Research for Health
Approaches to research system strengthening –
country perspectives
Michael Devlin, COHRED
Irish Forum for Global Health
30 November, 2010
Maynooth
Toward ‘system thinking’
What is research system building and why is it
important?


Issues for countries and donors.

The world COHRED would like to see.
Putting system building in to action:
‘Research for Health-Africa’

Redefining development
doing it
enabling it
charity
vertical
programmes
development
The issue
5 million lives saved...
…but a statistic is missing
The world we would like to see
After ten years of work – mostly targeting Africa –
there are
no WHO pre-qualified vaccine producers in Africa.
Question:
Ten years from now, should the Alliance’s work be
considered a success if it had not help build the
capacity for Africa to be a supplier and producer of
some of the vaccines used on the continent?
The world we would like to see
The economic success of the world’s high income
countries since the World War II was built
on deliberate and planned investments in science and
technology1.
Today, donors and development partners:
• Support primarily short term projects and activities targeting
short term resluts
• Seldom cover overheads
• Do not invest in the infrastructure and capacity building that has
brought their countries sustained growth and stability.
1.Science and Innovation for Development, Sir Gordon Conway and Professor Jeff Waage, with Sara Delaney.
UKCDS, 2010.
The world we would like to see
The missing link:
An investment in systems, for governance and
management of research in low income countries is a
direct investment in a country’s economic future.
Remark by NEPAD official in External Review
The international context is becoming more
complicated and needs more adapted tools and
mechanisms…..
….a gap between strategies/programmes of
international players mandated by the international
community (i.e. UN bodies including WHO) and the
true aspirations of the low and middle income
countries
Responsible Vertical Programming
Investing in research & innovation
• old examples: USA, Western Europe
Lisbon treaty – 3% of GNP on science and technology
• more recent examples : South Korea, Taiwan,
Singapore
• actively changing now : India, Brazil,
Africa, Thailand, China
South
• aspiring low income countries : Rwanda,
Uganda, Tanzania
India & Brazil
Uganda
The money will help Uganda fulfil an ambition, stated in the
government's budget for 2010–11, to cut its dependence on
foreign aid — the country received US$1.66 billion in
development assistance in 2008.
Museveni's plan for spending the oil windfall is set out in a five
year national development plan, published in mid-April, which
focuses on innovation and applied science. Among the aims
are the construction of four regional science parks and
technology incubation centres to foster entrepreneurship.
Rwanda
Nigeria
Governor Sule Lamido of Jigawa state has called on international donor organisations
and other developed countries of the world to always conceptualise their programmes
and projects of support in cognisance of the peculiar needs of the benefiting countries.
The governor declared that "The approach has to be changed, programmes and projects
like this have to be developed, based on our perspective and needs otherwise, it will be
of no impact to us".
He explained that Nigeria has passed the stage in which a concept will be developed in far away
Europe, "which has no connection with our peculiarity and expect that idea to work here".
Taking a systems perspective
COHRED support to countries
The world we would like to see
Strong national systems for ‘research for health’.
Low and middle income countries have skills and systems to
manage research and innovation for improved health, equity and
development. Donors and health programmes research funders
use country priorities as a starting point .
‘Responsible programming’ of vertical health initiatives
All external programmes and actors operating in research for health in
low and middle income countries will also build the capacity of
researchers and the systems their partner countries.
Council on Health Research for Development
COHRED
Support countries to strengthen their health research
systems.
Technical assistance, tools and approaches
Share experience between countries
‘Making the case’. Studies + advocacy for global health funds
to target priorities of low and middle income countries.
Practical tools, approaches
Framework - National Health Research System Strengthening
Support to policies priorities, governance, research management….and more
Framework – Research Capacity strengthening
Developing capacity – researchers, institutions, system
Pharmaceutical Innovation Tool
Support to countries – developing innovation strategies and capacity.
Political commitment
Priority setting
Policy development
Coordinating mechanism
Human resources for HR
Financing
Science communication
Information systems
increasing research capacity
developing comprehensive national research system support
‘level’ of
develop
ment
locus of
intervention
individual
institution
‘capacity
building’
master level
training
grants
manage-ment
2
‘capacity
strengthening’
doctoral
level training
merit-based
promotion
system
3
‘performance
enhancement’
networking
researchers,
peer reviews
research
communication
1
nature of
intervention
* equity-focus
research
system
basis of
NHRS
socioeconomic
&
political
international
collaboration
& linkage
increase
demand for
research
good partnerships (e.g. Alignm
research
ethics review
capacity
civil society
engagement
fair research
contracting
monitoring &
evaluation of
output and
impact
focus health,
equity &
soc-econ
focus on
research
competitiveness
development
& Harmonisation)
Health Research Web
www.healthresearchweb.org
Research for Health-Africa programme
NEPAD-COHRED supporting partner countries
Research for Health Africa
Goal:
Work with national institutions to become centres of excellence
for health research for development and system
strengthening
Research is a key driver for development
But insufficiently used in Africa - due to unclear:
• research governance structure
• priorities/direction, and policy framework
Partners
• Research + S&T institutions - Senegal, Tanzania (3rd country
to be confirmed).
• NEPAD Agency
• COHRED
• Netherlands Ministry of Foreign Affairs
• Other countries to join
Start-up phase – Support to countries
• Strengthen governance, including priority setting,
policy framework.
• Develop a national information system for research
for health
• Measurement and tracking - develop M&E system
• Further system strengthening - research utilisation
capacity, ethics review capacity
Tanzania – issues and challenges (2009)
• Strengthen research governance
• Improve access to essential
information to manage research
• Enhance financial stability for
research for health
Issues and challenges – Senegal
Partners:
Ministry of Health, Ministry of S&T and Higher
Education
• Governance: building blocks in place, but enhanced
coordination needed, also across sectors
• Financing: implementing international recommendations that
are supported by the MoH Senegal
• Desire to build national information system (also to track
financial resources)
Redefining development
doing it
enabling it
charity
vertical
programmes
development
Thank you
Rwanda
To prosper, Rwanda would have to confront
other dubious Western ideas. The rich world,
says Kagame, still looks at Africa with
"absolute contempt" for being poor. Aid and
human rights are just Western arrogance in a
white SUV, a fresh manifestation of the old
belief that Africans cannot take care of
themselves. Fix the poverty via business,
which has rocketed — not aid, which Kagame
insists is temporary — and you remove the
reason for prejudice. "The rich world says
Rwanda is a small country, an African country,
a poor country," he says. "I reject that."