Partnerships are essential to deliver research and innovation for global health and partner development. Sustainable Development Goal 17 is all about this. Yet, COHRED argues that there is no framework, no benchmark, no standard of best practice on which to model governmental, corporate, non-profit, or academic collaborations, particularly not for international collaborative research and innovation involving low- and middle-income countries. This is where the Research Fairness Initiative intends to make a difference: to create a reporting system that encourages governments, businesses, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. COHRED prioritises its application in global health because there are many urgent health-related issues, but it can be applied in any other setting also.
Monitoring equity and research policy
Hosted by COHRED, the Research Fairness Initiative aims to create a reporting system that encourages governments, business, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. The RFI prioritises its application in global health because there are so many urgent health-related issues, but it can be applied to other settings as well. By providing a guide to high quality reporting on measures and conditions that promote fair research partnerships, the RFI encourages all stakeholders in research and innovation for health to describe what is done within their organisation to promote fair partnerships. Through an extensive global consultative process, the RFI have identified 17 key areas of relevance to effective and lasting partnerships. The RFI acknowledges that successful partnerships often start at personal level but are then continued at institutional or national levels. While mutual admiration, respect and friendship are essential to create the foundation of effective partnerships – it is the institutional and national dimensions of research collaboration that define how, ultimately, benefits are shared.
In 1990, a report from the Commission on Health Research for Development pointed to the gross imbalance between the magnitude of diseases affecting the world’s poor majority and the meager funds spent on research to fight them. Responding to growing momentum, in 1997 the Global Forum for Health Research was founded to address this skewed research agenda. In the editorial, the editors of MEDICC Review reviews progress made since 1997 in terms of the Global Forum’s agenda. They refer to the contributions of Cuba and other developing nations to the evidence suggesting that only through simultaneous development of technologies and public health strategies can disease be effectively tackled and prevented. In turn, this requires the political will to consciously develop health research capacities and a health research system with lines of investigation well-matched to disease burden and national public health priorities. Since 1997, when lack of financing for biomedical research on diseases of the poor was the main health equity concern, over time the health equity lens has revealed other, more complex dimensions of the factors influencing research priorities and the eventual application of their findings. The editors argue that this requires an approach that moves the debate from issues of biomedical and technological research to introduce tough questions about implementation, bringing in discussion of health systems, social innovation, and ways for equity-guided research to become more influential in policy decisions.
This paper presented the results of a priority setting exercise that brought together researchers and program managers from the World Health Organization Africa and Eastern Mediterranean regions to identify key sexual reproductive health issues. In June 2015, researchers and program managers from the World Health Organization Africa and Eastern Mediterranean regions met for a three-day meeting to discuss strategies to strengthen research capacity in the regions. A prioritization exercise was carried out to identify key priority areas for research in sexual reproductive health. The process included five criteria which are answerability, effectiveness, deliverability and acceptability, potential impact of the intervention/program to improve reproductive, maternal and newborn health substantially, and equity. The six main priorities were identified as creation and investment in multipurpose prevention technologies, addressing adolescent violence and early pregnancy, improved maternal and newborn emergency care, increased evaluation and improvement of adolescent health interventions including contraception, further focus on family planning uptake and barriers, and improving care for mothers and children during childbirth. They indicate that setting priorities is the first step in a dynamic process to identify where research funding should be focused to maximize health benefits. A focus on priority setting suggests a need to identify who is thus involved in this process.
Research into Action is COHRED's quarterly Newsletter. Some of the articles included in this issue are:
* Bali meeting confirms establishment of the Asian and Pacific Forum for Health Research
* Latest steps towards the establishment of the African Health Research Forum
* Prioritised health research in support of health systems development in Mali
* Global health studies based on local realities.
The Mexico City Ministerial Summit in 2004 made the problem of poor knowledge translation (KT) a priority, and a solution imperative. Summiteers called for the increased involvement of the demand side in the research process, emphasising knowledge brokering and other mechanisms for ‘involving the potential users of research in setting research priorities’. Though the declaration was made with enthusiasm – and echoed in many follow-up meetings and papers – there was little guidance on how to actually bring together research and research-users. This guide addresses that gap. It discusses three core KT principles: knowledge, which depends on a robust, accessible and contextualised knowledge base, regular dialogue between all stakeholders and strengthened capacity, where researchers, decision-makers and other research users require a strengthened skill-base to create and respond to KT opportunities.
This study reported on research production and publications on health inequalities through a bibliometric analysis covering publications from 1966 to 2014 and a content analysis of the 25 most-cited papers. A database of 49,294 references was compiled from the search engine Web of Science. The first article appears in 1966 and deals with equality and civil rights in the United States and the elimination of racial discrimination in access to medical care. By 2003, the term disparity has gained in prominence relative to the term inequality which was initially elected by the researchers. The paper shows that research on health inequalities grown exponentially in the last 30 years; the terms inequity, inequality and disparity have been inconsistently used over time; the most-cited papers studied socioeconomic factors and impacts on health inequities with first reports studying relations of socioeconomic conditions and health outcomes and research growing toward theoretical models and proposals on methodological approaches.
With rapidly increasing globalisation, trends towards unhealthy diets, obesity, sedentary lifestyles and unhealthy habits are resulting in an increased worldwide burden of chronic non-communicable diseases (NCDs). In Africa this means that health systems face the challenge of an increasing burden of NCDs as well as continuing high morbidity and mortality from communicable diseases. This health transition represents an enormous challenge to Africa as the region with the least resources for an effective response, the authors of this paper argue. As previous epidemics, including HIV, have caught Africa unprepared, they urge the health community to plan ahead for health transition in Africa. Health research is identified as having a key role to play in meeting health and development goals, and must be responsive to changing disease patterns, such as health transition. Key areas for further research suggested in this paper include: epidemiological research so that a good understanding of the distribution in Africa of communicable and non-communicable diseases can inform health planning; research on the interactions between communicable and non-communicable diseases; health system research with a particular focus on new approaches to improve the primary care response to health transition; and policy research to evaluate the more upstream measures addressing the population-level determinants of NCDs. The authors call on government and public health stakeholders to capitalise on the global policy environment, which is becoming more favourable to action on health transition in Africa, and implement a research agenda for health transition. Alliances have a key role to play in Africa as well as in other regions in implementing the research agenda on health transition by building research capacity and mobilising the necessary investments.
Reducing children's exposure to harmful events and violence is essential for early childhood development. The authors used the Child Health and Nutrition Initiative method for the setting of research priorities in integrated early childhood development and violence prevention programs. An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of community health workers to deliver early childhood development and violence prevention programs interventions effectively and whether these interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The findings from this research priority setting exercise is argued to potentially help guide funders and others towards funding priorities for important future research related to early childhood development and violence prevention.
While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description in this study looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem. In two very different, but connected projects, the authors demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice.