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

Innovation✜ Creating a viable vaccine manufacturing industry.✜ Appropriate forms of telemedicine could assist intransforming rural health care provision 4 .The role played by the Department of Science andTechnology will be in conjunction with the other major playersin health research such as national and provincial governmentdepartments of Health, the Health Research Committee(HRC), the Medical Research Council and various institutionsthat conduct health research and develop or improve healthtechnologies. The Science and Technology Interventions forHealth Innovation can therefore be seen as interventions thathave a long-term time frame, constituting a high risk anddependant on disruptive and innovative technologies.The priorities outlined in the NRDS also find support fromthe Millennium Development Goals. The Report highlights theneed for research into HIV/AIDS, tuberculosis and malariaand mentions that: “Science, technology, and innovationpolicy needs to be oriented towards finding vaccines andcures for these diseases, while creating new institutionalframeworks from which new research collaborationscan spring” 4 .In defining the role of DST in health innovation, two criticalissues have been considered: the first deals with the scope ofthe work that will be undertaken, and the second deals withcriteria defining research areas that are of critical importanceto South Africa.Taking cognisance of the international trends, the SouthAfrican National Research and Development Strategy andalso the health research priorities for South Africa, it isconsidered appropriate that the role of DST in health researchcan be broadly defined as the promotion of the developmentand exploitation of new technologies and the advancement ofbasic knowledge of biology and human behaviour. TheDST should consequently be primarily involved with scienceinterventions with regard to vaccine development, issuesof drug discovery, the development of new diagnostics,as well as the development of medical devices andtreatment regimes.In order to insure that the research is sustainable and istranslated into appropriate social and economic benefit, DSTshould actively participate along the entire length of theInnovation Chain. For South Africa, this Innovation Chainencompasses capacity development, technologydevelopment, including basic science and frontierprogrammes, biotechnology, nanotechnology and technologytransfer, including clinical trials, commercialization ofIntellectual Property and implementation through pilotprogrammes.Determining health research priorities inSouth AfricaBased on these broad guidelines and to ensure focus on thecountry’s available resources, it is essential that the healthresearch expenditure is (and remains) highly focused. Variousother attempts have been made to identify national healthresearch priorities for South Africa; these include, inter alia:✜ the health research priorities listed by the Department ofHealth in their Essential National Health Researchconference held in 1996;✜ the March 2006 Health Research Conference;✜ the National Research and Technology Foresight projectof the Department of Arts, Culture, Science andTechnology (1998) that identified specific research andtechnology priorities for the health sector.In the 2003 Initial Burden of Disease Estimates for SouthAfrica 2000, the South African Medical Research Councilidentified the top 20 specific causes of premature mortality in2000 (see Table 1).Rank Cause of death %1 HIV/AIDS 39.02 Homicide/violence 7.53 Tuberculosis 5.04 Road traffic accidents 4.15 Diarrhoeal diseases 3.86 Lower respiratory infections 3.87 Low birth weight 3.38 Stroke 2.79 Ischaemic heart disease 2.410 Protein-energy malnutrition 1.411 Suicide 1.412 Diabetes mellitus 1.213 Hypertensive heart disease 1.114 Fires 1.015 Septicaemia 1.016 Chronic obstructive pulmonary disease 0.917 Neonatal infections 0.818 Asthma 0.819 Nephritis/ nephrosis 0.820 Bacterial meningitis 0.8Table 1: Top 20 specific causes of premature mortalityBased on the priorities and information from theseexercises, certain health areas have been identified as priorityareas for the development of Department of Science andTechnology interventions (see Table 2).Approach to health research, developmentand innovation in South AfricaThe South African Science and Technology Interventions forHealth Innovations will concentrate on the research andinnovation that leads to discovery and evaluation of new drugand treatment regimes, the development of new vaccines andnew robust diagnostics for the identified diseases orconditions, as well as the development of medical devices.The range of research activities will include the interrogationof indigenous knowledge, basic molecular science andgenetics, chemistry and bio-chemistry, biotechnology,nanotechnology, nuclear physics, ICT, manufacturingprocesses and engineering.Consortia of researchers are encouraged to develop aspecific research strategy per intervention area. Theseconsortia will have to be representative of most of theresearchers/research institutions in South Africa that aredealing with that specific disease or technology area. Theconsortia will have to appoint a manager/coordinator. One ofthe universities/science councils will then take responsibilityfor the management of the consortia and the coordinator willbe appointed on contract basis at the specific institution.Global Forum Update on Research for Health Volume 4 ✜ 077