Combining health and social protection measures to reach the ultra ...

Research resourcesChanging environmentGlobal health policyenvironmentEmphasis ondevelopment of toolsand interventions forhigh-burden diseasesEmerging public healthproblems and recentresearch developmentsBrain drain,globalizationOthers (cross-cutting)Examples of RSC needs✜ Health policy and systems research✜ Knowledge management systems✜ Surveillance and information managementsystems✜ Product discovery and development✜ Clinical and field trial design and methodology✜ Economic analyses✜ Surveillance and global alert systems✜ Research training on priority health problemsidentified by countries/regions✜ Equity research✜ Health policy and systems research✜ Interdisciplinary research✜ Centres of excellence and/or virtual centers ofexcellence✜ Research financing and incentive systems✜ Knowledge of regulatory issues andintellectual property rights✜ Leadership and management: e.g., prioritysetting, strategic planning, partnershipdevelopment, community involvement,monitoring and evaluation✜ ICT: equipment, access and know-how✜ Research ethics✜ Research synthesis✜ Knowledge translationTable 1: Specific RCS needs related to recent global healthdevelopmentspublications 17, 21, 33 as well as in the annual fora of the GlobalForum for Health Research. Broadly speaking, these relate totraining and retention of human resources, the researchenvironment, translation of evidence to policy and practice,and the management of the health research system. Inrelation to recent trends in the global health landscape, Table1 outlines some specific RCS needs to be able to respond tothese developments, ranging from training in strategic andimplementation research to leadership and managementskills. The needs have been so overwhelming that theresearch response has tended to be diffuse and patchy. Thetipping point for RCS is unlikely to be reached without aconsolidated strategy. This very much depends on theresponsiveness of the health research systems in LMICs.A number of countries have begun the process of reengineeringtheir health research systems. And yet, in spite ofthe clear evidence on the link of health research todevelopment, strengthening of the NHRS has failed to figurestrongly in national development plans and support fromoverseas development agencies. While the need for healthsystems research has been articulated strongly in connectionwith the MDGs, the very system that underpins thegeneration of sustainable research resources has failed togarner the same attention. The debates on RCS for basic vs.applied research, health systems research vs. innovation,SARS/AI/HIV/TB/malaria vs. non communicable diseases areall symptomatic of the “silo syndrome” in health research,aggravated by the “Willy Sutton Law” 34 .Reference has been made to the UNAIDS “three ones”principle of “one action framework, one coordinating authorityand one monitoring and evaluation system” as a model foreffective RCS at the national level 21 . More specifically, aunified framework and strategy for health research fornational development, in response to the changing landscapeat the national, regional and global levels, needs to be carvedout, advocated and vigorously implemented by each country.At the global level, recent moves to consolidate andinnovate on RCS efforts to strengthen NHRSs areencouraging. However, if this collaborative enterprise is tohave a significant impact on health research systems fordevelopment, it is equally essential to have wide, deep andlong-term political and financial commitments from nationaland international stakeholders towards a common vision andstrategic plan for “research for development”. ❏Mary Ann D Lansang is Professor of Medicine and ClinicalEpidemiology at the College of Medicine, University of thePhilippines, Manila, the Philippines. She is currently engaged in aUSAID-funded Health Policy Development Programme in thePhilippines.Dr Lansang serves on the Board of ICDDR,B, the WHO’sImmunization Strategic Advisory Group of Experts, and the Councilof Advisers of the Philippine Society of Infectious Diseases andMicrobiology. She is the immediate past Executive Director of theINCLEN Trust (International Clinical Epidemiology Network)(2000–2004). Her research and training activities cover infectiousdiseases, clinical epidemiology, health policy and the ethics ofhealth research.Rodolfo J Dennis is Professor of Medicine and ClinicalEpidemiology at the Pontificia Universidad Javeriana, as well asDirector of Medicine and Head of the Research Department atFundación Cardio-Infantil, both in Bogotá, Colombia. In addition tohis clinical specialty in internal medicine and lung diseases, DrDennis has an MSc in Clinical Epidemiology from the University ofPennsylvania in the USA and is a PhD candidate in Epidemiologyand Biostatistics from the McGill University in Canada. ProfessorDennis currently sits on the Advisory Board of the Health Scienceand Technology Program of Colciencias, the major funding andresearch capacity building body of Colombia.126 ✜ Global Forum Update on Research for Health Volume 4