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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
Research resourcesReferences1.Commission on Health Research for Development. Health research:essential link to equity and development. Oxford: Oxford University Press,1990.2.International Organizing Committee. International Conference on HealthResearch for Development. Conference report, Geneva, 2001.3.Global Forum for Health Research. Health research for equity in globalhealth. Statement by the Global Forum for Health Research at theconclusion of Forum 8, Mexico City, 16–20 November 2004. Available at:http://www.globalforumhealth.org/Forum8/Forum8-CDROM/Statement.htmlLast accessed on 28 July 2007.4.World Health Organization. The Mexico Statement on Health Research:Knowledge for better health: strengthening health systems. From theMinisterial Summit on Health Research, Mexico City, 16–20 November2004. Available at:http://www.who.int/rpc/summit/agenda/Mexico_Statement-English.pdf Lastaccessed on 28 July 2007.5.Ghaffar A, IJsselmuiden C, Zicker F. Research capacity strengthening: areport based on a consultation jointly organized by the Council onHealth Research for Development, Global Forum for Health Researchand the UNICEF/WHO/World Bank/UNDP Special Programme forResearch and Training in Tropical Diseases. 18–19 August 2005,Geneva, Switzerland. In press.6.Burke MA, Monot JJ. Global financing and flows. In: de Francisco F, MatlinS, (eds.) Monitoring financial flows for health research 2006: Thechanging landscape of health research for development. Global Forum forHealth Research, Geneva, Switzerland, 2006, pp. 33–62. URL:http://www.globalforumhealth.org/filesupld/monitoring_financial_flows_06/Financial%20Flows%202006.pdf Last accessed 28 July 2007.7.International health research (IHR):defined by Miller (see below) as healthresearch and training carried out in LMICs by high-income countries(HICs), or sometimes carried out in other HICs, or research donedomestically by HICs but on global issues.8.Miller C. High-income Country Investors: Financial Flows for InternationalHealth Research. Global Forum for Health Research, Geneva, Switzerland,2005.9.Europe Developing Countries Clinical Trials Partnership: Background Note.2003. Available at: http://europa.eu.int/comm/research/info/conferences/edctp/pdf/background_en.pdf Last accessed 28 July 2007.10.Cohen J. The New World of Global Health. Science (news feature), 2006,311 (5758):162-167.11.Leeder S et al. A Race against Time: The Challenge of CardiovascularDisease in Developing Economies. Columbia University, New York; 2004.12.Relman DA. Bioterrorism: preparing to fight the next war. N Eng J Med2006; 354:113-115.13.The Joint Learning Initiative. Human Resources for Health: Overcomingthe Crisis. Harvard University Press, Boston, 2004.14.World Health Organization. World Health Report 2006. URL:http://www.who.int/whr/2006/en/index.html Last accessed on 28 July2007.15.Dodani S, LaPorte RE. Brain drain from developing countries: how canbrain drain be converted into wisdom gain? Journal of the Royal Societyof Medicine, 2005, 98:487-91.16.Sitthi-amorn C, Somrongthong R. Strengthening health research capacityin developing countries: a critical element for achieving health equity.British Medical Journal, 2000, 321:813-817.17.Lansang MA, Dennis R. Building capacity in health research in thedeveloping world. Bulletin of the World Health Organization, 2004,82:764-770.18.Block M, Mills A. Assessing capacity for health policy and systemsresearch in low and middle income countries. Health Research Policy andSystems, 2003, 1 URL: http://www.health-policysystems.com/content/1/1/1Last accessed on 28 July 2007.19.Cilingiroglu N. Health, globalization and developing countries. SaudiMedical Journal, 2005, Feb;26(2):191-200.20.Labonte R, Spiegel J. Setting global health research priorities. BritishMedical Journal 2003, 326:722-723.21.Nuyens Y. No development without research: A challenge for researchcapacity strengthening. Global Forum for Health Research, Geneva,Switzerland; 2005. URL: http://www.globalforumhealth.org Last accessedon 28 July 2007.22Nuyens Y. 10 best resources for… health research capacity strengthening.Health Policy Plan 2007, 22:274-6. Epub 2007 June 21.23Sixtieth World Health Assembly. WHO’s roles and responsibilities in healthresearch (Resolution WHA 60.15) URL:http://www.who.int/gb/ebwha/pdf_files/WHA60/A60_R15-en.pdf Lastaccessed on 28 July 2007.24PHRplus. The Systemwide Effects of the Fund (SWEF) ResearchNetwork. Available at: http://www.phrplus.org/swef.php Last accessed on28 July 2007.25Katikireddi SV. HINARI. Bridging the global information divide. BritishMedical Journal, 2003, 328:1190-1193. Information on HINARI alsoavailable at: http://www.who.int/hinari/en Last accessed on 28 July 2007.26Momen H. Equitable access to scientific and technical information forhealth. Bulletin of the World Health Organization, 2003, 81:700.Information on Biomed Central also available at:http://www.biomedcentral.com Last accessed on 28 July 2007.27Walker R et al. What it will take to create new Internet initiatives in healthcare. Journal of Medical Systems, 2003, 27:95-103.28El Balaa Z et al. Construction of an instrument for measuring medicalstudent satisfaction with virtual campus. Studies in Health Technologyand Informatics, 2005, 116:897-902.29Egea K, Zelmer AC. Managing large online classes across multiplelocations. Studies in Health Technology and Informatics, 2004,109:167-81.30The Academy of Sciences for the Developing World. Information availableat: http://www.twas.org Last accessed on 28 July 2007.31Millennium Science Initiative. Current and Planned Initiatives. Informationavailable at: http://www.msi-sig.org/msi/current.html Last accessed on 28July 2007.32InterAcademy Council. Inventing a Better Future: Strategy for buildingworldwide capacities in science and technology. IAC, Amsterdam, TheNetherlands, 2004.33Nchinda TC. Research capacity strengthening in the South. Social Scienceand Medicine, 2002, 54:1699-711.34Willy Sutton was a 1930s outlaw who, when asked why he robbed banks,simply replied, “Because that’s where the money is.”Global Forum Update on Research for Health Volume 4 ✜ 127
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Contents096 Child immunization: acc
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IntroductionResearch contributions
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IntroductionType IType IIType IIIPr
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Introductionmaking), takes account
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Access to healthintegrating individ
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Access to healthA social determinan
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Access to healthemployment conditio
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Access to healthMaking human rights
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Access to healthResources outsideth
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Access to health“Two months ago I
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Decision-makingReferences1.Hawes H.
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