For anyone interested in building research capacity for health.

This ‘Top 10’ reader in Research for Health/Development/Equity is a totally subjective and eclectic effort to provide some relevant readings for anyone interested in supporting research capacity for health in low- and middle-income countries.

This list represents, of course, also a very limited view of the field as I do work most of the time and can not read everything that appears in print, nor do I read most of the world’s languages – in fact, the list is limited to publications that have appeared in English although publications in Dutch, Afrikaans, French or German may still make it to the top.

The publications in the ‘top 10’ are a mix of the technical, popular and inspirational. It includes books, scientific papers, transcripts of speeches, articles from popular magazines and even COHRED’s own publications if they are good enough! There is no reason why web-sites or any other form of publication may not appear here as well in future – and, indeed, they will. The list is definitely not fixed – it will change as time goes on but you can always find publications that were once listed in the ‘archive’. There is no fixed time for change – so if you want to be notified when changes are made, do RSS this page !

The purpose of this ‘top-10’ is more motivational than technical. So many people ask us why we engage in ‘research for development’ – it is so vague, so long-term, so ‘system’ focused or ‘process oriented’ instead focusing on hard outcomes and specific diseases.

Our answer is simple: “We are not a research organisation – instead we are into development, with a difference. Where others use food aid, education or agriculture as roads to development, we believe that research is a key ingredient of long-term, country-owned development”. ‘Knowledge is power’ is nowhere more appropriate than in development.

But we do realise that this is still vague – which is the reason for this reader ! It provides you with cases, examples, arguments, inspiration and technical facts and figures why research matters – for health, equity and development.

I hope you will enjoy the reading. Do send in suggestions (cohred@cohred.org) or other publications that you feel deserve to be on this list – who knows where they may end up ?

Health Research – essential link to equity in development

1. Commission on Health Research for Development. Health Research – essential link to equity in development. Oxford, Oxford University Press, 1990. ISBN-0-19-520838-2.

The Commission provided the basic evidence to show that there is a gross mal-distribution of research resources in the world. Over 93% of the worlds expenditure on health research in 1990 happened on diseases that cause less than 5% of all deaths – it is now known as the ‘10/90 gap’. The Commission’s report is still very readable and provides good insight into the need to spend on research – not only to find cures to diseases – but also on research that support the national ability of low and middle income countries to make decisions to improve health and health care. It is somewhat dated – it pre-dated the massive increase in private and ‘public-private’ research funding in developing countries – nor is it very intersectoral, looking at health research in a narrow sense rather than at ‘research for health’. Nevertheless, it should be serious study for anyone intersted in working in this field. It is a tough read, however !

As it is out of print, it is available from COHRED with permission from Oxford University Press and located in the Open Archive section of this website (under publications).

Exceptional economic returns on investments in medical research

2. Leon E Rosenberg. Exceptional economic returns on investments in medical research. Med J Australia 2002; 177: 368-71.

Economic arguments for health research investments made by a well-known medical researcher. There are many other articles in this field – but this is crisp and short.

Building capacity in health research in the developing world

3. Mary Ann Lansang, Rodolfo Dennis. Building capacity in health research in the developing world. WHO Bulletin 2004; 82: 764-770.

The first article to attempt to define ‘research capacity’ as much more than simply ‘training’ people. The realisation that well trained people still under-perform if their home institutions do not work seems obvious. But there is more. Research can not flourish if research or finance systems are clumsy, or if there is no demand for evidence by ministries of health, for example. International collaboration can be a help or a distractor. The article will need to be updated at some stage, but it remains relevant.

The quest of Dr Paul Farmer, a man who would cure the world.
4. Tracy Kidder. Mountains beyond mountains. The quest of Dr Paul Farmer, a man who would cure the world. Random House, 2004. ISBN 0-8129-7301-1.

Besides the inspiration from the work done by Paul Farmer and colleagues in Haiti, the book also has a message underlying the work in health for the poor. Examples why national research systems are needed even in poor countries are abound – including the multi-drug resistant tuberculosis epidemic in Peru. The book is a ‘must read’ for anyone in development – research for health is not the main focus at all !

Social entrepreneurs and the power of new ideas

5. How to change the world. Social entrepreneurs and the power of new ideas. New York, Oxford University Press, 2004. ISBN 0-19-513805-8.

By now a ‘recent classic’ the book describes many examples of how inspired individuals made significant contribution – in ways beyond normal aid. ‘Social entrepreneurship’ defines as much the idea of individual ability to change as the way in which to change it. In spite of its title, there are several examples of how ‘research for health’ also features in improving health and saving lives. Well worth reading.

Justice and the human development approach to international research

6. London AJ. Justice and the human development approach to international research. Hastings Cent Rep. 2005; 35(1):24-37.

Alex London is a well know philosopher focusing on the ethics of health research in low and middle income countries. He has published widely on technical aspects of the ethics in research, but with this article he approaches human development as the key outcome of the international research ‘industry’. And, if development is the end goal, then the way research is being done needs to be different. Different in a way that maximizes ‘social justice’. It is a great argument, one I fully agree with and that we use as an underlying value in COHRED’s work. It is a ‘dense’ paper – but worth working through it.

The importance of Science and Technology in Africa

7. The importance of Science and Technology in Africa. Paul Kagame. Speech to the Royal Society, London, 18 September 2006.

Paul Kagame, president of Rwanda, is one of Africa’s great proponents of investments in Science & Technology. Coming from one of the poorest countries on the continent, he is consistent in pointing out why S&T is key to development. Since then, more governments are making public declarations of increasing their S&T budgets – including Tanzania where president Kikwete committed to increasing spending on S&T to 1% of GDP this year (2009).

The challenge of global health

8. Laurie Garrett. The challenge of global health. Foreign Affairs, Jan/Feb 2007. http://www.foreignaffairs.org/20070101faessay86103/laurie-garrett/the-challenge-of-global-health.html

Laurie Garrett makes the case for systems rather than magic bullets. Since this article appeared in 2007, the ‘system’ has become more legitimate to speak about. Although she does not specifically address health research – she does focus on health systems – her message is easily enough transportable to systems the generate research for health.

Responsible Vertical Programming

9. COHRED Statement 2007. Responsible Vertical Programming: how global health research can deliver essential research, achieve impact and build national systems. Geneva, COHRED, 2007. ISBN92-9226-024-3.

Given that ‘vertical spending’ in research, health or development are going to be with us – it makes little sense to argue against these ways of funding. Science is compartmentalised, after all, and so are the reward structures for scientists. In low income countries dependent on external sources for their research budgets, the many research projects from outside the country can and do fragment national research agendas, monopolize scarce research capacity by focusing research on a few funded conditions, disempower national decision-makers and make it very difficult for low and middle income countries to build their own sustainable research institutions and systems. “Responsible Vertical Programming” aims to create awareness of this problem by providing facts and figures and proposes a way forward in which achievement of research goals can be productively married to strengthening national research systems. It is an easy read – produced to make the case – but is serious in its intent and evidence-base.

The cost of giving

10. The cost of giving. After billions of dollars in food aid, Africa needs different kinds of developent programs. Alex Perry. Time Magazine 2008; 18 August: 52.

Aid, aid, aid … after so many years, Africa needs to import more food than ever before. This article came at about the same time as Dambisa Moyo’s ‘Dead Aid’ book and takes a similar line in diagnosing that aid is not effective. Both make the case that ‘home grown’ solutions are needed. The reason why this article made my ‘top 10’ is that it implies that a ‘homegrown research capacity to provide the evidence-base for the ‘homegrown solutions – and for evaluation of effect’ is key. It is difficult to imagine how an Africa without substantial African research capacity can hope to  ‘develop’ itself !

On a lighter note

On a lighter note: – not all development literature is serious. This book is great to show how NOT to go about development, yet it seems uncannily close to what is actually going on! Read over a weekend !

Salmon fishing in the Yemen. Paul Torday. London, Weidenfeld & Nicolson 2007.
ISBN-10: 0753817683
See also : http://www.salmonfishingintheyemen.com/
It has been translated into several languages !  check here: http://www.librarything.com/work/1350846/editions