Responsible Vertical Programming:
what is the problem? 
Effects of vertical programmes on health research systems.
Action that countries and programmes can take.

Responsible Vertical Programming: what is the problem?

1. Health research needed by developing countries is mostly conducted for them, sometimes with them but rarely by them.

2. Health research in developing countries is problem-specific – or ‘vertical’ and does not usually contribute to building the national system for health research

3. The questions addressed by health research in developing countries are largely determined by the international community – specifically those funding ‘global health research’

4. Health research is not seen as a key driver of development in low income countries – and this constitutes a missed opportunity towards real and sustainable progress. 

Effects of vertical programmes on health research systems.

• The health research agenda in poor countries is mostly determined from the outside, not based on national health research priorities, and concerns only those conditions for which international funding is available – largely HIV/AIDS, TB and malaria.

• Externally funded research is not primarily concerned with leaving behind sustainable national research and research governance capacity – most capacity that is built focuses only on those competencies needed for individual research projects.

• An important opportunity for sustainable socio-economic development is missed, if health research does not become a driver for development in low income countries, where external investments in health research constitute a large part of total investments in science and technology.

• Research programmes rarely make provision to translate research findings into action – leaving this to under-funded, fragile health systems.

• Vertical research programmes can be highly effective at increasing research production and developing new interventions for neglected conditions that have the potential to improve the lives of millions of people.

However, the ways these programmes are managed can make the difference between research as a technical effort with dubious implementation potential and research as a catalyst for development that achieves its potential to improve people’s lives.

• A vertical research programme is responsible if succeeds in building the capacity of a country’s researchers and the national research system – in the process of achieving its own research goals.

Action that countries and programmes can take.

• Countries have to take responsibility to put in place and resource a basic national health research system. At the least, they should provide mechanisms for research governance that can guide, negotiate, contract, prioritise, manage, follow-up on research and translate it into action.

• External research programmes and sponsors working for the health of people in low and middle income countries should realise that their research cannot be done in isolation from the context of poverty and under-development.

Their response to this should be to invest in good partnership building that leaves behind substantial individual and institutional capacity when the programme is completed. This also means helping strengthen national research systems and governance.