and 76: Innovation The changes in internati
Page 77 and 78: Innovation promoting health in deve
Page 79 and 80: Innovation efficiently converted in
Page 81 and 82: Innovation future global health fin
Page 83 and 84: Innovation References 1. See http:/
Page 85 and 86: Innovation Health system strengthen
Page 87 and 88: Innovation Being healthy: the role
Page 89 and 90: Innovation when much progress and a
Page 91 and 92: Innovation The role of Knowledge Tr
Page 93 and 94: Innovation knowledge - the “know
Page 95 and 96: Research resources 110 Research imp
Page 97 and 98: Decision-making implemented on a sm
Page 99 and 100: Research resources 30 27.5 25 20 19
Page 101 and 102: Research resources poliomyelitis an
Page 103 and 104: Research resources Nursing research
Page 105 and 106: Research resources utilization are
Page 107 and 108: Research resources The need to deve
Page 109 and 110: Research resources ✜ Health resea
Page 111 and 112: Research resources References 1. Co
Page 113 and 114: Research resources investigated the
Page 115 and 116: Research resources A new landscape
Page 117 and 118: Research resources 13 + 1*- HIV/AID
Page 119 and 120: Research resources References 1. Da
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Research resources international le
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Research resources Partnership dyna
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Research resources that many public
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Research resources compounds from m
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Research resources References 1. So
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Decision-making Delivering evidence
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Decision-making Equitable access: g
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Decision-making years’ experience
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Decision-making Policy-makers Compl
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Decision-making interview studies),
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Decision-making References 1. Haine
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Decision-making reviews in this fie
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Decision-making Inequities in healt
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Decision-making Deaths Crude death
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Decision-making Group I Group II Gr
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Decision-making Low- and middle-inc
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Decision-making Europe and Central
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Decision-making Europe and Central
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Decision-making References 1. Banni
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Decision-making irresponsible-to be
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Decision-making Several strategies
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To achieve better health, particula
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