Are international health research programmes doing enough to develop research systems and skills in poor countries?

Global health research programmes are uniquely placed to become a catalyst for helping countries develop their health research systems.

December 12, 2007 — Geneva, Dublin, Kampala.
Global health research programmes working in the world’s poorest countries have the potential to make an important additional contribution to national  development – by supporting the growth of these countries’ health research systems.

This is the conclusion of a report released today by COHRED, the Council on Health Research for Development. It explores the effect of global disease-specific health research programmes on health research in low and middle income countries. The report advises that these ‘vertical’ programmes can become catalysts for improving health research capacity in poor countries over the long term – if they agree to invest in research system development, as well as achieving their programme’s research objectives.

In the world’s wealthier nations, a system for funding and managing research that responds to the health needs of their population is the basis of national health policies and services. The picture of health research in the south is quite different. The report shows that national health research priorities are largely set, and funding provided, by development donors and programmes that focus on solving specific problems – such as TB, Malaria, HIV/AIDS, child health, vaccine development and reproductive health.

Benefits of vertical health research
Vertical health research programmes bring significant benefits to countries by reducing health- risks for specific health conditions. But most do not contribute to building national systems for health research, and can in fact bypass them.

The question is not that the global programmes – or the multitude of donor health research projects active in the world’s poorest countries – do not contribute to improved health. But rather: that they can have a longer-term impact by having strategies to build the health research systems of their partner countries as a part of their work.

The study indicates that most of the money in health research in the poorest countries is in vertical (disease-specific) programmes, which provide funds – and the research agenda for most of a country’s work. “This creates a situation where national research production in many countries addresses only a few high-profile health conditions – those for which funding is available – and neglects other major national priorities that can benefit from research,” says Prof.
Carel IJsselmuiden, Director of COHRED.

A respondent in the report, Dr. Pascoal Mocumbi, former Prime Minister and former Minister of Health of Mozambique, offers a perspective experienced by senior policy makers in many low income countries: “When I was appointed a health minister in Mozambique, I thought I would be minister of health; instead I was minister of health projects – funded by donor countries,” he says.

Benefits of investing in national health research systems

Carel IJsselmuiden explains: “There is an ongoing debate in development and donor circles on issues such as: how to scale-up health research interventions at national level?; how to evaluate the impact of  health research programmes; or how to make health research in countries more sustainable and less dependent on long-term donor funding. An effective national system for health research supports these goals. And global health research programmes – as a part of their research – are an ideal partner to invest in building national systems.

These investments can help countries and makes the work of the global research even more effective in the long term.”    

The COHRED report cites examples that it sees as indicative of the situation faced by many countries.
 

In Cameroon, 25% of all health research in 1999 was contracted directly to individual researchers, bypassing government and institutional systems of governance.
 

In Zambia, only 12 health research projects were registered with the national Council of Science and Technology in 2006, a fraction of the existing research in the country.
 

South Africa does not have a national register of externally funded research. Where information is available, it often covers clinical trials only.
 

Uganda does not provide national project funding for health research, while income from externally funded health research projects totals some $24 million.

This release summarizes findings of the COHRED Statement 2007, available on www.cohred.org/statement
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For more information, please contact: Michael Devlin (media): devlin@cohred.org
Dr. Andrew Kennedy (health research system strengthening): kennedy@cohred.org

Notes for editors:
 

COHRED Statements highlight important issues in health research for development. They address issues around improving health research as an instrument to reduce poverty and improve health across the globe.

The way in which research is done and the questions it addresses make the difference between health research that is a tool to deliver technical solutions to those who can afford them; or health research as central element of alleviating human suffering, improving health and health equity, and making development activities sustainable.
 

About the Council on Health Research for Development — COHRED 

COHRED is an international non-governmental organization created in 1993 at the recommendation of the Commission on Health Research for Development www.cohred.org/sites/default/files/ComReports.pdf It is the only organisation dedicated to supporting low and middle income countries in building their national health research systems.

COHRED provides advice and services to countries in several areas: approaches and tools for profiling, assessing and strengthening a national health research system; processes for priority setting and communicating research produced by national health research systems; and capacity building and facilitation of learning between countries. It also publishes studies and advocates for greater investment in national health research www.cohred.org/cohred publications. It provides information that helps low and middle income countries better participate in international processes www.cohred.org/healthresearchwatch and helps all those involved in health research have a clearer picture of the situation www.cohred.org/HRWeb/

COHRED is funded by donor development agencies, international foundations and, for some of its project work, by partner countries.