A Policy on Research for Health (CD49/10) has been approved for implementation in PAHO (Member States and the Pan American Sanitary Bureau) by the 2009 49th Directing Council of PAHO/WHO. This policy aims for PAHO to remains true to being a knowledge-based organization, that strong and sustainable national health research systems are found in every country in the Americas, and that research evidence constitutes a cornerstone of all activities aimed at attaining the highest level of health and equity. To achieve these aims the Secretariat at the Pan American Sanitary Bureau, Member States and partners will need to work together to harness science, technology, innovation and broader knowledge.
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WHO Strategy On Research For Health
May 2010 saw the first organization-wide strategy on research approved by the World Health Assembly. Research for Health - defines a common framework for how research is approached in WHO and the role WHO is taking in global health research. The strategy has five main Goals:
- Capacity: Building capacity to strengthen health research systems.
- Priorities: Supporting the setting of research priorities that meet health needs particularly in low and middle income countries.
- Standards: Creating an environment to create good research practice and enable the greater sharing of research evidence, tools and materials.
- Translation: Ensuring quality evidence is turned into products and policy.
- Organization: Action to strengthen the research culture within WHO and improve the management and coordination of WHO research activities.
Resources
National Policies and Agendas
From the World Health Assembly (WHA) Resolution 43.19 on the role of research in health to the Bamako call for action in 2008 onwards, research has taken an increasingly higher profile. This has been accompanied by: a dramatic rise in funding for global health and health research; a stronger interest in innovation and technological advancement; an emergence of numerous global heath research initiatives; an increased attention paid to health systems research and evidence-informed policy and practice; and more awareness of the political, economic, environmental and social determinants of health (taken from PAHO's Policy on Research for Health).
Key events that contributed to the development of the PAHO policy on research for health, submitted to the 144th Executive Committee on 22-26 June 2009 are illustrated and listed below.
Highlights from PAHO/WHO Research Policies and Strategies:
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Milestones for a Policy on Research For Health
Detailed timeline events
2010 — 2014
2013
The World health report: research for universal health coverage
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In addition to identifying the benefits of increased investment in health research by developing studies, this report focuses on how research steers health priorities towards universal health coverage and defines the role of research through three key messages: universal health coverage cannot be achieved without evidence from research; all nations should be producers as well as consumers of research; and, research for universal health coverage requires national and international collaboration. The report includes a visual illustration of the cycle of research activities demonstrating how questions lead first to answers and then to more questions.
Reference: https://www.who.int/whr/2013/main_messages/en/index.html
2012
Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination
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The Consultative Expert Working Group on Research and Development produced this report to examine why market mechanisms and publicly-funded research collectively result in far too little investments in research on diseases that mainly affect developing countries. The report assesses a series of research financing proposals and financing sources to identify common measures that are not up to par. It concludes with a series of recommendations on financing and coordination, including a call to improve capacity building, promoting partnerships, improving and retaining human resources and expertise, developing institution and infrastructure, and sustaining long-term collaborations.
Reference: https://www.who.int/phi/CEWG_Report_Exec_Summary.pdf
Changing Mindsets: Strategy on health Policy and Systems Research
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This Strategy, launched in 2012, represents a major breakthrough in health policy and systems research by undertaking three broad aims: to unify the worlds of research and decision making; to provide insight into the dynamic processes of generating evidence; and to call attention towards Health Policy and Systems Research (HPSR) and ultimately move the field ahead. It encourages active engagement between researchers and policy/decision-makers by urging for both sides to understand the need and value of building capacity in HPSR. Furthermore, the strategy seeks to combine several weakly-connected knowledge generation platforms into an integrated instrument of change that can provide impetus to health system strengthening.
Reference: https://www.who.int/alliance-hpsr/alliancehpsr_changingmindsets_strategyhpsr.pdf
2010
The WHO strategy on research for health
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The Strategy defines a common framework for how research should be approached in the World Health Organization (WHO) and the role WHO is taking in global health research. It encompasses five main Goals: Capacity building, Priority setting, Standards, Translation and Organization. This document represents international recognition that global improvements in health are dependent on quality research that comes with a global perspective in mind. It not only shows how WHO's involvement in research will be strengthened but also how global standards are to be improved while acknowledging that health policies and practices should be based on the best research evidence available.
Reference: https://www.who.int/phi/implementation/research/en/index.html
2005 — 2009
2009
PAHO's Policy on Research for Health
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As the first regional policy on research for health to be endorsed by Member States, PAHO's Policy on Research for Health offers a strategic approach to strengthen health research governance and related aspects including: quality, ethical standards, partnerships, human resource, and knowledge translation. The policy takes into consideration appeals from the international community and harmonizes with other major global research strategies including: WHO's Strategy on Research for Health, the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property.
In 2009, this policy was approved by the PAHO's 49th Directing Council.
References: https://www.paho.org/hq/index.php?option=com_content&view=article&id=1414&Itemid=1658&lang=en
2008
PAHO Strategic Plan 2008-2012
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The Strategic Plan is PAHO's answer to the call of the countries of the Americas that gathered in Panama to launch the Health Agenda for the Americas, for an instrument to guide the collective action of national and international stakeholders who seek to improve the health of the peoples of this Region. Research governance and technical cooperation is highlighted in Strategic Objective 11: address research governance and capacity building in Member States and the Organization.
Reference: https://www.paho.org/English/GOV/CE/ce142-div3-e.pdf?ua=1
Spanish: https://www.paho.org/Spanish/GOV/CE/ce142-div3-s.pdf
Closing the gap in a generation: Health equity through action on the social determinants of health
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The Commission on Social Determinants of Health—set up by the WHO in 2005 to collect, collate and synthesize global evidence on the social determinants of health and their impact—prepared this report which enumerates a series of recommendations for action to address inequity in health. The report calls for a new global agenda for health equity because systematic differences in health are judged to be avoidable; therefore, correcting for these inequities is not only an ethical imperative but a matter of social justice.
Reference: https://www.who.int/social_determinants/thecommission/finalreport/en/
1st Latin American Conference on Research and Innovation for Health. Río de Janeiro, Brazil.
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This conference sought practical answers to a common challenge in the Region: 'How to ensure that research deals with the countries' health priorities and contributes to equitable development in Latin America?'. The conference focused on the creation, development and strengthening of National Health Research Systems, as well as the use of regional cooperation to take advantage of existing resources and reducing asymmetries. Portal to conference site, Conference report (1.07 MB) and a related paper.
Intergovernmental group on Public Health Innovation and Intellectual Property Rights. Río de Janeiro, Brazil.
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The follow-up report to the conference was published in 2009. This report summarizes the opinions of researchers and academics, authorities from the Ministries of Health and representatives of foundations and international organizations about recommendations for the design, development and/or strengthening of National Health Research Systems. Moreover, it provides updates on recent developments since the conference in Río de Janeiro in 2008 and summarizes presentations held during the follow up meeting in Cuba.
The 1st conference was followed by the 2nd conference which took place in Panama on the 23-25 November 2011, and focused on "Priorities for research for health and innovation". The full conference report can be found here with additional information found here.
Global Ministerial Forum on Research for Health Bamako, Mali
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The Bamako Global Ministerial Forum on Research for Health was presented to the 48th Directing Council of PAHO/WHO. It drew attention to the challenges that low and middle income countries face to develop a coherent approach to research priority setting and governance of health research. The delegates agreed on a paradigm shift that extends "health research" to embrace all sectors that contribute to "research for health". Additionally, the participants formulated an agenda for the "Strengthening Research for Health, Development and Equity."
Bamako call to action is to strengthen research for health, development and equity.
2007
Health Agenda for the Americas 2008-2017
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The agenda was presented in Panama City to the international community by the Ministers of Health of the Americas, and reflected countries' intent to work together and in solidarity to improve the health and development of the people of the Americas. Research is needed to respond to every area of action of the Agenda. Furthermore, it is particularly pertinent with regards to harnessing knowledge for Science and Technology.
2006
COHRED Latin American Consultation
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The consultation was held to develop strategic ideas for the promotion of research for health by focusing on: a) understanding the situation of the different countries regarding health research systems; b) considerating the role and value of networking, networks and south-to-south linkages in promoting research for health; and c) specific discussion on the potential roles of COHRED in the region in support of strengthening national health research systems.
2005
Commission on Social Determinants of Health; Report published in September 2008
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Responding to increasing concern about persisting and widening inequities in health, the WHO established the Commission on Social Determinants of Health in 2005, to provide advice on how to reduce inequities. The Commission's final report was launched in August 2008 and included a call to increase public health research on the social determinants of health. See final report at: https://www.who.int/social_determinants/thecommission/finalreport/en/
2000 - 2004
2004
WHO Report on Knowledge for Better Health
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The Report reviewed the current state of global health research to conclude that more investment is needed for newer, more innovative research approaches. Furthermore, health research must be managed more effectively and there should be emphasis placed on translating knowledge into action to improve public health by bridging the "know-do" gap that separates what we know and what we do in practice. This schism exists for each of the eight MDGs and represents a pragmatic challenge that must be addressed in any health systems strengthening effort.
Reference: https://www.who.int/rpc/meetings/pub1/en/
Ministerial Forum on Health Research, Mexico.
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The Forum called for a strengthening of national health research systems and for countries to commit to devote at least 2% of the public health budget to research, knowledge translation and clinical trials registration, transparency and accountability.
2003
Role of Science in the Information Society (RSIS)
More… Responding to a call from the UN to extend the benefits of modern science to developing countries, RSIS reviewed the prospects that developments in science and technology offered for the future of the Information Society, especially in education, environment, health, and economic development. This event brought together scientists, policy makers and stakeholders from around the world to develop a vision for how information and communication technologies could be applied for the greater benefit of all.
2002
Essential Public Health Functions (EPHF)
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The EPHF enumerates a set of fundamental actions that should be performed in order to improve the health of populations. Through the Public Health in the Americas Initiative, PAHO defined eleven Functions necessary to strengthen public health practice and developed a methodology that allows countries to evaluate their own public health capacity.
Reference: https://www.paho.org/hq./index.php?option=com_content&view=category&layout=blog&id=3175&Itemid=3617&lang=en
2001
Commission on Macroeconomics and Health
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Noting the high burden of preventable diseases in poor countries and communities, this Commission called for strategic planning of investments across health and health-related sectors to improve the lives of poor people and promote development.
Investment in Health: a summary of the findings
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The Second Consultation on Macroeconomics and Health, on "Increasing Investments in Health Outcomes for the Poor" took place in 2003. Ministers of Health, Finance and Planning from forty low- and middle-income countries came together with development partners to discuss issues related to improving the effectiveness of health delivery systems and increasing domestic and external resources to health. Participants endorsed a Declaration pledging to establish and strengthen appropriate national and sub-regional mechanisms and to give attention within investment plans to human resource constraints.
2000
Millennium Development Goals (MDGs)
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The MDGs were developed out of commitments set forth in 2000 through the Millennium Declaration that all 191 UN Member States have agreed to achieve by the year 2015 to free people from extreme poverty and multiple deprivations including hunger, disease and illiteracy. Achieving the MDGs relies on more than economic growth, and health systems research have shown that a "one size fits all" model will not sufficiently respond to the distinct, individual healthcare profiles of each developing country.
Reference: https://www.who.int/topics/millennium_development_goals/en/
International Conference on Health Research for Development
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This Conference reaffirms that health is a basic human right. Health research is essential for improvements not only in health but also in social and economic development. Rapid globalization, new understanding of human biology, and the information technology revolution pose new challenges and opportunities. Social and health disparities, both within and between countries, are growing. Given these global trends, a focus on social and gender equity should be central to health research.
1990 — 1999
1999
UNESCO: World Conference on Science, Hungary.
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For six days, some 1,800 science stakeholders from 155 countries, including 90 ministers and deputy ministers in charge of science and/or research, debated on major science and related societal issues, with delegates agreeing on a number of principles and guidelines for shaping the course of science, research and science-society relations in the new millennium.
1998
World Forum on Health Research and the 10/90 gap.
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The Global Forum for Health Research was established, founded on a broad statement of purpose and on the recognition of a wide range of relevant constituencies, its mission being "to help focus research efforts on the health problems of the poor".
1993
WHO — The World Bank: Relationships between health, health policy and economic development; DALYs concept.
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Reference: http://books.google.com/books?id=KiuBPFeh0uoC&pg=PA51&lpg=PA51&dq=WHO+World+Bank+Dalys+concept&source=bl&ots=UikwzRjQOz&sig=cM7vy4lK0quc08n9mxlAS6mt2dc&hl=en&ei=lK9fSoecO4vmMfeK-L8C&sa=X&oi=book_result&ct=result&resnum=1#v=onepage&q=WHO%20World%20Bank%20Dalys%20concept&f=false
1990
Commission on Health Research for Development
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The commission focused on research in the belief that it has enormous—and in great part neglected—power to accomplish that goal. It also determined that research was essential for health and development.
WHA Resolution 43.19: "Role of Health Research".
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Reference material: http://repository.searo.who.int/handle/123456789/5508