The Access to Medicine Index independently assesses how individual pharmaceutical companies perform in promoting universal access to essential medicines, and may be used as a tool in improving performance. The 2010 ranking reveals important progress, if only because companies have shown far greater willingness to open up. The Index unveils improvements research and development, and pricing, but also shows that the industry as a whole still has a long way to go, according to Wim Leereveld, the Index's founder. The Access to Medicine Index ranks 20 of the world's largest pharmaceutical companies on their efforts to make sure that medicines are made for, and reach, people in developing countries. The Index encourages drug companies to compete and offers investors and others a way to compare their social responsibility records.
Monitoring equity and research policy
This article discuss the work of the Global Forum, a global body of health decision-makers that focuses on questions of equity, advocating for more research to address the health problems of those most in need – essentially the poor and marginalised –and providing evidence to support greater investments in neglected areas. Since the Forum’s previous conference in 2009, the article notes that a paradigm shift has taken place from ‘health research’ to ‘research for health’. This new approach promotes greater understanding among all stakeholders of the impact on health of policies, programmes, processes, actions or events originating from other sectors. It also is intended to assist in developing interventions that will help prevent or mitigate any adverse impact on health and contribute to the achievement of health equity. While the number of resources, actors and efforts to address the health problems of the poor have grown signifi cantly in recent years, the range of health challenges faced by low- and middle-income countries has expanded considerably, demanding a more extensive research portfolio. Challenges include countries that are not on track to reaching the Millennium Development Goals, rising rates of chronic non-communicable diseases in low- and middle-income countries, urbanisation, demographic shifts, climate change, food security, the threat of pandemics, and the global financial crisis.
In preparation for the Science Online London 2010 Conference, which will be held from 3-4 September 2010 in London, United Kingdom, this video provides information on how the web is changing the way researchers conduct, communicate, share, and evaluate their work. The video is a panel discussion with Jimmy Watson, Stephen Friend and John Wilbanks, which is moderated by Tim O’Reilly. Some of the topics they talk about will also be discussed at Science Online London, such as new platforms for collaboration, networking and sharing research.
This paper examines the recommendations of the World Health Organization's Commission on the Social Determinants of Health regarding the need for improved research on determinants of health inequity and discusses the following barriers to implementation of those recommendations: the power of the biomedical imagination in health and medical research; emphasis on vertical health programming; ideological biases outweighing evidence in policy decisions; and academic reward systems, including the inherent conservatism of peer review. The paper concludes with suggestions for changing research funding and assessment systems to overcome these barriers, for example by setting the agenda for social determinants research in consultation with researchers, policy actors and, wherever possible, relevant affected communities.
In 1990, a report from the Commission on Health Research for Development pointed to the gross imbalance between the magnitude of diseases affecting the world’s poor majority and the meager funds spent on research to fight them. Responding to growing momentum, in 1997 the Global Forum for Health Research was founded to address this skewed research agenda. In the editorial, the editors of MEDICC Review reviews progress made since 1997 in terms of the Global Forum’s agenda. They refer to the contributions of Cuba and other developing nations to the evidence suggesting that only through simultaneous development of technologies and public health strategies can disease be effectively tackled and prevented. In turn, this requires the political will to consciously develop health research capacities and a health research system with lines of investigation well-matched to disease burden and national public health priorities. Since 1997, when lack of financing for biomedical research on diseases of the poor was the main health equity concern, over time the health equity lens has revealed other, more complex dimensions of the factors influencing research priorities and the eventual application of their findings. The editors argue that this requires an approach that moves the debate from issues of biomedical and technological research to introduce tough questions about implementation, bringing in discussion of health systems, social innovation, and ways for equity-guided research to become more influential in policy decisions.
The South African Child Gauge monitors the realisation of children’s rights and is published annually. Key features include: legislative developments affecting children; child-centred data tracking children’s access to social assistance, education, housing, health and other services; and a series of essays to inform, focus and sometimes direct national dialogue and debate. While South Africa is making progress towards meeting the Millennium Development Goal (MDG) target on sustainable access to safe drinking water, this has not trickled down to children – only 64% of children have access to safe drinking water on site. Progress has been slow for access to basic sanitation, education and gender equality. On the MDG targets for reducing child hunger, HIV, tuberculosis and child mortality, South Africa is not making any progress, according to the Gauge. South Africa has also failed to submit its reports on progress in relation to implementing the UN Convention of the Rights of the Child – the key accountability mechanism aimed at monitoring South Africa’s progress in promoting the maximum survival and development of children. The report further notes that South Africa is one of only twelve countries worldwide that has failed to reduce child mortality since 1990.
Health information systems (HIS) are increasingly being recognised as the ‘central nervous system’ of the health sector, with the information they generate being used for decision making to improve health system performance, accountability and health outcomes. To guide countries in developing and strengthening their HIS, Health Metrics Network (HMN) has developed a standard reference for health information systems development, the HMN Framework. This brief report demonstrates the widespread application of the Framework and the growing body of evidence that better health information improves health outcomes and contributes to saving lives. By 2010, HMN tracked a cumulative total of US$ 514 million from a limited number of domestic and donor sources that was invested in HIS strengthening globally. Although estimates show an upward trend in investment, the brief argues that further resources are needed to meet the increasing demand from countries for HIS investment. It argues that a strengthened HIS produces better quality information for use in decision making, and that information-driven decisions lead to cost savings, more efficient use of resources, better quality essential health services, improved coverage and more lives saved.
Africa's progress depends on her capacity to generate, adapt, and use scientific knowledge to meet regional health and development needs. Yet, according to this paper, Africa's higher education institutions that are mandated to foster this capacity lack adequate resources to generate and apply knowledge, raising the need for innovative approaches to enhance research capacity. The paper describes a newly developed programme to support PhD research in health and population sciences at African universities: the African Doctoral Dissertation Research Fellowship (ADDRF) Programme. It documents the authors’ experiences implementing the programme. As health research capacity-strengthening in Africa continues to attract attention and as the need for such programmes to be African-led is emphasised, the authors propose that their experiences in developing and implementing the ADDRF may offer invaluable lessons to other institutions undertaking similar initiatives.
According to this study, the availability, quality and use of health information, research evidence and knowledge is not adequate in the African Region. This has resulted in two major types of knowledge gaps: gaps in health knowledge, and the so-called ‘know-do gap’. Health knowledge gaps are where essential answers on how to improve the health of the people in the Region are missing. This is an issue related to the acquisition or generation of health information and research evidence. The ‘know-do gap’ is the failure to apply all existing knowledge to improve people’s health. This is related to the issue of sharing and translation of health information, research evidence, or knowledge. Although there are major structural constraints, the study argues that the key to narrowing the knowledge gap and sustaining health and development gains is a long-term commitment to strengthen national capability to ensure the availability of relevant and high quality health information and evidence and its use for policy and decision making. Close links and the co-ordination of fragmented disciplines such as information, health research and knowledge management are argued to be an essential step in this process.
Health impact assessment (HIA) has been proposed as one mechanism that can inform decision-making by public policy-makers, yet it has been criticised for a lack of rigour in its use of evidence. The aim of this study was to formulate, develop and test a practical guide to reviewing publicly available evidence for use in HIA. The formulation and development of the guide involved substantial background research, qualitative research with the target audience, substantial consultations with potential users and other stakeholders, a pilot study to explore content, format and usability, and peer review. Finally, the guide was tested in practice by invited volunteers who used it to appraise existing HIA evidence reviews. During development, a wealth of data was generated on how the guide might be applied in practice, on terminology, on ensuring clarity of the text and on additional resources needed. The final guide provides advice on reviewing quantitative and qualitative research in plain language and is suitable for those working in public health but who may not have experience in reviewing evidence. During testing, it enabled users to discriminate between satisfactory and unsatisfactory evidence reviews. By late 2009, 1,700 printed and 2,500 downloaded copies of the guide had been distributed. In conclusion, substantive and iterative consultation, though time-consuming, was pivotal to producing a simple, systematic and accessible guide to reviewing publicly available research evidence for use in HIA.