Intended for healthcare professionals


Progress is slow in narrowing the health research divide

BMJ 2001; 323 doi: (Published 20 October 2001) Cite this as: BMJ 2001;323:886
  1. Kamran Abbasi
  1. BMJ

    Progress has been slow in addressing the research needs of the developing world, speakers and delegates at last week's fifth global forum for health research in Geneva conceded.

    The aim of the conference was to assess progress in addressing the disparity between the global burden of disease and health research in the world's poorest countries. This is the so called 10/90 gap, whereby only 10% of the estimated yearly £47bn ($70bn) spent on health research is used to research 90% of the world's health problems.

    “Things have moved on but maybe not as much as we expected them to,” admitted Somsak Chunharas from the department of medical sciences in Thailand's ministry of public health. “We've talked, discussed a lot—perhaps that's right—but the question is how do we go about global governance?”

    Delegates were concerned that although last year's forum in Bangkok ended on a high note—with decisions having been taken to work on national, regional, and global levels to correct the 10/90 gap—one year later there was little to show for it.

    Several more countries now had research councils, and others had strengthened or reinvigorated theirs, but global coordination was still lacking. A major component of the initiatives arising from the Bangkok conference was the formation of a working party under the auspices of the World Health Organization, the World Bank, the Global Forum for Health Research, and the Council for Health Research and Development.

    The working party's mandate was to address global governance issues and undertake stewardship functions. It was to reflect the spirit of the conference, represent its constituents, and be independent. Delegates were told that, as yet, all that had been set up was an interim working party that would decide on the members and agenda for the working party proper.

    Delegates aired concerns that the working party was unlikely to be representative if all it did was co-opt participants from global health conferences, because an inability to attend such gatherings could well equate with need. Another criticism was that so much focus on the global response to the disparity in health research ran the risk of neglecting national activities, which was ultimately where reform had to happen. More attention was needed to develop an implementation mechanism for global strategies, said delegates.

    Dr Tikki Pang, director of research policy and cooperation at the WHO, pointed to some successful initiatives for poor countries, including health research awards aimed at improving research environments, free access to medical publications and information, and workshops on evaluating the performance of health research systems. It was also likely that a future world health report, probably 2004, would be devoted to health research.

    The sixth global forum will take place in Tanzania in November 2002. More information can be found at

    View Abstract