Annual global spending on health research has more than tripled in a period of 10 years rising to just under US$106 billion from US$30 billion. Despite this sharp growth, the "10/90 gap" persists. This study of financial flows for Health Research by the Global Forum for Health Research is presented as a contribution to answering the questions on how the world's health research resources are being used. Important gaps will be exposed and action galvanized to close them - namely, by leveraging global health research in a way that genuinely improves global health, i.e. the health of the many - the 90 per cent - not just the few.
Monitoring equity and research policy
Health systems research has the potential to produce dramatic improvements in health worldwide and to meet some of the major development challenges in the new millennium. Effective research could prevent half of the world's deaths with simple and cost-effective interventions, the World Health Organization (WHO) says in a new World Report on global health research. The WHO World Report on Knowledge for Better Health: Strengthening Health Systems highlights aspects of health research that, if managed more effectively, could produce even more benefits for public health in future. It sets out the strategies that are needed to reduce global disparities in health by strengthening health systems.
The Report focuses on bridging of the "know do" gap, the gulf between what we know and what we do in practice, between scientific potential and health realization. The bridging of this gap is central to achieving the health-related Millennium Development Goals (MDG’s) by 2015. The gap exists for each of the MDG’s and represents a fundamental and pragmatic knowledge translation challenge that must be addressed to strengthen health systems performance towards achieving the MDG’s. The Report will expound the message that we must turn scientific knowledge into actions, which improves people’s health, and that health improvement through knowledge applications is a critical factor in human development and alleviation of ill-health and poverty worldwide.
Complex global public health challenges such as the rapidly widening health inequalities, and unprecedented emergencies such as the pandemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) demand a reappraisal of existing priorities in health policies, expenditure and research. Research can assist in mounting an effective response, but will require increased emphasis on health determinants at both the national and global levels, as well as health systems research and broad-based and effective public health initiatives. Civil society organizations (CSOs) are already at the forefront of such research.
This article from the Bulletin of the World Health Organization highlights health inequities both between and within countries, and how this is reflected in research, focusing on poverty and gender. The authors argue that there has been little research into the social causes of ill-health among groups, or factors affecting health inequity that are beyond the control of the individual. They highlight the publication bias in medical journals, where research into diseases that most affect the poorest people is often less likely to be published.
Health systems constraints are impeding the implementation of major global initiatives for health and the attainment of the Millennium Development Goals (MDGs). Research could contribute to overcoming these barriers. An independent task force has been convened by WHO to suggest areas where international collaborative research could help to generate the knowledge necessary to improve health systems. Suggested topics encompass financial and human resources, organisation and delivery of health services, governance, stewardship, knowledge management, and global influences. This article from The Lancet medical journal is part of a wide-ranging consultation and comment is invited. (Registration is required to access this article.)
This new collection turns a critical anthropological eye on the nature of health policy internationally. The authors reveal that in light of prevailing social inequalities, health policies may intend to protect public health, but in fact they often represent significant structural threats to the health and well being of the poor, ethnic minorities, women, and other subordinate groups. The volume focuses on the "anthropology of policy," which is concerned with the process of decision-making, the influences on decision-makers, and the impact of policy on human lives. This collaboration will be a critical resource for researchers and practitioners in medical anthropology, applied anthropology, medical sociology, minority issues, public policy, and health care issues.
"In today's cost-conscious health care environment, translating evidence-based quality innovations into clinical practice is a challenge. Limited resources mean providers and health systems must follow proven methods for diffusing and adopting effective interventions.” For this study, the authors conducted case studies of four varied clinical programs to learn key factors influencing the diffusion and adoption of evidence-based innovations in health care.
This paper examines some recent yardsticks used to sort the evidential sheep from the research goats by questioning why, how and when such research standards should be brought to bear. It concludes that the drive to cast standards as formal checklists of quality indicators is premature, and that appraising quality is not and cannot be a technical preliminary to research synthesis. Open and critical debate on the interpretation of research findings remains the surest way to establish and maintain investigatory standards.
The use of international comparisons is an essential element of modern, professional policy making. Looking abroad to see what other governments have done can point us towards a new understanding of shared problems; towards new solutions to those problems; or to new mechanisms for implementing policy and improving the delivery of public services. This toolkit pack is intended to provide help and guidance in the use of international comparisons in policy making.