Coordinating health research to promote action: the Tanzanian experience

doi:10.1136/bmj.321.7264.821

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Andrew Y Kitua, secretary, National Health Forum (akitua@twiga.com)a,
Yohana J S Mashalla, member of National Health Forumb,
Joseph K Shija, chairman, National Health Forumb

^a National Institute for Medical Research (NIMR), PO Box 9653, Dar es Salaam, Tanzania
^b Muhimbili University College for Health Sciences, PO Box 65001, Dar es Salaam, Tanzania

Correspondence to: A Y Kitua

Developing countries carry 90% of the global burden of disease. Infections such as malaria and HIV are debilitating their economies by killing the young and economically productive workforce. Research is essential for health development, yet less than 10% of the annual global expenditure on health research is allocated to addressing developing countries' problems.1 Poor countries must face this challenge seriously. It is essential that they create strong national research infrastructures so that they can define priorities for health research priorities; influence national, regional, and global health agendas; and lobby for a more equitable allocation of resources. This paper discusses some of the barriers to establishing coordinated health research programmes in developing countries and describes how Tanzania has developed a new research model to try and overcome these.

Summary points

The failure of the malaria eradication programme in some developing countries illustrates the failure of those countries to coordinate their health research activities

Coordination is needed to use scarce resources effectively but also to identify priorities and communicate these to policymakers and the public

After years of Tanzanian health research institutions failing to collaborate they have now joined in a national health forum

Already the forum has identified research priorities and is setting out an ethical framework for research

Barriers

Lack of a strong research infrastructure is a common feature of many developing countries and is a major hindrance to effective health research. Health resources are often used inefficiently. There is also duplication of effort and little sharing of knowledge and skill. Institutional rivalry and intellectual dependence on the “North” often results in research institutions in the “South” employing external research consultants at high cost when appropriate expertise is available locally.

Although a colonial past and financial dependence on rich donor countries are undeniably important factors behind the failure to establish effective well …