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Kamran Abbasi (News, BMJ, 323, 886, Oct 20, 2001) laments the slow
progress in narrowing the health research divide following the
International Conference on Health Research for Development in Bangkok in
October, 2000 (1,2). As was mentioned, an Interim Working Party was
established during the fifth global forum for health research in Geneva.
This body will strive to rapidly move through membership issues and agenda
setting towards articulating the complex task of the Working Party in
defining global governance and stewardship of health research. However it
needs to do this through a democratic and transparent process which will
ensure representativeness of all stakeholders and will ultimately be
acceptable to the wider global health research community. For example, the
involvement of civil society groups and the private sector needs to be
enhanced as was mentioned during the Geneva forum.
I fully agree with Dr Abbasi that the Working Party must also ensure
a strong focus on national activities where reform needs to happen. This
was clearly expressed by Dr David Nabarro, World Health Organization (WHO)
Executive Director in the Director General's office when he stated, during
the closing session of forum 5 in Geneva, that there is great potential
for "societal, national and regional participation based on networks with
common purpose, shared values and open processes". As a step in this
direction, the World Health Organization, in close collaboration with
others (e.g. the Council for Health Research & Development, the Global
Forum for Health Research, the Alliance for Health Policy & Systems
Research, INCLEN, WHO regional offices, researchers in countries, etc), is
launching an initiative to develop a system which will enable countries to
monitor the performance of their own national health research systems. We
have also worked with the Rockefeller Foundation to strengthen national
health research capacity and with leading publishers to improve access to
research information. We believe that the ability of countries to
effectively manage their own health research systems and improve the
enabling environment for research will be the ultimate catalyst in
mobilizing more domestic resources and commitment and, crucially, in
redirecting resources from international funding agencies (3) into, for
example, novel, autonomous research 'trusts' as one possible example of
the implementing mechanism Dr Abbasi refers to. This is, ultimately, the
only way to narrow the 10/90 gap where less than 10% of global funding for
health research is used to investigate 90% of the world's health problems.
Global governance and stewardship of health research will remain an
unattainable pipe dream without strong, effective and accountable health
research systems in the countries. "The bird's eye view is usually the
privilege of those who can afford to fly" (3); perhaps it is time to focus
on those remaining on the ground.
Tikki Pang
REFERENCES
1 Lee K, Mills A. Strengthening governance for global health
research. BMJ 2000; 321:775-776.
2 Editorial. Enabling research in developing countries. Lancet 2000;
356:1043.
Country focus on health research the key to progress
Kamran Abbasi (News, BMJ, 323, 886, Oct 20, 2001) laments the slow
progress in narrowing the health research divide following the
International Conference on Health Research for Development in Bangkok in
October, 2000 (1,2). As was mentioned, an Interim Working Party was
established during the fifth global forum for health research in Geneva.
This body will strive to rapidly move through membership issues and agenda
setting towards articulating the complex task of the Working Party in
defining global governance and stewardship of health research. However it
needs to do this through a democratic and transparent process which will
ensure representativeness of all stakeholders and will ultimately be
acceptable to the wider global health research community. For example, the
involvement of civil society groups and the private sector needs to be
enhanced as was mentioned during the Geneva forum.
I fully agree with Dr Abbasi that the Working Party must also ensure
a strong focus on national activities where reform needs to happen. This
was clearly expressed by Dr David Nabarro, World Health Organization (WHO)
Executive Director in the Director General's office when he stated, during
the closing session of forum 5 in Geneva, that there is great potential
for "societal, national and regional participation based on networks with
common purpose, shared values and open processes". As a step in this
direction, the World Health Organization, in close collaboration with
others (e.g. the Council for Health Research & Development, the Global
Forum for Health Research, the Alliance for Health Policy & Systems
Research, INCLEN, WHO regional offices, researchers in countries, etc), is
launching an initiative to develop a system which will enable countries to
monitor the performance of their own national health research systems. We
have also worked with the Rockefeller Foundation to strengthen national
health research capacity and with leading publishers to improve access to
research information. We believe that the ability of countries to
effectively manage their own health research systems and improve the
enabling environment for research will be the ultimate catalyst in
mobilizing more domestic resources and commitment and, crucially, in
redirecting resources from international funding agencies (3) into, for
example, novel, autonomous research 'trusts' as one possible example of
the implementing mechanism Dr Abbasi refers to. This is, ultimately, the
only way to narrow the 10/90 gap where less than 10% of global funding for
health research is used to investigate 90% of the world's health problems.
Global governance and stewardship of health research will remain an
unattainable pipe dream without strong, effective and accountable health
research systems in the countries. "The bird's eye view is usually the
privilege of those who can afford to fly" (3); perhaps it is time to focus
on those remaining on the ground.
Tikki Pang
REFERENCES
1 Lee K, Mills A. Strengthening governance for global health
research. BMJ 2000; 321:775-776.
2 Editorial. Enabling research in developing countries. Lancet 2000;
356:1043.
3 Cohen J. Philanthropy's rising tide lifts science. Science 1999;
286:214-223.
4 Macfarlane S, Racelis M, Muli-Mussime F. Public health in
developing countries. Lancet 2000; 352:841-846.
Competing interests: No competing interests