Michael Devlin, COHRED

Irish Forum for Global Health 30 November, 2010

Maynooth

Research for Health Approaches to research system strengthening – country perspectives  

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’

charity

vertical programmes

development

doing it enabling it

Redefining development

The issue

5 million lives saved...…but a statistic is missing

The world we would like to see

The economic success of the world’s high incomecountries since the World War II was builton deliberate and planned investments in science andtechnology1.

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. 

The world we would like to see

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

•old examples: USA, Western EuropeLisbon treaty – 3% of GNP on science and technology

•more recent examples : South Korea, Taiwan, Singapore

•actively changing now : India, Brazil, South Africa, Thailand, China

•aspiring low income countries : Rwanda, Uganda, Tanzania

Investing in research & innovation

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.

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.

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".

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 tomanage research and innovation for improved health, equity anddevelopment. Donors and health programmes research fundersuse country priorities as a starting point .

‘Responsible programming’ of vertical health initiatives

All external programmes and actors operating in research for health inlow and middle income countries will also build the capacity ofresearchers 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 strengtheningDeveloping capacity – researchers, institutions, system

Pharmaceutical Innovation ToolSupport to countries – developing innovation strategies and capacity.

Priority setting

Policy development

Coordinating mechanism

Political commitment

Human resources for HR

Financing

Science communication

Information systems

increasing research capacity

developing comprehensive national research system support

‘level’ of

development

locus ofintervention

nature of intervention

individual

institution

research system

socio- economi

c&political

international

collaboration & linkage

1‘capacity building’

master level training

grants manage-ment

basis of NHRS

increase demand for research

good partner-ships (e.g. Alignm & Harmonisation)

2‘capacity strengthening’

doctoral level training

merit-based promotion system

research ethics review capacity

civil society engagement

fair research contracting

3‘performance enhancement’* equity-focus

networking researchers, peer reviews

research communica-tion

monitoring & evaluation of output and impact

focus health, equity & soc-econ development

focus on research competitiveness

Health Research Web www.healthresearchweb.org

Research for Health-Africa programme

NEPAD-COHRED supporting partner countries

Goal:

Work with national institutions to become centres of excellence for health research for development and system strengthening

Research is a key driver for developmentBut insufficiently used in Africa - due to unclear: • research governance structure• priorities/direction, and policy framework

Research for Health Africa

• Research + S&T institutions - Senegal, Tanzania (3rd country to be confirmed).

• NEPAD Agency• COHRED • Netherlands Ministry of Foreign Affairs• Other countries to join

Partners

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)

charity

vertical programmes

development

doing it enabling it

Redefining 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."

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."