World Health Organization Information, Evidence and Research The Road to Bamako Tim Evans Assistant...

Information, Evidence and Research

World Health Organization

The Road to Bamako

Tim Evans

Assistant Director General, WHO

Scaling Up Research and Learning for Better Health

Divonne, June 2, 2008



Overview

• The historical context– The value of research– Some important antecedents

• The "Call to Action"• The Ministerial Discussions



The value of research

The health research system is the brains of the health system: it is a tool to organize, understand, operate and improve it

Prawase Wasi



Value of Research for Health

• Describe the health situation

• Discover the causes of ill-health

• Development of solutions

• Delivery of solutions

• Determine impact

WHO Research for Health Strategy

framework for research priorities

Research on neglected

priority needs

Measurement of th

e

problem – diagnosis

Understand causes of

the problem –

determinants

Dev

elo

pm

ent

of

solu

tio

ns

Translation and delivery of the solution

Evalu

ation

of th

e

imp

act of th

e solu

tion

WHO research priorities framework identifies 5 types of research that are pertinent to any given health need.



Commission on Health Research for Development (1990) : Action

Agenda

• Essential national health research (ENHR) in every country

• International partnerships• Capacity building• More financial resources for

health research • Mechanisms to monitor

progress and generate support



Ad Hoc Committee on Health Research Relating to Future Intervention Options (1996)

:

• R&D priorities … "Best Buys"

– Products for neglected diseases– Child and maternal health– Microbial threats– Non-communicable diseases and

injuries– Health care systems



International Conference on Health Research for Development, Bangkok

(2000) : Key challenges for health research

• Adherence to values of ethics, equity and excellence

• Sustainable health research systems

• Favorable research environment

• Knowledge production and application



Ministerial Summit on Health Research, Mexico (2004) : Key

messages

• More investments in health systems research

• Better management of health research

• Secure public confidence in science

• Stronger emphasis on turning knowledge into actions to improve people's health



58th World Health Assembly, Geneva, May 16-25, 2005



The Bamako Call to Action

• Based on consultations in all WHO regions in 2007/2008• Reflects:

– the WHO Research Strategy – The World Health Assembly approved Global Strategy and Plan of

Action on Public Health Innovation and Intellectual Property

• Identifies priority directions for research policy– Both the "what" and the "how"

• Priority areas of focus• Capacities• Standards - • Translation

• Will be further revised over the next three days of Ministerial discussions



Ministerial Discussions Agenda

• Day 1 – Monday 17 November– Session 1 –

• Introductions

• Overview

• Report of WHO/AFRO Consultation in Algiers

– Session 2 – • Reports from other regional consultations

• Overview of the Call to Action



Ministerial Discussions (cont'd)

Day 2, Tuesday November 18• 3 sessions• Focus:

– a broad topical area of research

• Presentation:– Brief overview

• Panelists:– to provide inputs from Forum parallel sessions

• Moderated discussion:– " how can countries and international partners work more

effectively on these issues? "



Ministerial Discussions (cont'd)

• Session 3 - 11:00-12:30 – Research for Health Product Innovation

• Session 4 - 13:50- 15:50 – Research for Global Health Security

• Session 5 - 16:20 – 18:20

– From Global Health Initiatives to Primary Health Care: Scaling up Research and Learning for Health Systems



Research for Health Product Innovation

• Longstanding focus of recommendations and action • WHO Special Program on Tropical Disease Research 1976

• Concerns in 1990s…• "dry pipelines"; "market failures"

• Major global response:• Product-development partnerships - many! • Reconsidering rules and incentives

– WTO/TRIPS – public health considerations– Advanced market commitments

• Commission on Public Health Innovation and Intellectual Property followed by Intergovernmental Working Group, Global Strategy and Plan of Action 2008



2003 Map of Initiatives Addressing Communicable Diseases

ACHAP (Botswana) GET 2020

FEW PARTNERSHIPS FOCUSED ON DIAGNOSTICS

The Global Fund for Aids, TB & Malaria

Stepping Forward

IIDRI (leishm. et al)

FundsFlow

Coordin/DiseaseControl

New Prod.R&D

Prod.Transfer

Prod.Distrib.

Operat.Research

Prevention/Vaccine Treatment/Drug Diagnosis/Tests Advocacy/HealthEduc/Community Mobiliz

MDPDiflucan

ActionTB TBDI

GDF

SEAMSEAM

MSFDND

TBMalaria

AIDS/HIV

OTHER

GAELF

ITI Coartem

SDI

IAVI JPMW

Stop TB

MMV

MIM

MVPMVI TB Alliance

SequellaFound.

AAI

Artesunatesuppo

EMVI

GAIN

GAELAPOC

GAVI & VF GPEP

Roll Back Malaria

HIN

IPAAA

Lap-dap

MNT

PDVI

SIGN

SSI

Vision2020

CVP

CONRAD

CICCR

DVP

GWEP

GMP HVI

HACI

NetMarkPlus

ICCADD

PHW

Securethe

Future

Vira-mune

DP

AMD

ConceptFoundation

CCA

GBC

GRI

IOWH

IPM

PSI

TB Solutions (Sequella F.)TB Solutions (Sequella F.)

Partners(MDRT)

VITA

GFUNCHPTN

AAACPA

ECI

HVDDT

UNFPAcontraaccess

TFCSD

LFI

INDEPTH

TBMalariaAIDS/STDOther

Size ~Funding

Italics = Global

Note: Funding levels preliminarySource: BCG Analysis, Bill & Melinda Gates Foundation Website, IPPPH database, Partnership websites

Micro-bicides



IGWG on Public Health Innovation and Intellectual Property Global Strategy and Plan of Action, May 2008

1 Priority Setting for R&D

2 Promoting R&D

3 Building and Improving Innovative Capacity

4 Transfer of Technology

5 Application and Management of IP

6 Improving Delivery and Access

7 Promoting Sustainable Financing

8 Establishing Monitoring and Reporting Systems



Research For Global Health Security

• A relatively new and quickly growing focus of research

• Reflects complex health challenges that are often driven by globalization:– Unpredictable crises/threats

• pandemics, humanitarian, food, energy, and financial

– Largely predictable challenges - • NCDs, social determinants of health, aging, lifestyle behaviors

• Demands research response that is cross-sectoral and cross-border and fast!

Commission on Social Determinants of Health

Overarching Recommendations

1. Improve Living Conditions

2. Tackle the Inequitable Distribution of Power, Money, and Resources

3. Measure and Understand the Problem and Assess the Impact of Action.



From Global Health Initiative to Primary Health Care:

Scaling up Research and Learning for Health System

• Specific focus of progress from Mexico Summit 2004

• Reflects growing policy interest in health systems e.g. G8, UNGASS

• Draws on 12 parallel and special sessions of Bamako forum related to health systems research

• Recommendations from WHO High Level Task Force

Common systems constraints to scale up services for HIV, TB, malaria, and immunization

HIV/UA assessment report

Global Plan to stop TB

World Malaria report

GAVI/Norad report

• Inadequate financing• HR crisis • Affordable commodities • Stigma, discrimination…• Accountability

• Partnership alignment • Inadequate financing • Laboratory capacity • HR crisis • Quality drugs

• Drug efficacy • Information system • Inadequate financing

• HRH and Community

services • M&E

• HR crisis • Inadequate financing • Leadership and

management • Inter-agency

coordination

C. Research for Primary Health Care



Ministerial Discussion (cont'd)

Day 3 19 November

11:00 – 12:30

Final review of the Call to Action

13:50- 15:5-

Reading of the Call to Action in the plenary

World Health Organization Information, Evidence and Research The Road to Bamako Tim Evans Assistant...

Documents

Transcript of World Health Organization Information, Evidence and Research The Road to Bamako Tim Evans Assistant...