Can health evidence work to save lives?
Walgate R: Real Health News, 21 May 2008
Writers and journalists are invited to submit articles for a 44-page magazine for the Global Ministerial Forum on Research for Health in Bamako later this year, with support from IDRC (Canada), on the connection - or lack of connection - between research for health, health policy-making, and health action, mainly (but not entirely) in Africa. These need to be submitted by latest, end July 2008. It can mean the difference between life and death if you know what drugs work or don't work, how best to use a bed net, or how to prevent diabetes, or save a mother's life in childbirth, or a child from fever, or prevent the transmission of HIV/AIDS, or make sure the health carers stay and are well trained, or that the pharmacy is well-stocked, or that emergency surgical care is in reach, or you have a social health insurance scheme that works - or that people can get clean water or good food. And what does 'research' mean? It's not just lab work, although that's included. It means good thinking and observation - finding out what really works, and really fails, and creating new ways to save lives and reduce pain, with scientific care and precision, which just means making sure by careful observation that you have a very good chance of being right about what you say, and that you are not just repeating hearsay or popular opinion or following some old or new fashion, and that the tools and methods you propose really work. If you are a writer who tackles or would like to tackle this subject, the creation and use of good evidence to save lives in health, can you help, can you produce a strong story or interview with a key individual in this field for us within a month or two months, ie by the end of June or July? (By the way 'research for health' is quite broad - it means not just traditional 'health research', like malaria research, but includes also - for example - research on environment or water or food production and nutrition that affects health, and of course it includes health systems research and 'implementation research', research to make sure that health interventions actually work and reach the people in need.) How should you approach these stories? There are four ways to look at these stories - from the research side; from the policy-making side; from the point of view of health carers; and from all angles with some extraordinary story that affects all of these, a story that is unexpected and striking, 'out of the box' - perhaps a human story. We need good stories in which the following kinds of questions arise, directly or by implication: 1. From the research side, do researchers link up with policy makers? Do they even link up with each other (often they are dominated by relations with Northern partners)? Do they try to present their results in a way policy makers would understand? Do they cooperate to do that or does each researcher send a different message? Do the policy makers get the message? Do they act upon what they hear? So does research make a difference? If so, we want the positive stories - how was it done, what made it work? If not, we also need the negative stories of what went wrong and how. Then we need some ideas on what researchers thinks needs to change so their research will really have an impact - ie in the field and saving lives. Does the system of research funding need to change (eg more South-South than North-South)? The research that is actually done? The combination of researchers in the country to produce a coherent message to the policy makers? The communications links and meetings with policy-makers? The level of the meetings? The final impact of evidence on policy-making? The impact of policy-making on action? 2. From the policy-making side, we need to ask the same questions in reverse. Do you hear about research? How? Does it make sense to you? Is it even relevant to the kinds of decision you need to take? Do you meet your country's researchers? Would you like them to do something different, more relevant to your problems? Do you have any good stories of engagement with researchers? What went right and how? Do you have any stories of poor linkages? What went wrong, and how? Then we need the ideas from the policy makers on what needs to change about the relations with research and researchers. 3. From the point of view of health carers - does research matter to you? Has it ever mattered to you? Have you been involved in research? Did it go well or badly? Did any ethical problems arise? Who was doing the research? How could relations with researchers improve? What kind of research needs to be done, in your view - what could it improve? Have you heard of any research that you wish policy makers would act on, but haven't? Have you even had some research result imposed on you that doesn't work, in your view? Or the reverse, has research been very helpful in some way? What are your stories on these matters? Tell us what happened. And tell us what you think needs to change. 4. For the stories 'out of the box', obviously I can't predict what they are. But feel free. Don't feel constrained by my list of questions above, but do keep to the area of connecting hard evidence, policy and action for health - and tell a great story. It may be a positive or a negative story. It could well be a human story, a story of tragedy or of joy. It could even be a creative tale or a poem (but if it is fiction please tell us!!). First, at the 60th World Health Assemby here in Geneva there has been an extraordinary new commitment to primary health care, the creation of the Alma Ata declaration of 1978. Its architect Halfdan Mahler has been here still full of energy and passion at 86, and the present D-G of WHO Margaret Chan is now working full out for a 21st century PHC in the new world of globalization and NGOs and PPPs, and she's put women's health and Africa at the top of her list. So how do policy makers react to that - how will they implement this - do they need research to create and consolidate a new PHC? What can researcher do to help them? What indeed is the research evidence that PHC works, especially in a modern context? This is all very very new - look at the WHO website to learn more - but it should be refelected in our edition for Bamako. PHC will be the subject of a major World Health Report to appear at the end of October, just before our Bamako meeting, and everyone will be talking about it. Second, the WHO Commission on the Social Determinants of Health has completed its report, which will be published in September. This is also a very radical development, which talks about the continuum of inequity from poorest to richest, and a continuum of health consequences. Where you are in the social hierarchy affects your health - equity and health is not just a matter for the poorest. That also will be in the air and setting a mood in Bamako. So we will not be talking about PHC as something for the poorest - it's going to be seen as the access to care at every level of society. Combined with the idea of 'research for health' and not just 'health research' there is likely to be quite a heady and radical mood in Bamako, into which our copy will be falling. What's in it for you as a writer? The first is exposure. The best of these stories will appear in the Bamako edition of RealHealthNews magazine, to be read by 200 ministers and 600 scientists from around the globe in the meeting in Bamako later this year. Others will appear on our web site. So it will be great opportunity for writers for their work to be seen. The second is of course some money. We will pay professional rates, but only for those for those stories we publish - and we expect highly professional journalism and writing in return. There will be no 'kill fee' for articles rejected and the editors' decision will be final. Contact Robert Walgate at www.realhealthnews.net for more information and to submit article ideas.
2008-06-01