Almost any major problem in global health – from discovering new drugs to developing vaccines, to finding solutions to environmental changes that can affect health in vulnerable countries – requires research and innovation solutions that are beyond the scope of individual countries, organisation, or companies. In the case of research and innovation for health, there are few, if any, functional platforms where multiple players can negotiate towards creating constructive solutions, or share global resources better. COHRED outlines opportunities to play a role in the complex array of partners, with attention to Africa, enabling sustainable and usually complex solutions for complex global health problems.
Monitoring equity and research policy
Science for health diplomacy: complex problems need complex solutions
Rinaldi A: COHRED, February 28 2014
Scientific research vs health security: The case of the H5N1 papers
Kamradt-Scott A: Health Diplomacy Monitor 3(1): 4-6, February 2012
In September 2011, it was announced that Dutch, Japanese and American scientists had independently genetically altered the H5N1 avian influenza virus, transforming it into a highly lethal, airborne strain that could conceivably spread easily between humans. The studies were funded by the United States (US) and the US National Science Advisory Board for Biosecurity (NSABB) then prevented the researchers from releasing their findings on the grounds that the experiment could be replicated by terrorists. The scientists involved in the H5N1 research have questioned the need for redacting the studies’ findings, arguing that “there is already enough information publicly available” to reproduce their experiments and that withholding the information only serves to disadvantage legitimate scientific research. The incident has sparked intense international public debate, clearly dividing much of the scientific and policy-making community. Some commentators have argued that an international consensus on appropriate approaches is needed, as national governments can only control matters in their own jurisdiction and this is an international question. The World Health Organisation, which has maintained a relatively low profile regarding the controversial H5N1 studies so far, agreed to host a technical meeting on 16-17 February 2012 to discuss the issues.
Scoping review: national monitoring frameworks for social determinants of health and health equity
Pedraza L; Pamponet M; Walker R; Costa F; Rasella D: Global Health Action 9(10.3402), 2016
The strategic importance of monitoring social determinants of health (SDH) and health equity and inequity has been a central focus in global discussions. This study aims to define a framework for monitoring SDH and health equity. This review provides a global summary and analysis of the domains and indicators that have been used in recent studies covering the SDH. It describes the range of international and national studies and the types of indicators most frequently used; reports how they are used in causal explanation of the SDH; and identifies key priorities and challenges reported in current research for national monitoring of the SDH. The authors conducted a scoping review of published SDH studies in PubMed 2004-2014 to obtain evidence of socio-economic indicators. The final sample consisted of 96 articles. SDH monitoring is well reported in the scientific literature independent of the economic level of the country and magnitude of deprivation in population groups. The research methods were mostly quantitative and many papers used multilevel and multivariable statistical analyses and indexes to measure health inequalities and SDH. In addition to the usual economic indicators, a high number of socio-economic indicators were used. The indicators covered a broad range of social dimensions, which were given consideration within and across different social groups. The authors identified a need to make indicators more wide-ranging in order to include a broader range of social conditions, and for WHO to provide intersectoral and interdisciplinary means of building a more comprehensive standardised approach to monitoring the SDH and improving equity in health.
SDGs indicators: more about politics than statistics
Vandemoortele J: Deliver 2030, February 2016
In his book Damned Lies and Statistics (2001), Best points out that ‘people who bring statistics to our attention have reasons for doing so’. Some statistics are manufactured and manipulated as ammunition for political struggles, although their purpose is hidden behind assertions of objectivity and accuracy. The author argues that numbers often get amplified in the echo chamber of mainstream media and that one should never accept on face value that statistics always reveal truths. He argues that they are often used to manage perceptions more than to help analysis and understanding of complex realities. He thus urges people to be involved in reviewing and commenting on the work of and proposals from the UN Statistical Commission as they develop indicators for the SDGs.
Setting global health research priorities: Burden of disease and inherently global health issues should both be considered
BMJ April 5, 2003;326:722-723
The social and environmental contexts that determine disease are no longer simply domestic but increasingly global. The box in this article lists what we consider the main inherently global health issues, a term describing health determining phenomena that transcend national borders and political jurisdictions. Considerable research exists on each of these issues, although not always with health as a principal outcome. Greater attention in research is required to the linkages between these issues and to their economic and political drivers that are, like the issues, increasingly global in scope. Such drivers include macroeconomic policies associated with international finance institutions, liberalisation of trade and investment, global trade agreements, and technological innovations, all of which are creating greater interdependence between people and places. Assessing how these inherently global health issues affect health is a complex task. Recent work on locating these inherently global health issues in comprehensive health frameworks, however, will prove useful in identifying specific research questions that are useful to policy makers and civil society.
Setting research priorities across science, technology, and health sectors: the Tanzania experience
de Haan S, Kingamkono R, Tindamanyire N, Mshinda H, Makandi H; Tibazarwa F; Kubata B; Montorzi G: Health Research Policy and Systems 13(14), 12 March 2015
Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. The authors report here on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a ‘training-of-trainers’ workshop, a demonstration workshop, and seven priority setting workshops with representatives from public and private research and development institutions, universities, non-governmental organisations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting a science, technology, and health research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, to make proper use of research investments.
Setting the global research agenda for community health systems: literature and consultative review
Agarwal S; Kirk K; Sripad P; Bellows B; et al: Human Resources for Health 17(22), doi: https://doi.org/10.1186/s12960-019-0362-8, 2019
Globally, there is renewed interest in and momentum for strengthening community health systems. Recent reviews have identified factors critical to successful community health worker (CHW) programs but pointed to significant evidence gaps. This systematic review identifies areas for a global research agenda to strengthen CHW programs. Research gap areas that were identified in the literature and validated through expert consultation include selection and training of CHWs and community embeddedness, institutionalisation of CHW programs (referrals, supervision, and supply chain), CHW needs including incentives and remuneration, governance and sustainability of CHW programs, performance and quality of care, and cost-effectiveness of CHW programs. Priority research questions included queries on effective policy, financing, governance, supervision and monitoring systems for CHWs and community health systems, implementation questions around the role of digital technologies, CHW preferences, and drivers of CHW motivation and retention over time. As international interest and investment in CHW programs and community health systems continue to grow, the authors propose that it becomes critical not only to analyse the evidence that exists, but also to clearly define research questions and collect additional evidence to ensure that CHW programs are effective, efficient, equity promoting, and evidence based.
Setting the stage for equity-sensitive monitoring of the maternal and child health MDGs
e-Civicus, 7 July 2006
This analysis seeks to set the stage for equity-sensitive monitoring of the health-related Millennium Development Goals (MDGs). The MDGs and other development initiatives must become more comprehensive and explicit in their analysis and tracking of inequities, and the design of policies to narrow health gaps must take into account country-specific inequities.
Sex and gender matter in health research: addressing health inequities in health research reporting
Gahagan J, Gray K, Whynacht A: International Journal for Equity in Health 14(12), 2015
Attention to the concepts of ‘sex’ and ‘gender’ is increasingly being recognised as contributing to better science through an augmented understanding of how these factors impact on health inequities and related health outcomes. However, the ongoing lack of conceptual clarity in how sex and gender constructs are used in both the design and reporting of health research studies remains problematic. Conceptual clarity among members of the health research community is central to ensuring the appropriate use of these concepts in a manner that can advance our understanding of the sex- and gender-based health implications of our research findings. During the past twenty-five years much progress has been made in reducing both sex and gender disparities in clinical research and, to a significant albeit lesser extent, in basic science research. Why, then, does there remain a lack of uptake of sex- and gender-specific reporting of health research findings in many health research journals? This question, the authors argue, has significant health equity implications across all pillars of health research, from biomedical and clinical research, through to health systems and population health.
Sex and gender matter in health research: addressing health inequities in health research reporting
Gahagan J; Gray K; Whynacht A: International Journal for Equity in Health 2015, 14(12), 2015
Attention to the concepts of ‘sex’ and ‘gender’ is increasingly being recognised as contributing to better science through an augmented understanding of how these factors impact on health inequities and related health outcomes. However, the ongoing lack of conceptual clarity in how sex and gender constructs are used in both the design and reporting of health research studies remains problematic. Conceptual clarity among members of the health research community is central to ensuring the appropriate use of these concepts in a manner that can advance understanding of the sex- and gender-based health implications of the research findings. During the past twenty-five years much progress has been made in reducing both sex and gender disparities in clinical research and, to a significant albeit lesser extent, in basic science research. Why, then, does there remain a lack of uptake of sex- and gender-specific reporting of health research findings in many health research journals? This question, the authors argue, has significant health equity implications across all pillars of health research, from biomedical and clinical research, through to health systems and population health.