The 20th anniversary of the report of the Commission on Health Research for Development inspired a Symposium to assess progress made in strengthening essential national health research capacity in developing countries and in global research partnerships. Significant aspects of the health gains achieved in the 20th century are attributed to the advancement and translation of knowledge, and knowledge continues to occupy center stage amidst growing complexity that characterizes the global health field. The way forward is argued to entail a reinvigoration of research-generated knowledge as a crucial ingredient for global cooperation and global health advances. The authors argue that this needs to overcome in the divides between domestic and global health, among the disciplines of research (biomedical, clinical, epidemiological, health systems), between clinical and public health approaches, public and private investments, and between knowledge gained and action implemented.
Monitoring equity and research policy
As the urban population of the planet increases, putting new stress on infrastructure and institutions and exacerbating economic and social inequalities, public health and other disciplines are being forced to find new ways to address urban health equity. The authors propose that urban indicator processes focused on health equity can promote new modes of healthy urban governance, where the formal functions of government combine with science and social movements to define a healthy community and direct policy action. An inter-related set of urban health equity indicators that capture the social determinants of health, including community assets, and to track policy decisions, can help inform efforts to promote greater urban health equity. Adaptive management, a strategy used globally by scientists, policy makers, and civil society groups to manage complex ecological resources, is a potential model for developing and implementing urban health equity indicators. While urban health equity indicators are lacking and needed within cities of both the global north and south, the authors warn that universal sets of indicators may be less useful than context-specific measures accountable to local needs.
This document presents the context, including mapping of key actors and their capacity in relation to health policy and systems analysis (HPSA) research and teaching and their potential implications on capacity of the University of Ghana School of Public Health (UG-SPH) in HPSA research and teaching, networking and getting research into policy and practice (GRIPP). It assesses the capacity needs at the organizational and individual levels within the UG-SPH in relation to HPSA research and teaching and getting research into policy and practice.
Coinciding with the International Day against Drug Abuse and Illicit Trafficking, the WHO launched its Global Health Observatory Database – Resources for the Prevention and Treatment of Substance Use Disorders. This global information system maps and monitors health system resources at the country level to respond to the health problems due to substance use. The system provides data for each of the assessed countries, such as funding, staff and services, and thereby complements already available information on the scope and associated harms of substance use disorders. The country profiles included in the new system cover 147 countries, which is 88 per cent of the world’s population. Current estimates indicate that worldwide, about 230 million adults aged 15-64 – or five per cent of the world’s adult population – used an illicit drug at least once in 2010, including about 27 million people with severe drug problems.
For many sub-Saharan African countries, a National Health Research System (NHRS) exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, the authors discuss the ongoing development of Zambia's NHRS. They reflect on their experience in the ongoing consultative development of Zambia's NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. Their critical argument is that three streams of concurrent activity are central to developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system's boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonise, unify and strengthen the overall capacities of the research community.
Health system resilience and capacity for emergency risk management are critical to effective disaster management supporting sustainability goals. That is one of the key messages emerging from this paper by the World Health Organisation (WHO). WHO also found that monitoring and reporting on the human health aspects of disasters are important for strengthening disaster risk management, and should be included in government measures to improve risk assessment, prevention, preparedness response and recovery from disasters. This will help reduce health impacts, particularly the loss of human lives, WHO argues. Building health system resilience and capacity for emergency risk management, particularly at a community level, is also critical to effective disaster management, which also supports wider sustainability objectives. Indicators of health system resilience to natural disasters include the proportion of health facilities, new and improved, to withstand hazards, including access to reliable clean energy and water supplies, daily and in emergencies.
Many food-related diseases and conditions – including undernutrition, micronutrient deficiency, and obesity as well as food safety risks and farmworker health – are interlinked, according to this report. Sustainable food policies that place the promotion and protection of health at the core of strategies from the farm field to the dinner plate can help advance the provision of sustainable, quality foods for all, across the supply chain and the human life-cycle, the World Health Organisation (WHO) argues. WHO offers three health indicators that can be used to monitor progress. 1. Health outcomes: prevalence of anaemia in women of reproductive age; prevalence of stunting in children under 5 years; and prevalence of obesity in children under five and in adults. 2. Food access and dietary quality in association with sustainable foods production: adequate access to protein supply; excessive adult saturated fat consumption; household dietary diversity; and prevalence/incidence of foodborne disease outbreaks. 3. Food market/trade policies supporting health and sustainability: foods that comply with international food safety standards, including hormone, pesticides and antibiotic residues; number of countries that have phased out use of antibiotics as growth promoters; and assessment of health and sustainability impacts in agricultural trade negotiations, policies and plans.
Health offers a universal indicator of progress in attaining the United Nations Secretary General's goals for sustainable energy for all, argues the World Health Organisation (WHO) in this report. Citing estimates of close to 1.3 million deaths annually due to urban air pollution and 2 million death to household air pollution, WHO notes that this health burden could be avoided with more efficient, better used and better distributed energy technologies. WHO puts forward some key health-relevant indicators of progress on sustainable energy, including: household access to modern, low-emission heating/cooking technologies; energy access at community health facilities, particularly for reliable electricity; health burden from air pollution-related diseases and injuries; health equity impacts of energy policies including access by poor and vulnerable populations; clean electricity generation across the energy supply chain in terms of reduced pollution; and greater efficiencies and reliance on renewable energy sources.
CEWG, the expert working group advising the World Health Organisation (WHO) on research and development, has recommended that the May 2012 World Health Assembly adopt an international convention on research and development (R&D) that will bind member states to action and catalyse new knowledge for diseases that primarily affect the global poor but for which patents provide insufficient market incentives. In this editorial, the chairpersons of the expert group summarise the recommendations and report of CEWG, which they say constitute a transformative change for achieving access to medicines. They argue that financial contributions should be determined based on the concept that both the costs and benefits of R&D should be shared. They recommend a role for WHO in the stronger coordination of R&D and suggest pooling of financial investments to secure efficient allocations to where demands and opportunities are identified through active participation of developing countries. An international convention, the authors argue, is a way to secure a systemic and sustainable solution since it creates a formalised platform for the future where countries can be held accountable.
This presentation, delivered at Forum 2012 in April 2012, describes a partnership between the Dutch Council on Health Research for Development (COHRED), the African Union (AU) and the NEPAD Agency (a technical arm of the AU) to help African countries develop their national health research agendas. The partnership aims to support Africans’ ownership and optimal utilisation of research for health to achieve health and health equity, reduce poverty, and contribute to the socio-economic development of countries, regions and the continent. It is also intended to strengthen the existing capacity of African institutions and networks to support the process of capacity building at the governance and policy levels of national research systems. At the initial phase, three countries have been identified and selected to participate in the programme: Mozambique, Senegal and Tanzania. In Mozambique, a national priority setting process is being carried out, while in Tanzania, national research priorities and agenda have been set and the partnership has developed a ‘research ethics ‘management’ platform, as well as a national research for health management information system.