supporting national health research systems in low and

Supporting national healthresearch systems in low andmiddle income countries

COHREDCouncil on Health Research for Development

Making health research work... for everyone.

Annual Report 2008

© Copyright Council on Health Research for Development (COHRED) 2009

ISBN 92-9226-033-2

Cover, from the left © Manoocher Deghati/IRIN, © James A. Rodríguez/MiMundo, © Manoocher Deghati/IRIN, © Manoocher Deghati/IRIN.

The photographs used in this publication come from organisations encouraginghumanitarian aid and development. MiMundo is related to Rights Action, it fundscommunity controlled development in Latin America. IRIN Humanitarian News makesphotos available to enhance awareness of humanitarian needs and responses and toencourage greater media coverage of forgotten and under-reported crisis. Photoshare(Knowledge4Health) encourages international non-profits to communicate health anddevelopment issues. Ethical code of conduct is part of its editorial principles.

Printed on chlorine-free 100% recycled paper.

TABLE OF CONTENTS

2. Board Chair's comment

4. Director’s note

6. How COHRED works

7. Frameworks and Guides

8. Workplan 2008 – Progress against targets

17. The year in review

27. Essays – New perspectives on health research system strengthening

41. Corporate and financial information

Council on Health Research for Development (COHRED)

Health research as a development tool.The way in which health research is doneand the questions it addresses makes thedifference between health research thatis done to deliver technical solutionsfor those who can afford them; or healthresearch as a central element ofalleviating human suffering, improvinghealth and health equity, andcontributing to a country’s development.

COHRED's vision is a world in which everyone can achieve optimal health

To achieve this vision, we support countries to optimise their health research potential to:

Improve health and reduce health inequities

Improve health sector performance

Link health research with science, technology and innovation

Promote health sector accountability

Encourage donor alignment and harmonisation

Generate economic and social prosperity

In its work, COHRED prioritises the poorest countries, regions and populations

BOARD CHAIR'S COMMENT

Professor Marian Jacobs

Almost two decades have passed since the report of the Commission on HealthResearch was presented to the global community, leading to the establishment ofthe Council on Health Research for Development in 1993.

In the intervening years, there has been a burgeoning of global organisations,partnerships, initiatives and meetings - all focused on strengthening aspects ofhealth research for development across the globe, and each proposing a differentroute to this end.

There have been three major world conferences on this topic. Against thebackdrop of an agreed set of values and principles, the Bangkok conference in2000 achieved consensus around a plan which focused on strengthening nationalhealth systems, through national, regional and global actions. The Mexico summit,held in 2004, recommended strengthening health systems research, as well as theresearch-policy nexus. And last year, the Bamako conference placed the spotlightback on the recommendations of the 1989 Commission – re-emphasising a focus oncountries, with adequate funding from national and global sources.

Throughout this time, what has been COHRED's contribution to the mission ofhealth research for development?

In the years leading up to the turn of the century, and under the leadership of astrong partnership between the Board and a facilitating secretariat, strong valuesrooted in the principles of social justice and health equity were established as a basisfor the direction, the activities and the modus operandi of COHRED.

The Board was characterised by a membership derived from civil society, thepublic health sector and researchers, and most of these were from low- or middle-income countries. The countries concerned included the poorest in the world, inregions from Latin America and the Caribbean, across Africa, to South East Asia,and in each of these, 'focal points' acted as both advocates for, and practitioners of,this new approach.

Working groups representing the triad of 'research-health service-community'grappled with issues such as capacity building, community engagement andpriority setting as key competencies to be considered in a strong national healthsystem. By the end of the decade, COHRED's approach was firmly established andrecognised widely.

The turn of the century brought new organisational challenges for COHRED, asa diversification of global organisations led to funding uncertainty. But withchallenge came the opportunity for building on the strong foundation set by theleadership of the 1990s, and the past decade has been witness to consolidation ofour mission and its translation into expanded programmes.

10 years at the service of countries and equity

2 COHRED ANNUAL REPORT 2008

3

Conceptualising COHRED as a 'southern alliance' with a developmentperspective on health research, and advocating for country voices to be heard inthe global decisions about health research, we have maintained our focus onenabling countries, especially the poorest, to strengthen health research systems asa means to promote good health and reduce inequity. Our current programmesand achievements are documented in this report, and updates are also providedthrough our website and regular communication.

I have been a member of COHRED's Board for ten years, and my imminentdeparture from the Board offers an opportunity to pay tribute to those from whomI have learnt over the years of my tenure: my fellow board members, who havecome and gone; the staff of the secretariat and later, the directorate; those whowere designated as focal points in the early years; and all the members of theCOHRED family across the world.

We have been bound by a common view of the world and concern for itsdisparities; by a belief that health research has a crucial role to play in promotinghealth equity four partners; and by a commitment to social justice.

It has been a privilege to learn from you all, to serve COHRED, and to knowthat membership of the COHRED family extends into perpetuity.

To Yvo Nuyens and Charas Suwanwela: my appreciation for inviting me to bepart of this great movement; to my colleagues on the Board, Carel IJsselmuidenand the staff: thank you for your support and camaraderie. And to my successor aschair of the Board, Cheikh Mbacké – may your tenure as chair be your bestexperience ever!

Dr. Cheikh Seydil Moctar Mbacké was elected as new Chair of the

Board, beginning in 2010.

Dr. Mbacké has held senior research and leadership positions in

public health at the service of developing countries for the past

20 years. Much of this time was spent with the Rockefeller

Foundation, where he was Senior Vice President, Director for Africa,

and Senior Scientist for Population Health, among other

management positions.


DIRECTOR'S NOTE

Professor Carel IJsselmuiden

Winds of change in Africa … again!

1 Dambisa Moyo. Dead Aid. Why aid is not working and how there is a better way for Africa. London, Allan Lane, 2009

Bernardo de Niz

In her radical book ‘Dead Aid: why aid is not working and how there is a better way forAfrica’1, Dambisa Moyo observes that after more than 60 years of aid to Africa, herpeople are not better off … so why continue?

“The 1970s were an exciting time to be African. Many of our nations had just achievedindependence, and with that came a deep sense of dignity, self-respect and hope for the future”.

This trust in own ability is sometimes relived in parts of the continent. South Africahad such a moment in 1994 – having transformed apartheid into democracy, wedeveloped a ‘can do’ mentality – based on these very same attributes of dignity, self-respect and hope. ‘Afri-can’!Moyo puts much of the blame for loosing dignity, self-respect and hope on ‘aid’ – themassive bilateral and multilateral financial aid to governments that has keptundemocratic governments in power, allowed inefficient systems to continue wherethey should have failed, and caused corruption everywhere.

At the same time, she points to African economic successes. Countries we only hearabout in the context of disease, poverty, war and disaster have substantial growth rates,increasingly reliable financial mechanims and growing industries. Logically, she locatesher solutions in this domain: eliminating ‘aid’ and replacing it by free marketmechanisms and diversified sources of trade – with a focus on China and India ratherthan the US and Europe – Africa can begin to take control of its own development –and become “Africa’s Africa” rather than a “donors’ Africa”.

What about research for health?In the field of research for health a similar dynamic is needed for “Africa’s researchagenda” to become “Africa’s” research agenda. Across the continent, countries areremoving restrictive legislation, encouraging the growth of research and innovationsectors both through government stimulation and engaging the private sector. Tunisia,South Africa and Kenya were the top 3 ‘innovators’ in Africa in 2008 and interest inscience and technology as a cornerstone of national development is growing – and notjust in Africa but in low and middle income countries across the globe.

Moyo’s spirit also reflects changing attitudes by African health workers. Forexample, at a recent conference of Public Health Associations in Turkey in April 2009 –the director-general of health of an African country ended his presentation with a pleafor ‘more aid to help solve our health problems’. Promptly, a delegate from Nigeriachallenged this, expressing his hope that he would live to see the day that Africa wouldpropose its own solutions at conferences like this – rather than continue the quest forexternal support.

Many years of ‘research capacity building’ have left many very capable persons on thecontinent – notwithstanding the brain drain – but not very many capable researchinstitutions! Research remains largely determined by external funding – it can buy thesalaries and consumables needed for research projects. Africa’s health research expertiseis concentrated in only a very limited range of disease-specific topics (HIV/AIDS,

5

tuberculosis and malaria are the top 3). And within these narrow confines, researchfocuses mostly on clinical and epidemiological areas, and rarely on discovery,implementation or production. Where, for example, is the research capacity in socialdeterminants, childhood disability, environmental health, health economics,effectiveness of treatment in chronic diseases or in translating any of these intomeaningful products – diagnostics, therapeutics or prosthetics, to name but a few?

Many countries – even those that are successful in attracting foreign researchfunding – spend little, if anything, of their own budgets on research. Few havesupportive research policies, priorities or governance structures defined (‘anyway … it isthe donors who decide what the money is spent on … so why set priorities?’ is a regularly heardstatement). And, surveys of the state of Africa’s universities, show a shocking absence ofeven the most basic facilities and equipment in many countries. Yet it is here where thenext generation of researchers must come from!

There is also a second message. Research, science and technology and ‘innovation’ arekey to any country’s development. Continued reliance on external funding inevitably setsthe research agenda and develops human and institutional resources only as far as isneeded for ‘projects’ rather than for national self-reliance in research. This and acontinued lack of effective research governance structures – a problem which nationalauthorities can solve rather rapidly – is denying Africa the potential to use research as acatalyst for socio-economic development, equity and health.

Yet there are signs that this message is being heard. Following the ‘top 3 innovators’,Tanzania’s president announced an increase in spending on science and technologyfrom 0.3% to 1% of GNP. Rwanda’s president is very outspoken on investment inscience and technology as a driver of development. Private investments inpharmaceutical production and biotechnology are growing in east, west, north andsouth Africa. And in regional economic communities and continental bodies, politicaland technical efforts to support the momentum towards research for health aregrowing. Afric-can … also in research!

How is COHRED supporting this increasing self-reliance on research for health?Over the past five years, COHRED has repositioned itself – from a ‘donor-driven’effort, towards a ‘southern alliance with key northern partners’. We are nowpermanently present in Africa, Latin America and Asia – which allows us to contribute‘south-south’ collaboration and share lessons that may not be learned if ‘research aid’ isonly ‘north-south’. Our work in middle and South America and North Africa grewrapidly in 2008 through institutional partnerships. We have moved beyond ‘advocacy’to becoming an enabling organisation – developing the tools, methods, approaches andplatforms that countries and institutions can use on their own to strengthen theirgovernance and management of research. We helped evolve the ‘essential nationalhealth research’ strategy into a concept of ‘national health research systems’ – thesystem needed to optimize the use of research for health, development and equity.And, finally, our funding is become increasingly based on joint applications withsouthern colleagues – or through direct contracts with southern countries, institutionsand individuals – locating accountability where it should be.

We are taking leave from Marian Jacobs as chair of the Board. Although Marian andI worked together as early as 1983 in finding solutions to a rural health anddevelopment programme in South Africa, it was in 2004 that we joined forces again –this time to revitalise COHRED – to lead the change towards an enabling southernalliance with key northern partners – and the shift in the role of the Board as an‘advisor to wisely spend donor funds’ to one that ‘advocates for low and middle incomecountries to take over the initiative and run the next leg of the development marathonmore on their own terms’. This was Marian’s great contribution to COHRED and to‘research for health’ globally. For me, this has been a great run and I look forward toanother one in the future.

Marian’s work does not end here. In Cheikh Mbacké we have found anotherchampion for the further transformation of COHRED. In the following years, we willneed to change further to appropriately support the increasing capacity of low andmiddle income countries everywhere – and ensure that health equity remains in focus!

Note on Moyo's book:This is a great read – even if

you are not directly concerned

with Africa. Having been at the

receiving end of donors and

research sponsors for all of my

professional life in Africa before

joining COHRED, her diagnosis

resonates very strongly with me.

However, the proposed solution

of market mechanisms to

replace aid is too simplistic by

half. Equity, after all, is not an

automatic by-product of free

markets … to the contrary. Yet,

as a first step, it offers Africa

the opportunity to take charge

– and that is crucial!


HOW COHRED WORKS

AdvocacyCOHRED engages with low and middle incomecountries, and with global health programmesand organisations to improve the understandingof two questions:• What steps do countries need to take to have

health research and research systems that areeffective and focused on national priorities?

• How can global health programmes andorganisations better appreciate and focustheir activities and resources on countries’specific health and health research needs?

Several COHRED initiatives andpartnerships aim to produce evidence tohelp answer these questions and advocatefor change: - ‘AHA’ Alignment and HArmonization –

examining how the Paris Declaration canwork for health research.

- Responsible programming of verticalhealth initiatives.

- Call for engagement of civil societyorganisations in health research.

- Health Research Watch – provides asynthesis of international health researchmechanisms, and comment on how low -and middle - income countries can becomeinvolved in and influence these processes.

FacilitationCOHRED facilitates learning and experiencesharing activities throughout the year. Theseinclude jointly organised expert consultations,regional meetings and special meetings atcountry level to examine key issues related tostrengthening health research in countries.

These exchanges are typically organised tobring together several countries in joint learningactivities and are done in partnership withnational health research organisations (ministries,universities, councils, NGOs, etc.) to maximizelearning and the exchange of experience.

Technical supportCOHRED provides technical support tocountries, on request, to enable them tostrengthen their health research systems.Activities include support for: health researchsystem mapping, profiling, assessment and

development, policy development, prioritysetting, research management and contractingand research communication.

Research and developmentA core COHRED activity is to produce evidencethat makes the case for effective national healthresearch systems. This is done throughcollaborative research and studies done toimprove the understanding of country needsand make the case for strong systems and theskills to support them at national level.

In 2008 COHRED published some 20 technical reports, peer reviewed journalarticles and syntheses of learning interactionsbetween countries. Manuals and guides onhealth research system development, policydevelopment, priority setting, equitable researchcontracting and research communication areavailable or in preparation.

Supporting national health researchsystem innovationsIn its work with countries, COHRED learns ofpractical approaches created by countries toimprove health research, that can be useful toothers. Innovative approaches are identifiedand supported by COHRED so they can beshared with others. Two recent examples are atracking tool for a country’s peer reviewedpublications, developed in Tunisia; and on-lineproject registry module developed by theBrazil Ministry of Health.

Knowledge sharingThe sharing of knowledge and experience iscentral to all COHRED’s activities. The results ofCOHRED’s work with countries are synthesizedin learning materials, publications andinformation resources of various kinds. These aremade widely available as ‘global public goods’.

Health Research Web – the globalinformation platform on health research in low- and middle - income countries. This is acontinually evolving resource that providesnational contacts, policies, priorities. As itdevelops, it will include donor activities andfunding information, clinical trials information,maps and assessment of research capacity invarious areas, etc.

COHRED's programme

1 Advocacy

2 Facilitation

3 Technical support

4 Knowledge Sharing, Advocacy and Communication

5 R&D

6 Supporting national research system innovations

7 Support actions

Actions and Activities Country Regional /Multi-country Global

7

FRAMEWORKS AND GUIDES

Tools and approaches help countries developstrategies for system strengthening The starting point for strengthening a country'shealth research system is to have a clear pictureof the current state of health research. TheNational Health Research System (NHRS)Framework, is informed by COHRED’s workwith many countries. It proposed tools andapproaches for countries to start a strategy ofsystem strengthening.

Practical guides: for decision makers to putsystem strengthening into action Once the strategy is set, the next challenge fordecision makers is how to put it into action. Atthis stage, accurate information is needed as thebasis for decisions and policies. TheFramework’s practical guides take a step-by-step approach to gather the evidence needed todevelop the different components of a healthresearch system. The NHRS Guides distillCOHRED’s past experience of working withcountries to find approaches to how they canbest strengthen their health research systems.Current guides cover system Assessment,Profiling and Development, and Policy

Development. Further guides are inpreparation for: Priority Setting, CapacityBuilding, Communicating Research andInternational Partnerships.

NHRS Assessment GuideThe Assessment Guide helps decision makers gather the evidence needed to plan the development of a National HealthResearch System.The NHRS Assessment Guide is a continuousimprovement process. It helps policy makersanswer critical questions such as:• What are the key institutions?• Are there gaps in regulatory frameworks?• What information is needed to build political

support for health research?• What areas need priority action?

NHRS Policy Development Guide This Guide identifies the measures policy makerscan take to establish the legislative andregulatory framework that will guide systemdevelopment.The NHRS Policy Development Guideaddresses questions such as:• What level of authority is required for each

element of the policy framework - e.g. Act(Legislative); Regulation (President, PrimeMinister, Minister); Policy (Ministerial,Provincial, Institutional)?

• What actions are required to authorise theacts, regulations and policies?

• What consultative processes can buildownership to develop and implement thepolicy framework.

• Are policy development and evaluationbased on sound evidence?

Framework for developing anational health research system

Guides in progress• Priority Setting process for national health research • Research communication• Research capacity strengthening• Health research ethics• Civil society engagement in research for health

Manuals and resources for countries• Manual NHRS Strengthening• Manual Priority Setting• Guide: strategic communication for Health Research Institutions

Workplan 2008 Progress against targets

9

Projects & Programmes

Project title Project description 2008 - Deliverables 2008 - Achievements

Country activities

Argentina Work with Argentine HealthResearch Forum (FISA) andpartners on health researchprofiling.

Support to health researchprofiling.

Project not taken forward in 2008.The Argentine Forum participatedin the 1st Latin AmericanConference on Research andInnovation for Health; did notrequest further technical supportfrom COHRED.

China, ShanghaiHealth research system assessment.

Completed the second stage ofNational Health Research Systemstrengthening in Shanghai provinceas a next step in the further systemdevelopment activities in Shanghai

No contact from local partner in 2008.

LaosDeveloping health researchstrategy and providing a platformfor exchange

Facilitating development ofnational five year master plan forresearch for health and setting upof regular national forum meetings

Continue developing healthresearch forum

Second national health researchforum held in September. COHREDprovided financial support.Technical support will be providedin developing human resources forhealth research strategy in 2009.

CameroonPolicy development and priority setting

Setting health research prioritiesand developing health researchpolicy

Priorities set and draft ResearchPolicy delivered.

Planned activities delayed due tochange in Minister of Health andreplacement of Director ofResearch. Activities have focusedon building working relationshipwith new actors.

Guinea BissauDeveloping a health researchmanagement structure.

Developing health research policy,health research priorities andresearch management structure.

Health research policy frameworkdeveloped; health research prioritysetting process initiated

1. Worked with the Ministry ofHealth and FIOCRUZ (Brazil) toinclude health research in the overallhealth policy of Guinea Bissau.2. Developed study proposal toprepare an inventory of 30 years ofhealth research in Guinea Bissauand its impact on health andhealth system development in thecountry. This inventory (plannedfor 2009) will help inform thedirection and priorities of healthresearch in the country.

Tunisia Develop health research agenda,institutional development

Follow-up of research prioritysetting, done in 2007.

Invitation to support research forhealth through TunisianTechnopolis network - to beactivated in 2009.

Exploratory visits and discussions.Taking a proactive approach tonew countries.

Exploring opportunities forcollaboration: Malawi, Ethiopia,Liberia, Bangladesh.

Effective mechanism establishedfor responding to invomingrequests for collrboration andexplorations of upcomingopportunities.

1. Discussions with Bangladeshand Vietnam have led to theagreement for a first exploratoryworkshop in the first half of 2009.2. Liberian Ministry officials briefedon COHRED's work; Minister ofHealth has voiced interest inCOHRED's expertise in systembuilding.3. No exploratory visits were heldin Malawi, Ethiopia and Liberia.

Regional activities

CaribbeanPromoting National HealthResearch System (NHRS) thinkingin the region and developingregional health research policy.

Jointly with Caribbean HealthResearch Council (CHRC) promoteNHRS in the countries of theregion. Development of a regionalhealth research policy and supportto implementation at regional andcountry level.

Support priority setting process.Facilitate NHRS session at CHRC meeting.

Organised and contributed toNational Health Research session at the annual meeting of theCaribbean Council on CHRCin Suriname. Reached agreement with CHRC todevelop a regional researchagenda, using the Delphi method,of which a first draft will bepresented and discussed at the2009 annual CHRC meeting.




Regional activities

Central AsiaEnhancing regional collaboration inresearch for health.COHRED's work in Central Asiawas led by a COHRED collaboratorbased in Uzbekistan, as part ofCOHRED's decentralisationstrategy.

Working with partners inKazakhstan, Kyrgyzstan, Tajikistanand Uzbekistan on mappingNational Health Research Systems(NHRS) and developing regionalprogrammes to address priorityareas for NHRS strengthening(includes COHRED central Asia).

Clear action plan and strategies forCOHRED collaboration withpartners in the region.

Meetings held throughout the yearin Kyrgyzstan and Uzbekistan withkey people from the ministries ofhealth, and other stakeholders.The focus of work for bothcountries is initially around HealthResearch Web - responding to theneed for better access to healthresearch information to better planfurther investments in research inboth countries.

Latin America meeting First Latin American Conference onResearch and Innovation forHealth, Rio de Janeiro, 16-18 April.Organised, jointly with the Ministryof Health Brazil, Pan AmericanHealth Organization, the GlobalForum for Health Research,NicaSalud and INSalud Mexico

Meeting held, report frommeeting.

1. Conference convened some 120 people from 20 countries.2. 14 countries gave evidence ofNational Health Research System(NHRS) assessment papers. Aconference report published inEnglish and Spanish. 3. As a result of the meeting,technical support was given toHonduras (linking them to Panamaand Costa Rica) for NHRSstrengthening.3. Follow-up meeting planned for2009 in Cuba, to trackdevelopments in NHRSstrengthening since 'Rio-meeting'.4. As a general result two journalarticles and one COHREDpublication came out, refering tothis conference.

Middle EastPromoting research for health andequity in the region.COHRED's work in the Middle Eastis led by a collaborator based inTunisia; as part of COHRED'sdecentralisation strategy.

Jointly with WHO EasternMediterranean Regional OfficeCOHRED to working on a prioritysetting process for countries in theregion; operationalisedecentralisation.

Technical support to priority settingprocess and key areas of COHREDcollaboration with partners in theregion defined. Clear action plan and strategies forCOHRED collaboration withpartners in the region.

Reached agreement with WHOEastern Mediterranean RegionalOffice (EMRO) and Research Policycluster to conduct national healthresearch system analysis inDjibouti, Libya and Syria (extensionof 2006 study), followed byresearch policy development andpriority setting in these countries.Country visits to Libya and Syriaplanned for early 2009.This work provides new countryinformation for Health ResearchWeb for EMRO countries.

Global activities

Global Ministerial Forum onResearch for Health.

Ensuring COHRED's contribution,as one of the six core partners, tothe Bamako 2008 conference

Achieve a focus on Research forHealth, country leadership,Research Ethics and SustainableSociety Engagement.

1. COHRED provided extensiveinput into the Bamako process. 2. Contributed to and participatedin the regional preparatorymeetings in Europe, Asia/Pacificand Africa.3. Organised two special sessions,jointly with partners, in Bamako:* Research for Health and HealthSystem Strengthening in Africa;* The Yaoundé Processstrengthening health innovation inAfrica: from agendas to action.4. Spearheaded and co-facilitateda consultation of civil societyorganisations as input to Bamako;that provided a Statement on CivilSociety Engagement in Researchfor Health, referred to in theBamako Call to Action and FinalCommuniqué.

11



Global activities

Global Forum on Bioethics in Research

Establishment of Secretariat ofGFBR and developing agenda forethics in research

Secretariat functions developed well.1. Two ethics fellows hosted (fromChina and the Philippines).2. Database of information on pasteight annual bioethics fora. See:www.gfbronline.com.3. Secretariat contributed toprogramme development of the9th Global Forum for Bioethics in Research (New Zealand,December 2008).4. The financial sustainability ofthe Secretariat remains achallenge, and various avenues arebeing explored to continueSecretariat core functions.

Civil society consultations Organise civil society consultativeprocess leading to Bamako 2008

Develop action plan based on civilsociety process work done to date;to strengthen civil societyengagement in health research inthe south.

1. Organised civil societyconsultation in Copenhagen,October 2008 - in collaborationwith the Centre for HealthResearch and Development (DBL,Denmark) and the Public HealthResearch and Development Centre(CIAM, Gambia). Consultationoutputs identified strategies forstrengthening civil societyengagement in health research.2. A statement from theconsultation informed a parallelsession on the same topic duringthe Bamako Forum and wasrefered to in the Bamako FinalCommuniqué. The Bamako Call toAction for CSO engagement inResearch for Health was ready atthe end of the Bamako Forum.

Health Research Web, includingAlignment and Harmonization ofHealth Research initiative (AHA).

Development of Health Research Web.

1. Completion of Alignment andHarmonisation (AHA study). 2. Development of HRWeb as aseperate platform.

1. 'AHA' Study completed - asynthesis report and five countryreports (Burkina Faso, Cameroon,Mozambique, Uganda, Zambia).2. AHA study results have beenused to enrich country pages ofthe five countries in HealthResearch Web.3. David Abreu appointed as full-time manager HRWeb.4. HRWeb has been upgraded as aseparate division within COHRED.5. Health Research Web expandedits information on countries inEastern Mediterranean, LatinAmerican, and Pacific regions. 6.Consultative meeting held inAugust with Senegal, Zambia andIDRC to see how Health ResearchWeb can be most useful, visibleand up-to-date. This core groupremains a sounding board forHealth Research Webdevelopment in 2009.


Knowledge Sharing, Advocacy and Communications


Country-based communication Build on Country Communicationwork of past two years withMakerere University, expand to aregional activity. Develop genericapproach to researchcommunication that COHRED canuse with other countries.

This project is divided into fouractvities:1. Makerere researchcommunication strategyimplementation.2. Expanding to a regional activitywith other centers - most probablyin East Africa.3. Develop COHRED approach tocommunication.4. Provide advice and technicalassistance on researchcommunication at country level.

All activities feed into developmentof the COHRED communicationapproach.

Makerere adopts and implements(some) recommendations of theproject's framework and actionplan.

COHRED-Athena Institute (FreeUniversity of Amsterdam)Programme developed andprogressing with one AfricanInstitute - partners providing in-kind or financial investment inproject.

COHRED-Athena have research inprogress on Health Researchcommunication approaches

COHRED communicationsapproach for NHRS published aspart of NHRS framework.

Home institute established forcollaborator COHRED and forCOHRED's regional researchcommunication work.

1. The Board of MakerereUniversity School of Public Healthin Uganda adopted the project'sframework and action plan andstrongly endorsed it as a way tomake the institute a leading playerin the country.2.COHRED-Athena drafted list ofactivities to pursue for 2008-2009.Two masters students will do aliterature review on health researchcommunication (early 2009) andCOHRED-Athena will apply forNetherlands government fundingfor PhD student from East Africa inresearch communication as part ofthis project (June 2009).3. Record Paper draft finaliseddocumenting Makerere work onhealth research communication;Draft ready of guide to strategiccommunication of health researchfor research institutes andprogrammes. Explicit link to NHRSframework not yet made.4. Home institute not yet agreed. Three East African institutes haveformally requested COHRED'ssupport for capacity building oncommunication in a regionalprogramme.

Publications Production, editing and distributionof COHRED publication series,including: Annual Report, WorkingPapers, Record Papers, NationalHealth Research, Manuals and jointCOHRED, Global Forum for HealthResearch series.

Annual Report 2008

Indicative list of 2008 outputs fromCOHRED programme:two Working Papersthree Record Papersthree National Health Researchone Manual

25 publications completed in2008, including reports, capacitybuilding and informationmaterials:- Four peer reviewed journal articles - Nine COHRED publications(Record Papers)- Two targeted advocacy materials(COHRED Health Research Watch)- Seven technical support andcapacity building materials (Guides,manuals, frameworks, specialpresentations)- Three joint publications withpartner organisations.- various information materials andweb articles. (see completepublications list on page 50).

COHRED statement COHRED Statement 2008 COHRED Statement 2008 published- reactions and feedback received

Research, synthesis and drafting completed in 2008.Rethinking of applicability ofAlignment and Harmonisation toresearch for Health has delayed thedecision on continuation of thisstatement.

13

Knowledge Sharing, Advocacy and Communications


Website Continuous improvement ofCOHRED's Web presence.

New higher performance website.

Improved web architecture andstructure. Full contentmanagement system allowing staffto add and change content.

1. Staff and user consultationsdone.2. Study of information needsand architechure requirementsdone.3. Low cost project plan ready, development started. Nov 2008.4. First version of new site(architecture and content) plannedfor first quarter 2009.

Learning approaches Operationalise learning approachesand provide platform for learningexchanges in priority settting andother key COHRED programmes.

1. D-Groups platform (or similar)used for learning interactions for two COHRED programmes (prioritysetting and one otherr) and - asuseful - other internal teamactivities of COHRED.2. Guidelines ready for projectleaders to animate learningactivities as part of their work(lessons synthesized from prioritysetting experience).

1. Decision not to select D-Groupspending other options anddevelopments.2. Some project leader discussionsheld, policy and process will startin 2009 with priority setting

Health Research Watch Expanded web page.Yearly report publication.Briefings publication.

1. Expanded web page created 2. HRW Yearly Report published3. 4 COHRED Briefings publishedand promoted4. Summary of feedback

1. Two briefings produced. Anadditional Briefing based on 2008events (Bamako 2008) is planned. 2. Additional layer of webcontent ready for January 2009.

Innovation in Africa - Yaoundé process

Meeting and process to buildpolitical support for an Africaperspective on pharmaceuticalinnovation and local production.

1. To conduct a baseline study toprepare a technology framework.2. Organise a stakeholder meetingin Africa.

1. Proposals acceptedby Netherlands government.2. Research officer hired.3. Two studies launched (publicationin second quarter 2009):- Yaoundé Baseline: Synthesis ofpharma-related initiatives in Africa.- Health Innovation Framework forAfrica (joint project with GeorgeInstitute).4. Two consultative meetings togather political support,understand country needs andexperiences to date.5. Gave input to six internationalhealth research meetings. Theproject will be finalised in 2009.

Marketing & Communication Increase COHRED's visibiilty amongkey stakeholders and attractpotential new users and partners.

Board Newsletter.Launch of COHRED publications.Contact database improved.

1. four Board Newsletterspublished.2. Contacts databasefully up-to-date; structureimproved. Options for bettersystem explored but not decided.3. Numerous publications and webresources launched to severalthousand users during the year.4. Bamako 2008. Many meetings,several information sessions andmedia activities on health researchsystsem development, Yaoundéand HR Web.


Research and Development


Research contracting Develop a series of modelcontracts and a contracting processfor southern research institutionsand research management bodies.

1. Finalise the proposal withpartners.2. Publish a first article on settingthe context for the project.3. Secure funding.4. Start the first phase of theproject.

1. Proposal finalised in March2. First article finalised andsubmitted to WHO Bulletin (inpress).3. Proposal submitted to the Billand Melinda Gates Foundation,but rejected. Other fundingavenues currently being pursued.4. COHRED has committed ownfunds to conduct the pilot phase,now in progress.

NHRS development guide Develop methods, approaches,process and indicators to provideevidence for managers to informNHRS improvement efforts (basedto NHRS management conceptualframework).

Develop a series of one page'NHRS Development Guides',targetted at decision makers,highlighting the steps they cantake to strengthen their systems.

Three guides completed: * NHRS Development Framework* Health Research Policy* NHRS Assesment

Plans are ready for the followingguides:* Paris Declaration on HealthResearch.* Priority Setting for HealthResearch.* Research Capacity Strengtheningfor Health Research.* The rule of Civil SocietyOrganisations in Health Research.

Priority setting-developingmananagement process

Develop a management approachtowards the process of prioritiysetting in health research

Develop a web-based prioritysetting approach.

A draft of the proposed web-basedapproach has been developed, butit has not been completed. To becompleted as a priority in 2009.

National Health ResearchSystem (NHRS) strengthening insmall islands/states

Define 'reasonable' / practical /optimal approach to NHRSoperationalisation for thesecountries.

Publish findings of the 15 pacificcountry NHRS Mapping study

1. Draft report at editors.2. Results presentend at Bamako2008 Ministerial Forum on researchfor Health.

National Health Research policy Develop an approach to guideNational Health Research Policydevelopment.

1. Publish a record papersummarising the results of the2007 expert consulation on 'goodpractices in Health Research PolicyDevelopment.2. Develop a National HealthResearch System (NHRS)Development Guide on HealthResearch Policy

Record paper eight published 'Bestpractices in health reserch policydevelopment'.

Understanding research todevelopment links

Develop a better understanding ofthe pathways from research to thedifferent goals of the NationalHealth Research System (NHRS):improved health, more efficienthealth systems, reduced healthinequity, socio-economicdevelopment. Use this map as thebasis for guiding strategy andfurther work in this area.

An internal paper summarising theresults of an initial review of thefield to inform decisions on thenext steps required in this work.

Paper completed. Further work onthis subject planned for 2009,based on these results.

NHRS mapping meta-analysis. Conduct a meta-analysis of the 40NHRS Mapping studies thatCOHRED has been involved with.

Publish a journal article presentingthe results of the meta-analysis

1. Journal article final rounds ofdrafting before submission. 2. Paper presented at UNESCOGlobal Research Seminar, Paris(November 2008).

Priorities, Policies andGovernance meta-analysis

Conduct a review of Priorities,Policies and Governance bodies forHealth Research in Low IncomeCountries.

Publish a journal article presentingthe results of the review.

1 Initial results presented at theUNESCO Global Research Seminar,Paris (November 2008).2. Publication expected for secondhalf of 2009.

15

Research and Development


African National HealthResearch System (NHRS)Initiative

Establish an iniatitive to catalyseand support NHRS Development inAfrica.

Build the partnership necessary totake this initiative forward andsecure funding.

1. An agreement with NEPAD-Health to partner with COHRED onthe initiative is near conclusionearly 2008.2. An approach to funders will bestarted shortly.

National Health ResearchSystem/National HealthInformation System

Set out the links between nationalhealth research and healthinformation systems.

Paper on this topic, highlightingevidence needs for health systemdevelopment.

Essay published COHRED inCOHRED Annual Report 2007.

Support of innovations incountries.Sousse Software PublicationsRegistry Database

Identify tools, methods,approaches, processes that mayhelp innovate health researchsystems in Low and Middle IncomeCountries.

Re-develop the Sousse Databasefor application in other countries.

Sousse Database will be includedon a funcion in Health ResearchWeb in 2009/2010.

Governance and Management


Finances: advice financial managementsystem

Improve bookkeeping and financialmanagement system.

Atract a Head of Administration. Post of Head Administration isfilled from January 2009.

Human Resources: Staffprofessional development

Ensure possibilities for professionaldevelopment of staff.

Sylvia de Haan: received herMasters in Public Health degreefrom Chulalongkorn University inThailand, supported by COHRED.Jennifer Bakyawa enrolled in adistance-learning degree course onKnowledge Management withRobert Gordon University, UK,supported by COHRED.

Board activities: Board meeting

Yearly and regional board meetings Board meeting. Held in October 2008.

Fund raising Developing an ongoing resourcemobilisation strategy

1. Longterm Resource MobilisationStrategy.2. Increased funding, core anddesignated.

1. New programme funds receivedfrom EDCTP (Health Research Web)and Netherlands (YaoundéProcess). 2. Project funds received for LatinAmerica conference (PAHO) andCivil Society consultation(Wellcome Trust).

Exploring institutional capacitybuilding

Increasing understanding ofinstitutional capacity building anddefining COHRED's role in this.

Development of basic ResearchCapacity Strengthening (RCS) andunderstanding of COHRED's rolein this.

Reseach Capacity Strengtheningframework ready.

Monitoring and Evaluation Develop a continuous andfunctional quality control systemfor all COHRED's work andfunctions.

Systematic Monitoring andEvaluation Program.

Plans developed forimplementation in 2009.

External evaluation Stakeholder survey on expectationsfrom COHRED.

To be done in 2008 as part ofMonitoring and Evaluation.

Lack of staff time stopped asurvey; product related feedback isbeing implemented systematically.


Governance and Management


Decentralisation: Latin America

Develop COHRED engagementwith Latin America.

Institutional CollaborationAgreement

Agreement signed with INSP(Instituto Nacional de SaludPública) in Cuernavaca, Mexico.

Decentralisation: North Africa

Develop COHRED engagementwith North Africa.

Institutional collaborationagreement joint project withWHO/EMRO on research policydevelopment has started.

No institutional arrangement hasbeen achieved yet.

Decentralisation: Sub Saharan Africa

Develop COHRED engagementwith Sub Saharan Africa.

Regional consultations to helpposition COHRED with the(complex) African landscape.

Lack of staff time to organise anconsultation prevented themeeting from taking place in2008, shifted to 2009.

Decentralisation: Central Asia

Develop COHRED engagementwith Central Asia.

Implement Health Research Web inKyrgystan and Uzbekistan.

Key meetings held.Fundraisinginitiated for 2009.

Decentralisation: Asia

Develop COHRED engagement inAsia.

Regional consultations to helpposition COHRED for effectiveaction in South East Asia with the(complex) Asian landscape.

Decentralisation

The year in review

Advocacy in 2008: Making the case for research for healthKey advocacy activities for COHRED in 2008 involved providing input and commenton a number of international health research processes and initiatives.These included participation as a core partner in the Bamako 2008 Global MinisterialForum, where COHRED’s participation ensured a strong perspective on theimportance of health research systems and civil society actors in the health researchprocess (see ‘Shaping the agenda on ‘research for health’: COHRED at Bamako 2008’,page 22).

COHRED also provided input and comment to the new research strategy of the WorldHealth Organization – calling for actions such as: a sharper focus on country needs;broad consultation with countries on their needs; for a focus on system strengtheningas a key success factor in national health research; and for the WHO to cooperate withspecialised regional and international organisations who can ensure the optimalimplementation at national level.

Input and comment was provided to the research strategy of the National Institutes ofHealth/Fogarty International Center.

Health Research Watch entered its third year. ‘COHRED Research for HealthBriefings’ were produced to synthesise and clarify the workings of theIntergovernmental Working Group on Public Health, Innovation and IntellectualProperty (IGWG) – and the significance of this work for low income countries, andclarified the process of the WHO research strategy’s development. Further COHREDBriefings summarised the process of strategy development points of the Algierspreparatory meeting for Bamako 2008 and of the Bamako meeting and its likelyoutcomes for the future of research for health.

COHRED Statement 2, the organisation’s flagship advocacy activity, presents a studyand policy recommendations on how the Paris Declaration on aid effectiveness can beapplied to improve health research for countries. It is set for publication in early 2009.

Resourceswww.cohred.org/healthresearchwatch

www.cohred.org/main/COHRED_statement.php


Learning, partnership and capacity building: COHRED’s supportto countries in 2008In 2008, COHRED worked with 21 countries to help strengthen theirsystems for health research.

This work consisted of providing technical support, conducting researchand development, providing tools and approaches for systemstrengthening, and facilitating joint learning activities for groups ofcountries and experts in health research management and policy whoshared experiences on health research system development.

These activities helped improve the understanding of what is needed forcountries to organise research and produce evidence for better populationhealth; to attract funds for research on their national priorities andencourage funders to focus their programmes on countries’ needs.

How can the WHOResearch Strategy bestserve countries’ needs?COHRED and partnersproposed practical inputs –promoting a systems’ focusand working with regionaland specialist organisations,who are best placed to putthe strategy into action.

How can the ParisDeclaration support betterhealth research forcountries? COHRED’sStatement 2008 is the firstsuch policy document forresearch for health.

19

Facilitation: sharing experience and knowledge between countriesCOHRED was active in the facilitation of a number of regional and country consultationsin 2008.

The first phase of the ‘AHA’ - Alignment and Harmonisation initiative was completed withfive partner countries. An AHA consultation was held in Uganda to support partners intaking stock of their current situation, constraints and challenges, and to discuss an actionplan for improving alignment and harmonisation in the country. The meeting broughttogether some 40 members of the research establishment, academic leaders, ministry ofhealth, donors, research sponsors and the media, to better understand Uganda’s currentsituation and discuss developing an alignment and harmonisation action plan.

At global level, the COHRED-supported secretariat of the Global Forum on Bioethics inResearch (GFBR) was a partner in the organisation of Forum 2008 in New Zealand, whichcovered ethical aspects of research in vulnerable and minority populations – a first on this topic.

Resourceswww.gfbronline.org

Health Research Web As Health Research Web enters its third year it is now flourishing and has become aseparately managed programme. The team has been expanded with a newly hired manager,and new funding received from two donors – Canada’s International Development ResearchCenter, and the Swiss Department for Development and Cooperation. A third partnershipwith EDCTP allows integration of research ethics capacity mapping on the service (see articlepage 21). The Initiative to Strengthen Health Research Capacity in Africa (ISHReCA) – agroup of 70 African health scientists – has endorsed HRWeb a key service for nationalresearch system development in the African region.

HRWeb is moving into its second phase of providing dynamic information on healthresearch to countries. As a first step, a project registry module with information on healthresearch activities in both Zambia and Senegal is in progress and nearing completion. Thisis a pilot for this ‘open-source’ service available to low and middle income countries tocollect and present their health research information – by project, region, disease, fundinglevel and donor, etc. When fully operational, it will be a strategic information tool that willimprove the quality and relevance of investments in health research.

Resourceswww.cohred.org/HRWeb

Rapid access tostrategic information.COHRED with Zambia,Senegal and Canada'sInternationalDevelopment ResearchCenter (IDRC) aredeveloping HRWeb as anational Health ResearchManagementInformation System.

20

Priorities, Policies and Governance for health research Policies, priorities and governance structures are the three basic elements thatneed to be in place for a country to develop its health research system. Thisconcept is being reviewed and tested in a study by COHRED with the AgaKhan University in Kenya.

The team analysed the current situation in 30 African countries. The studyreveals that many of the countries surveyed lack of governance, policies andpriorities for health research. It also suggests that the presence of agovernance structure for health research can be a catalyst for creation ofpolicies and priorities.

A publication is forthcoming and this thinking is being incorporated into theCOHRED Framework for NHRS strengthening, to guide policy makers andresearch managers in their efforts.

Emerging partnershipsAt the core of COHRED’s approach as an enabling and capacity building organisation is itsgoal of expanding its work and reach worldwide, through a series of effectivepartnerships, with like-minded organisations. This list is not exhaustive, but illustrates anumber of activities which are emerging through the COHRED programme.

• Centre for Health Research and Development, Denmark (DBL) – a university-basedglobal health programme – involving organised civil society in health research; andexploring collaboration around national health research system development in The Gambia and Zambia.

• Athena Institute at the Free University of Amsterdam – on ‘country-based sciencecommunication’.

• Ministry of Health of Brazil – for Health Research Web, regional meetings, translationsof texts.

• Fiocruz Institute in Brazil – for joint work in institutional capacity building inLusophone countries in Africa.

• ISHReCA Initiative to Strengthen Health Research Capacity in Africa – forcooperation on Health Research Web.

• Tunisia Technopole – for ‘research for health’ and institutional capacity building. • University of Kwazulu Natal in South Africa as part of the bioethics partnership with

European and Developing Countries Clinical Trials Partnership (EDCTP).• Aga Khan University in Kenya, for mapping of policies, priorities and governance

structures across sub-Saharan Africa. • Pan-Amercian Health Organization – PAHO. • World Health Organization, Western Pacific Regional Office. • Global Forum for Health Research – partner in organising the Bamako 2008 Global

Ministerial Forum on Research for Health (with WHO, UNESCO, the World Bank andMali), and organisation of Latin American regional meeting on Research for Health.

COHRED-NEPAD African initiative: national health research system mappingand developmentThe NEPAD-COHRED African National Health Research System Initiative builds on the2006 Memorandum of Agreement between the two organisations, which specifies COHREDas a partner to support capacity strengthening of national health research systems and thecreation of African centers of excellence in health and health research in the region. Thisphase is the first step in the development of an Africa-wide NEPAD-COHRED initiative onnational health research system mapping and development. In a first phase, this initiativeaims are to catalyse and support NHRS development in up to 18 countries.

Policies, priorities andgovernance for health research arethe foundations of a strong national researchsystem. Results of a 30 country analysis byCOHRED.

COHRED ANNUAL REPORT 2008

A clearer picture of ethics review capacity in sub-Saharan AfricaToday there is no comprehensive or updated information on ethical reviewcapacity in Africa. The ethics references that do exist are not accessible in onelocation and focus primarily on contact and membership information or project activities.

The partnership between COHRED and the European and Developing Countries ClinicalTrials Partnership (EDCTP) aims to produce the first picture of ethics review and trialregulatory capacity in sub-Saharan Africa. The initiative was created in 2008 and starts itswork in 2009.

Today, health research programmes can spend considerable time to locate national reviewboards and mechanisms in African countries. Having rapid and simple access to thisinformation helps managers run their clinical trials more effectively. It will give quick linksto the right people and an idea of the experience and capacity of the different boards.

This is the first effort of its kind and will be made widely available on the Health ResearchWeb service. It is the first step toward a platform for dynamic and continually updatedethics review information.

Yaoundé ProcessTechnology transfer and local medicines production in AfricaYaoundé Process is a joint activity of the Government of Cameroon, The Netherlands andCOHRED. It was created in late 2006 to bring a stronger country perspective to thedebate on medicines production and technology transfer for African countries. Two studiesare being completed to improve the understanding of countries needs and how technologytransfer can work best in the African context. The Yaoundé Baseline Study will producethe first map of medicines production and related initiatives across Africa. A Frameworkand tools for developing innovation strategies is being developed by the the GeorgeInstitute for International Health and COHRED. It will help simplify the complex view ofpharmaceutical research and system development, in a format countries can easily use.Both studies will be published in early 2009 and serve as input for the Yaoundé Processcountries consultation planned for Cameroon in mid-2009 (see essay page 30).

Resourceswww.yaoundeprocess.org

21

Capacity building inhealth research. TheCOHRED-EDCTP partnershipis a first step toward south-south learning andcooperation on ethics reviewcapacity. It encouragesnetworking of Africanregional ethics traininginitiatives and will maphealth research andregulatory activities acrosssub-Saharan Africa.

“What does your countryneed for healthinnovation and drugproduction – from otherAfrican countries,international partnersand global healthinitiatives?” COHRED facilitated aconsultation at the Bamako2008 meeting to seekcountry-level engagementand inputs.

Olivier Asselin

Cameroon Ministry of Public Health in collaboration with the Ministry of Scientific Research and Innovation

Government of the Netherlands I Council on Health Research for Development (COHRED)

April 2009 - Cameroon

European and Developing Countries Clinical Trials Partnership (EDCTP)


Shaping the agenda on ‘research for health’: COHRED at Bamako 2008 For the Bamako 2008 Global Ministerial Forum on Research for Health,in Mali, COHRED was an active and visible partner and one of the sixconvening organisations, together with the World Bank, UNESCO,World Health Organization, Government of Mali and the Global Forumfor Health Research.

COHRED activities and themes featured prominently in the Bamakoprogramme, and in a number of special sessions.

Some highlights:

Keynotes and presentations• Presence at the Ministerial sessions and comments to drafts – to bring

the systems perspective to the text of the Bamako Call for Action. • Keynote presentations in the opening and closing sessions; comments

on national health research system issues and country needs in twopress conferences.

• Chairing of the panel on ‘the paradigm shift from research to health’ andparticipation in several panels, two partner press conferences andkeynote remarks to the Bamako closing session.

Special sessions Partner in a special session for a Call to Action for Civil Society Engagement in Research forHealth – a partnership of 11 civil society partners from around the world – cited in theBamako Final Communiqué. (See essay page 32).

Organisation of a special session on ‘research for health and health systemstrengthening in Africa’ convened by COHRED, the Swiss Agency for Development andCooperation (SDC) and the Swiss Tropical Institute (STI).

Yaoundé Process consultation on country needs for health innovation and medicinesdevelopment in Africa.

Briefings Media briefings and interviews with COHRED staff; partner briefings on Health Research Web.

COHRED Board member,Aissatou Toure meets hisExcellency, the Presidentof Mali at Bamako 2008.

COHRED's call to action:research based oncountry priorities andinvolvement of civilsociety. COHRED Director Carel IJsselmuidenaddresses the Bamakoclosing session.

'The road from Mexico to Mali', Francisco Becerra-Posada, COHRED’s Latin America advisor, speaking at the opening plenary of Bamako 2008.

23

Guinea Bissau: A health research policy to support the national health reformsThe partnership with Guinea Bissau continues with theMinistry of Health, where COHRED provides support tothe development of the national health research policy – acomponent of the health policy. Together with theMinistry and Brazilian health research organisation,Fiocruz, COHRED is supporting the creation of the newnational public health institute. The partners areexploring how to leverage this experience to benefit otherLusophone countries. Another activity is a review of 30years of health research done in Guinea Bissau and theimpact this has had on health and health systemdevelopment in the country.

Lao PDR: national health research forumCOHRED provided financial and technical support to the second national health researchforum. Together with Laotian partners and Concern Worldwide, COHRED is exploringopportunities to support development of a strategy for ‘human resources for healthresearch’.

Central Asia: advocating for health researchWork continued in Uzbekistan for the fourth year, through advice to academic andgovernment partners on research system strengthening. COHRED’s regional advisor,based in Tashkent, facilitated the involvement of Uzbekistan and Kyrgyzstan in theEuropean preparatory meeting for the Bamako Ministerial Forum.

A meeting with senior Uzbek and Kyrgyz Ministry of Health representatives, exploredoptions for further collaborative work. Both countries showed an interest in having rapidaccess to health research produced in the region, and saw Health Research Web as a wayto achieve this.

First Latin America meeting on research for health

Some 120 participants from 20 Latin American countries attended the First LatinAmerican Conference on Research and Innovation for Health – to which COHRED was akey contributor – providing expert input on health research system development. Themeeting was jointly organised by COHRED, the Ministry of Health of Brazil, the PanAmerican Health Organisation (PAHO), the Global Forum for Health Research, NicaSaludand INSalud Mexico.

The meeting examined the current state of national health research,through 14 country assessment papers provided by partners as input tothe discussions. The conference resulted in acknowledgement of theneed to focus on health research system strengthening in the region,and for more cross-country and regional collaboration.

A follow-up meeting will be held in Cuba in 2009, where the partners will review developments in their countries since the Rio conference.

A direct result of this meeting for COHRED is the technical supportCOHRED is providing to Honduras, and linking this to activities in Panama and Costa Rica.

Resourceswww.cohred.org/main/healthresearchlatinamerica.php

www.cohred.org/main/Rio_Report_EN.php

COHRED and Brazil'sFIOCRUZ are supportingthe creation of the newnational public healthinstitute in Guinea-Bissau.

From left to right: Carel IJsselmuiden, Director COHRED, Mirta Roses, Director of PAHOand Reinaldo Guimarães, Secretary of Science,Technology and Strategic Inputs, Ministry of Health, Brazil.


Caribbean: support to a regional health research agenda COHRED contributed to the Caribbean Health Research Council annual meeting in aspecial session on National Health Research System Strengthening in the region. Othertechnical support was given in discussions on regional health research priority setting andon processes to follow for developing a regional agenda for health research.

Engaging civil society in a new partnership for health researchThe COHRED programme on community engagement in health research was expandedin 2008. A new partnership organised an international consultation to explore this topicfrom a southern perspective. The group prepared a Call to Action that was presented atthe Bamako 2008 Ministerial Forum and mentioned in the Final Communiqué (see essaypage 32). This was jointly financed by the Wellcome Trust, DBL-Center for HealthResearch and Development and COHRED.

This work will be broadened in 2009 as a part of COHRED’s work to implement theBamako Call to Action.

Signatories to the initiative are:• ANIS, Instituto de Bioética, Direitos Humanos e Gênero, Brazil• Centre for Public Health and Equity, SOCHARA, India• Centre for Science and Environment (CSE), India• CIAM - Public Health Research and Development Centre, The Gambia• Community Health Sciences, Aga Khan University, Pakistan• Council on Health Research for Development (COHRED), Switzerland• DBL - Centre for Health Research and Development, Denmark• International Centre for Reproductive Health (ICRHK), Kenya• L’Association Tunisienne de Promotion de la Recherche en Santé (ATUPRES), Tunisia• Project Africa, Kenya• Research!America, USA

Resourceswww.cohred.org/main/Assests/PDF/Bamako_web.pdf

Civil society engagement in health research asks the question: ‘how can communities be actively involved in shaping nationalhealth research agendas and priorities – based on people’shealth needs?’ Nelson Sewankambo, Dean of Medical School ofMakerere University, Uganda and Sylvia de Haan of COHRED at theBamako 2008 sessions.

25

How research communication makes evidence more useful…forpolicy makers, communities and others in society

COHRED research communication work included activities in East Africa and Asia. InUganda, work progressed with Makerere University School of Public Health, whose boardadopted a framework for strategic communication that was developed in partnership withCOHRED. In consultations with other African and Asian partners, COHRED has beenasked to provide input and perspectives on the research communication. The teamcontributed its thinking to the strategies of the Philippine Council on Health Research andDevelopment and the Institute for Health Systems Research in Malaysia.

The Philippine work consisted of a series of focus groups held with different stakeholdersin society on the question: what do you need from others to better communicate or usethe results of health research? Some 50 people were involved in five different focusgroups, including: research, the media, journal editors, research managers and civilsociety organisations.

In Malaysia, COHRED provided support to the Institute for Health Systems Research andEVIP-Net Asia (Evidence Informed Policy Network), by working with the research teamsand institute management to develop a process and templates for ‘translating’ researchresults into information that is useful for policy makers. The course started with basiccommunications concepts and a dialogue between researchers and policy makers. Itconcluded with seven completed policy briefs and research summaries - ready for sharingwith the users defined for each research activity.

COHRED has received requests for similar support from other countries, which willcontinue in 2009. Its goal with this work is not to become a training specialist, but toprovide learning opportunities to southern organisations and networks that can spreadthese skills to others. The results of these experiences will be published in a strategiccommunication guide for research managers in 2009.

The perspectives and experience gathered in theseactivities will feed into a research activity thatCOHRED has started with the Athena Institute forScience Communication, which will involve partnersin Uganda and Tanzania.

Resourceswww.cohred.org/main/researchcommunication.php

How can our evidence be made more useful topolicy makers? COHRED’s Michael Devlin facilitatesa consultation between researchers and policymakers, with Dr. Sondi Sararaks of the MalaysianInstitute for Health Systems Research (IHSR). Sevenresearch teams defined and produced finished policybriefs during this five-day session. This activity was insupport of EVIPNet Asia activities.


Peer review in Malaysia of guides for National Health Research System strengthening COHRED was invited to participate in the Malaysian National Institutes of HealthScientific Conference. A keynote presentation was given on National Health ResearchSystem Development and a second in a session on Translating Research to Policy.

As a part of the conference COHRED organised a peer review session on its NationalHealth Research System Development framework guides for health research policydevelopment, with Ministry of Health officials. The ministry has committed to developa formal health research system in the current five year national planning cycle —citing the Mexico Statement from 2004 as the influence on this policy commitment.

COHRED studies presented at UNESCO ‘Knowledge Systems’ conferenceThe UNESCO Global Research Seminar on ’Sharing Research Agendas on KnowledgeSystems’ invited COHRED collaborators from Uzbekistan and Kenya to present the resultsof its National Health Research System meta-analysis of 38 countries and the results of thePolicies, Priorities and Governance study of 23 African Low Income countries (see page 28).The COHRED team facilitated a discussion comparing and contrasting differentapproaches to research system assessment in a special session presenting experiences fromwork on health research systems.

Building a better healthresearch system. AndrewKennedy, senior researchofficer at COHRED, discussesthe COHRED National HealthResearch and PolicyDevelopment frameworks atthe Scientific Conference ofthe Malaysian NationalInstitutes of Health.

EssaysNew perspectives on health research system strengthening


The main aim of COHRED’s work on NationalHealth Research System (NHRS) mapping hasbeen to describe the governance and policyframeworks for health research in low andmiddle-income countries. This allows decisionmakers to assess the current state of theirhealth research system, and to make informeddecisions on the best choices that can improvethe efficiency and impact of national health

research. An additional benefit of this approachis that it generates a standardised set of datafrom which more generalisable lessons can belearned. The first of these meta-analyses wasconducted this year examining the relationshipsbetween three core components of agovernance and policy framework - a)governance structures, b) health researchpolicies, and c) health research priorities.

ANDREW KENNEDY

Governance structures – the drivers of National HealthResearch System development A new study gives evidence – for the first time – of the close relationshipbetween strong national governance structures and the presence of healthresearch policies and priorities, in low and middle income countries.

Over the past three years, COHRED has collaborated in studies that have mapped theresearch systems of 38 countries. What have we learned from the results of these studies?Meta-analysis of the information collected clearly shows the importance of strongstructures for the governance and management of national health research as the enginesthat drive system development. At the same time, the study shows that many low andmiddle income countries have yet to establish bodies to fulfil these roles.

Governance structuresNHRS governance is concerned with therelationships, systems, processes and rulesfor making decisions within the system. Itprovides the structure through which theobjectives of the system are set, and bywhich the performance and achievement ofthese objectives are planned, executed,monitored and evaluated. Countries differ inthe models of research system governancethat they employ. Structures can take theform of government departments; researchcouncils, committees or commissions;academies of science; or research forums.These structures can focus specifically onhealth research. They can deal with healthresearch as part of the overall science andtechnology sector; or can involve a numberof structures – each dealing with specifictypes of health research or health researchthat is done in different sectors.

Policy FrameworkA policy framework for health research canbe composed of a series of specific polices,regulations or pieces of legislation. Theseformal plans or strategies provide nationaldirection for health research and can formpart of broader policy directions. The healthresearch policy framework, for example, canbe focused on health or be part of thebroader research, science and technology,innovation or general national development.

Priorities Health research priorities identify the researchneeds of countries to achieve their healthgoals and, if available, are usually formallystated by the Ministry of Health or anotherministry or national research governancebody. Health research priorities can form partof general research priorities for a country –as part of national socio-economicdevelopment goals, or can be research areasidentified as necessary to address nationallydetermined health priorities.

29

COHRED’s analysis reveals that many low andmiddle income countries have major gaps intheir governance and policy frameworks forhealth research. Only half of the 38 countriesstudied had established governance structuresfor health research; 11 (29%) have put in placea policy framework to guide health researchdevelopment; and 20 (53%) have identifiednational health research priorities.

Our study also shows a close relationshipbetween governance structures and thedevelopment of policy and priorities for healthresearch. Of countries without a governancestructure (n=19), none had a policy for healthresearch, and only three countries hadestablished national health research priorities.

While these findings may seem entirely logical,this is the first study to provide the evidence ofthis link, and it supports COHRED’s approach toNHRS development. It is also essential to convincenational decision makers about the relevance ofspending effort and time on improving researchsystems in their countries and pointing towardscrucial areas for such improvement.

The analysis demonstrates that NHRS mappingstudies provide a useful step on the road toNHRS optimisation and development andprovides the evidence to ensure that NHRSdevelopment is itself evidence- based.

The scope of COHRED’s work in this area to datehas been to describe the existence of healthresearch governance and policy frameworks inlow and middle income countries. It has notbeen possible to go further to examine whetherthese components increase the effectiveness,efficiency and quality of health research outputs,or assess their impact on health and socio-economic development. These questions willstart to be addressed in the coming year asinformation from an additional 44 countriesbecomes available and we are able to conductmore in-depth analyses.

For further information on COHRED’s approachto NHRS development see:www.cohred.org/NHRSsupport

The team working on NHRS mapping is: Andrew Kennedy,Hassen Ghannem and Carel IJsselmuiden. For further informationcontact Andrew Kennedy: [email protected]

Essa

ys


In today’s global context, with the health ofpopulations generally improving, unacceptableinequalities persist between regions and countries– in many cases, influenced by conflicts, economiccrisis or natural disasters. Not surprisingly, poorpopulations are the most vulnerable and affectedby ill health, as they have the least access tohealth care and treatments they greatly need.

Conscious of the urgent need to correct thisimbalance, the international health community hasintensified its efforts to develop strategies, toolsand products to address the health needs of poorand neglected populations1. The current debate onavailability and accessibility of drugs for thediseases that most affect the poorest countries hassucceeded in focusing attention and funds onsolving this problem, and progress is being made2.

In June 2007, participants to theOECD/Netherlands High Level Forum issued theNoordwijk Medicines Agenda. It aimed to‘…enhance the availability of medicines forneglected infectious diseases’. In December 2007,Cameroon, the Netherlands and COHRED initiatedthe Yaoundé Process, a complementary activitydesigned to bring to Noordwijk a stronger Africanperspective and a clearer picture of specific Africancountries’ needs for health innovation. Its goal isto enable strengthening of health innovation byand for African countries.

In May 2008, the World Health Assemblyadopted the Global Strategy on Public Health,Innovation and Intellectual Property3, thesuccessful achievement of a series of long anddifficult negotiations.

The Strategy is an important instrument forfocusing global health innovation on the specificneeds of low income countries. It provides formalpolitical commitment and a useful conceptualframework. But to be truly successful, it still needsto produce concrete results, especially at country

level. This calls for a flexible implementation of thestrategy that addresses the more specific needs ofregions and countries, through well defined,sustainable and efficient partnerships.

The Yaoundé Process is producing evidence andinformation that directly supports the practicalimplementation of the Global Strategy in Africaand provides a clearer picture of African countries’needs. It considers two central questions:• What is the situation of innovation activities,

projects and programmes in Africa today?• What are the specific needs of African

countries; and what technologies and solutionsdo they need to acquire or produce to improvethe health of their populations?

Health innovation is a complex issue that can beaddressed by various stakeholders through manyentry points at national, regional and global level.Many global initiatives and programmes focus ona few specific steps of medicines research anddevelopment and production. They tend to workfor low income countries rather than with them.

The Yaoundé Process encourages a broaderperspective. One where countries have nationalhealth innovation strategies that include: policies,regulation issues, market environment andincentives, financing, local production, humanresources, and other health, social, legal and

MARTINE BERGER, JULIE MURUGI

The Yaoundé Process:strengthening health innovationin Africa

The Yaoundé Process is producing new evidence for a clearer picture of African countries’needs for better access to drugs and local medicines production; and practical approachesto support implementation of the Global Strategy on Public Health, Innovation andIntellectual Property.

1 Global Fund to fight AIDS, TB and Malaria, Global Alliancefor Vaccines and Immunization (GAVI), Commission onIntellectual Property Rights and the resulting IntergovernmentalWorking Group (IGWG), Gates Global Challenges2 Increased interest and financing for neglected diseases: forexample: creation of the neglected diseases department inWHO; special meetings on neglected diseases convened byGermany in the past two years; adoption of the Global Strategyand Plan of Action on Public Health, Intellectual Property Rightsand Innovation (IGWG process); Gates Foundation’s shift ofpriorities for a broader approach to diseases of poverty andcountries needs, including its reorganisation and creation ofdivision for Integrated Health Solutions Development.3 Resulting from the work of the Intergovernmental WorkingGroup on Public Health, Innovation and Intellectual Property(IGWG).

31

economic aspects. In this light, national strategiesneed to reflect the reality of the countries'situation. For example, rather than having an end-to-end plan for local development and production,some countries’ strategies may specify whichelements of the development chain are best donelocally, and which can be sourced from othercountries in the region.

The research currently being completed by theYaoundé Process will help countries make the bestchoices for their needs. Two studies now beingpublished will serve as the basis for a series ofconsultations and a larger partners meeting inYaoundé. The meeting will be a working sessionwhere African countries will further assess theircurrent situation, define national priorities andstrategies and plan future activities and investmentsneeded to progress on health innovation.

Yaoundé Process - complementary initiativesAs an open forum, the Yaoundé processwelcomes input and perspectives from all playersactive in health innovation in Africa, and seeksinput from complementary activities, including:- Study on regulatory systems by Drugs for

Neglected Diseases Initiative (DNDi) and theGeorge Institute.

- Study on local pharmaceutical manufacturingcapacity by the United NationsIndustrial Development Organization (UNIDO)

- Work on discovery research for drugs anddiagnostics (WHO-TDR)

- Activities on access to drugs by AntiretroviralAccess for Africa (AA4A)

- African Network for Drugs and DiagnosticsInnovation (ANDI)

The COHRED team working on the YaoundéProcess is Martine Berger, Julie Murugi and Carel IJsselmuiden. For further information:Martine Berger, [email protected]

Yaoundé Baseline Synthesis on Health ResearchInnovation in Africa4.

This study provides a comprehensive inventory and mapof the current landscape of health innovation activities inAfrica – with critical review and analysis by Africanstakeholders.

It confirms that there is no comprehensive synthesisedevidence on current status of health innovation in Africa.Evidence gathered points to a complex and fragmentedlandscape, with multiple actors, engaged at multiple levelsand sectors, and addressing diverse components of healthinnovation. It shows that health innovation initiatives arelargely focused on drugs, diagnostics and vaccines forneglected and high- burden diseases occurring in Africaand that most of them focus on specific narrow aspectsof health innovation, often without due attention tostrengthening broader health innovation building blockssuch as regulatory frameworks, research governance,capacity building and incentives for trade and investment.

Framework and tools for countries to planinnovation strategies5.

The aim of this joint research with the George Institute forInternational Health is to develop a framework thatcountries and health research funders can use to simplify

the complex view of pharmaceutical research activities inAfrica – to develop scenarios for local production andtechnology transfer. Countries will be able to visualisetheir different levels of innovation, collectively assess theirregional and respective national capacities and plan forphasing-in complementary initiatives.

The framework is built on Yaoundé baseline data anduses case studies to illustrate country experiences inmoving to different levels of the innovation andproduction process – or highlighting attempts that havenot succeeded.

The areas being explored include: experiences ofcountry pharmaceutical industry development, localmanufacturing and access to products; the NEPADScience, Technology and Innovation Initiative. It alsocompiles documentation on Pharmaceutical R&D Policies:existing reports, documents, reviews and articles onpolicies relevant to African pharmaceutical research anddevelopment, in the areas of: regulatory, intellectualproperty, and tariff/tax policy.

This new perspective will help countries developinnovation skills and strategies – in areas such asregulatory and intellectual property systems; industry, taxand tariff policies; ethics boards; governance structuresand policies; financing; human resources strategies; andcommunity involvement.

4 The Yaoundé Baseline Study on Health Research Innovation in Africa is currently being completed and will be published in thefirst quarter of 2009. ©Council on Health Research for Development (COHRED), Cameroon Ministry of Public Health, Governmentof the Netherlands ISBN 92-9226-030-8 5 The Framework and tools for countries to plan innovation strategies is currently being completed and will be published in early2009. © George Institute for International Health and Council on Health Research for Development (COHRED) ISBN 92-9226-031-6

Essa

ys


From its establishment in 1993, COHRED has beenvocal about the need to involve civil societyorganisations (CSOs) in health research and healthresearch management. However, good strategiesto operationalise initial commitment were lackingand ‘token involvement’, for example in thepriority setting process, was the result.

To learn from good experiences in the South andNorth, and to develop operational strategies,COHRED organised a first consultative meeting inMumbai, India, in 20065. This year a follow-upconsultation was held in Denmark, organisedtogether with the Public Health Research andDevelopment Centre (CIAM) in The Gambia andthe Centre for Health Research and Development(DBL) in Denmark6. This consultation resulted in aCall for Civil Society Engagement in Research forHealth (of which an excerpt is included in thisannual report). It defines strategies to strengthenthe role of CSOs in research for health, andpresents key recommendations to all actors inresearch for health.

The Global Ministerial Forum on Research forHealth (Bamako, November 2008) gave widerecognition to the need to engage civil societyorganisations in all aspects of the research forhealth process. This is expressed in the BamakoCall to Action and the Bamako Communiqué. Inaddition, the Call for Civil Society Engagement inResearch for Health was read out during the finalplenary session, and it thus became one of thethree outputs of the Bamako Forum.

The challenge – for civil society organisations andother partners in research for health – is to acton this recognition of the need for theirinvolvement, and ensure CSO engagement inresearch for health as standard practice forresearch, especially in the South. COHRED, withits partners, will continue building the informal

network of CSOs involved in research for health,and will monitor and report on progress made inthe years to come.

Excerpt from the Call for Civil SocietyEngagement in Research for HealthThe Call to Action was prepared by:• ANIS, Instituto de Bioética, Direitos Humanos

e Gênero, Brazil• Centre for Public Health and Equity,

SOCHARA, India• Centre for Science and Environment (CSE), India• CIAM - Public Health Research and

Development Centre, The Gambia• Community Health Sciences, Aga Khan

University, Pakistan• Council on Health Research for Development

(COHRED), Switzerland• DBL - Centre for Health Research and

Development, Denmark• International Centre for Reproductive Health

(ICRHK), Kenya• L’Association Tunisienne de Promotion de la

Recherche en Santé (ATUPRES), Tunisia• Project Africa, Kenya• Research!America, USA

The goal of research for health is better healthfor all. Reaching this goal is possible with the

SYLVIA DE HAAN1, SAMUEL ANYA2, PAUL BLOCH3, AYO PALMER4

Civil Society Engagement in Research for Health

A number of factors have come together in the past year that bring broad recognition ofthe added value that civil society organisations can bring to research for health – as apathway to improved population health for low and middle income countries. The workof a group of civil society actors, each with a stake in research for health, has beenrecognised by Ministers in the Bamako Call to Action and the final Bamako Communiqué.The challenge now is for civil society organisations to work with others to ensure thatengaging the public is a standard practice in the research process.

1 Sylvia de Haan, COHRED.2 Samuel Anya, CIAM, Public Health Research andDevelopment Centre, The Gambia.3 Paul Bloch, DBL, Centre for Health Research andDevelopment, Denmark.4 Ayo Palmer, CIAM, Public Health Research andDevelopment Centre, The Gambia.5 Can Communities Influence National Health ResearchAgendas? Record Paper 3, COHRED, 2006.http://www.cohred.org/main/publications/recordpapers/COHREDRP3Communities.pdf6 This consultation was co-funded by the Wellcome Trust andthe organising partners.

33

involvement of the stakeholders in health thatrepresent the rich spectrum of sectors anddisciplines, including civil society organisations(CSOs).

We define civil society organisations asorganisations that are not-for-profit, operatebetween the state and the public, represent orserve population groups, and are guided by theprinciple of social justice. Our focus is on thoseorganisations with an interest in research forhealth, and in using research to assess healthdeterminants, influence health policies andimprove health outcomes. While acknowledgingthe diversity of CSOs and the challenges ofrepresentativeness, we believe that CSOsrepresent and build alliances with communitybased organisations and community groupings,and that their contribution to research for healthhas a positive impact on the population at large.

Civil society organisations are a missing voice inthe successful move from health research toresearch for health. We - the authors of this Callto Action - are a group of CSOs that, throughtheir work, demonstrate how research leads toaction for change. CSOs: • Drive, participate in and conduct research that

embraces health in its broadest sense,including the determinants of health andhealth-related inequities;

• Can hold all stakeholders accountable fortheir commitments made towards research for health;

• Can increase skilled local capacity enablingeffective responses to national andinternational priorities and demands;

• Provide missing viewpoints and culturalperspectives to research for health;

• Translate research for health into action forhealth; and

• Disseminate research findings to a wideaudience of stakeholders in health using more accessible formats such as stories and narratives.

We therefore call on all stakeholders in researchfor health to:1. Acknowledge the importance of research for

improving health for all, and to recognise thecontribution CSOs can make to support thebroad scope of research for health, with afocus on health development and equity.

2. Build and nurture partnerships with CSOsaround common concerns on national andglobal priorities in research for health, and tobase these partnerships on the principles ofmutual respect, fairness, inclusiveness,transparency and trust and with a multi-discipline approach.

3. Create environments at national and globallevels in which CSOs can exercise theirlegitimate roles in research for health,through providing financial, infrastructuraldevelopment and institutional capacitybuilding support to CSOs.

4. Provide funding which is long-term andflexible, based on fair-contracting principles,thus strengthening CSOs to engage inparticipatory processes, build their institutionalcapacity, and becoming a strong partner indeveloping and implementing researchstrategies at local, regional and global levels.

5. Value additional and creative means ofcommunicating research, using a variety ofchannels and languages, and to acknowledgethe role CSOs can play in raising awareness ofresearch, in increasing engagement inresearch, in transforming research findingsinto action, and in communicating this to thepublic, thus helping build public trust inresearch.

6. Jointly identify indicators andmethodologies for evaluating the impact andcontribution of all stakeholders, includingCSOs, in research for health.

The COHRED team working on CSO engagementis Sylvia de Haan and Carel IJsselmuiden. For further information: contact Sylvia de Haan,[email protected]

Essa

ys


Research managers often cite policy briefings asan effective way to link research to decisions. Butbefore launching into the creation of policybriefings as strategy to ‘influence policy’ theresearch communications approach beinginvestigated by COHRED and its partners advisesresearch managers to take a step back – andbetter understand who are the potential users oftheir research and what is the best way to informand influence them.

In 2008, COHRED designed an approach tostrategic communication of health research, andtested it together with the Institute of HealthSystems Research (IHSR), of the Ministry ofHealth in Malaysia. The result was a reflectionwith a group of 20 researchers working onseveral research projects. The main objective wasto propose a platform for a better understandingof how research based evidence can best informpolicy makers and others in society.

In a one-week session these research teams wereinvolved in a hands-on practical work designedto link their research with specific user groups.They started by asking five simple questions:• What do we want to happen - what is the

ultimate result of successfully communicatingyour evidence? Who will act differently as aresult of it?

• Which people and groups can we influencedirectly?

• How are my target users likely to access anduse my research evidence?

• What are the benefits to the user of theapproach I am proposing?

• What communication actions do I need todevelop to achieve this goal?

By answering these questions, and relating themto their research, each research team formed apicture of the potential benefits of their work,who they can influence and what was the bestway to achieve this. The week concluded with aseries of finished research summaries prepared byeach team. Based on these initial productscoming from the workshop, IHSR proceeded overthe next following months to design a templatefor the synthesis of all research in progress, in aconcise and benefit-oriented way.

MICHAEL DEVLIN1, SONDI SARARAKS2, SEBRINA SU3, AZMAN ABU BAKAR4

Communicating evidence – to policy and practice Policy briefings can be useful. But first, research managers should knowtheir users and how the research can benefit them.

The past several years have seen increased interest in how health research evidence can beeffectively ‘translated’ to better inform and influence countries’ health policies andpractices. Evidence-to-policy communication is important. It is also part of a broader pictureof what needs to happen for health research to be useful to society.

Who can we influence directly?

Research ProjectProgramme

(evidence produced)

Health ResearchCouncil

Health Ministry

Population

A more detailed analysis reveals who we needto engage directly. And suggests whatinformation and activities are most effective

Research Institute/Programme leader

(evidence produced)

Council Review Board

or colleagues

Minister Health services

LegislativeProcess

Civil societyCommunity/

Patient group,etc.

Population

Who can we influence directly?(detailed view)

Media

Ministry Policy

analysts and

advisors

Influence pathway for communicating evidenceto decision makers – a summary view.

35

Who can make use of my research?The research teams identified and definedgroups that they felt they can influence directly– and mapped the influence pathways neededto reach them. This reflection suggested thekind of information and activities that wouldmost effectively reach these groups. Usefulapproaches ranged from arranging specialmeetings, or preparing information for differentaudiences – decision makers, district healthofficials, or for the general public.As an example, one research team concludedthat – while the health ministry was the ultimatebeneficiary – the specific group they could mosteffectively influence was a technical committeecharged with defining and enforcing qualitymanagement standards for food service in thenational health system. To influence change inthis case, the approach required that specifictechnical information and personal interactionswere developed with this group of experts. Thisteam’s strategy was to participate in specificcommittee meetings and prepare a researchsummary of the study.

Dialogue between researchers and decision makersAs part of the session, IHSR research teamsparticipated in a roundtable discussion withMinistry of Health and government agencyrepresentatives. This conversation centered onthe question: what do you need from healthresearchers to better do your work? Theseinteractions revealed that there are differentkinds of ‘policy and decision’ makers, each withdifferent needs.• A request for a short summary of research

findings, with recommendations.• Request for all the data, details of the

methodology and the published research.Their need was to examine and understandthe details of the research done and produceconclusions and recommendations. Ifrecommendations are proposed, anaccompanying implementation plan thatincludes cost implications must be attached.

This exchange helped each group betterappreciate the needs of the other.

As a result of this work, the IHSR identified theneed to develop two types of information:i) Research highlights - to document

work-in-progress in a concise and benefit-oriented way.

ii) Policy briefs - where conclusive evidenceemerges from a research, a systematic reviewwill be conducted to support and strengthenthe research evidences and this will then befollowed by the generation of a smallernumber of policy briefings to highlightactionable recommendations.

Based on this experience and its work withpartners in other countries, COHRED isdeveloping a method that research institutes canuse to focus their research and evidenceproduced on the needs of users.

This strategic communication approach forresearch producers is one part of how COHREDsees communication, as integral part of a well-functioning health research system.Communication and advocacy activities shouldbe a part of the research process, and engage allstakeholders in dialogue so that researchresponds to population health needs. Thisrequires that research activities are done indialogue between researchers, communities,policy makers, funders and the media – in aword: all those with an interest in improvingpopulation health.

The team working on science communicationteam is Michael Devlin, Jennifer Bakyawa (inUganda) and Carel IJsselmuiden. For furtherinformation contact Michael [email protected]/researchcommunication

Essa

ys

1 Michael Devlin, COHRED.2 Dr Sararaks, Medical Officer (Research) at the Institute of Health Systems Research (IHSR), Ministry of Health Malaysia3 Sebrina Su is junior researcher at IHSR, Ministry of Health Malaysia4 Dr Azman Abu Bakar is Director IHSR, Ministry of Health Malaysia


Rio de Janeiro, Brazil, was the site for the FirstLatin America Conference on Research andInnovation for Health held in 2008. It broughttogether some 120 strategic actors in healthresearch from across the region, includingofficials and professionals in the fields of health,science and technology; representatives fromtechnical cooperation and development agencies;national, regional and worldwide researchnetworks and organisations2.

The group sought practical answers to questionssuch as: how to ensure that research addressescountries’ health priorities and contributes toequitable development in Latin America. Themeeting emphasised the creation, developmentand strengthening of National Health ResearchSystems (NHRS) and the use of regionalcooperation as a means of taking advantage ofexisting resources and reducing asymmetries.

The conference produced a rich exchange ofexperience, and reports on the status of healthresearch systems of 14 countries in the region. Thefinal conference report provides a synthesis of thediscussions, in Spanish and English.

The results of this consultation were used bygovernments and regional civil societyorganisations to agree on an input to theBamako 2008 Global Ministerial Forum onResearch for Health. Conclusions from themeeting will also contribute to designing PanAmerican Health Organization’s research policy,and that of other international agenciesconcerned with health. A summary of the mainrecommendations is listed below.

The strengthening and stewardship of NHRS andregional cooperation are vital to facingchallenges in health care and promotingequitable development in Latin America.Therefore, health research and the equitable

distribution of its results and benefits must be atop-level priority on national and regionalpolitical agendas, done in a democraticenvironment and with citizen participation.

All discussion groups in the Conference agreedon one strategic vision: NHRS stewardship –including research, development and distributionof technologies – is the State’s responsibility andcannot be delegated. This is the only effectiveway to combine research and innovation withdevelopment and public health priorities. Tomake this vision a reality, it must be linked to aset of updated research priorities in thecountries, so it responds to their health systemneeds and national development objectives. Tosupport this, funds should be allocated tofacilitate national researchers to do researchfocused on the defined priorities.

Research for health needs to develop in anenvironment based on inclusiveness and thatfavors research aimed at achieving equitabledevelopment. This is best done through anethical framework and accountability, supportedby laws that safeguard ethics in research andestablish bodies that monitor activities andguarantee the recording of information. Training of human resources is key for thestrengthening of national research. Youngresearchers should be trained by working onprojects linked to NHRS priorities. Evaluation of

FRANCISCO BECERRA-POSADA1

Recommendations of the First Latin America Conference on Research and Innovation for Health

The strengthening and stewardship of national health research systems – and regionalcooperation – are vital to facing challenges in health care and promoting equitabledevelopment in Latin America.

1 COHRED Senior Consultant for Latin America based inMexico City, Mexico.2 The meeting was organised in a partnership with theBrazilian Ministry of Health, PAHO, the CoordinatingCommission for National Institutes of Health and High SpecialtyHospitals of Mexico (INSalud), the Council on Health Researchfor Development (COHRED), the NicaSalud Network Federationand the Global Forum for Health Research (Global Forum). Theconference was financed by PAHO, the Brazilian Ministry ofHealth, the Wellcome Trust (London, UK), COHRED, the GlobalForum and the UNICEF/UNDP/ World Bank/WHO SpecialProgramme for Research and Training in Tropical Diseases (TDR).

37

researchers’ performance is needed and wanted,as a path to excellence.

In regards to financing with national funds, theConference recommended countries to seekinnovative strategies for obtaining funds, such astaxes on industries that increase the incidence ofdisease and death (tobacco, alcohol andautomobiles), or the inclusion of research forhealth agreements in loans from multilateral banks.

To ensure the highest possible quality, fundsshould be allocated through open competition toresearchers and research institutions. Projectsshould be subjected to a peer review process.

Regarding innovation, discussions were heldon: strengthening drug regulatory agencies;providing transparency in the context of publicprocurement; promoting public access to

products of social and technologicalinnovation; explicitly incorporating traditionalmedicines into the innovation cycle, and payingattention to the equitable distribution of theresulting benefits.

The conference called for a common strategicvision for approaches to health research. Anumber of key factors were highlighted, suchas: regional cooperation is vital to supportingnational health research systems; theintellectual property needs must be reconciledwith public health interests; asymmetriesshould be reduced between information,funding and technology. To implement thisvision, the group specified lines of action thatseek to take advantage of countries’ existingcapabilities. Countries agreed to report back onactivities done and progress made at a specialmeeting in Cuba in 2009.

For more information, please consult the following links:

Country input reports

www.cohred.org/main/publications/background_papers.php

Final report:

Spanish

www.cohred.org/main/publications/Rioreport/Rio_report_ES_low_res.pdf

English

www.cohred.org/main/publications/Rioreport/Rio_report_EN_low_res.pdf

Essa

ys


Over the last decade, health research has becomeprogressively more relevant in both internationaland national development. There has been amajor increase in research funding from high-income countries directed at finding globalsolutions for the health problems of low andmiddle income countries (LMICs). Also privatesector (pharmaceutical) funding in LMICs hasgrown tremendously since the 1990’s.

However, the increased funding does notnecessarily mean that the health priorities forimproved population health in LMICs are beingadequately addressed. On the contrary, some ofthese global investments have resulted in theweakening of already fragile health researchcapacity in low and middle income countries bydrawing scarce national research expertise intoresearch on globally determined health priorities– mainly HIV/AIDS, tuberculosis and malaria –even though many other health problems requiresimilar research investments to find local – andglobal – solutions.

In addition, many LMICs see the development oftheir own national health research capacity andresearch systems as a key strategy to address ownhealth priorities, improve their own healthsystems, reduce health inequities, and, indeed,support development through building a sciencebase. In many low income countries, theoverwhelming proportion of research funding(>90%) comes from external sources and is oftenthe only budget available to stimulate the nationalresearch, science and technology, and innovationsectors. It is not a surprise, therefore, that manynational research managers in LMICs areincreasingly interested in having access to

systematically collected, collated and analysedinformation on international health researchinvolving their own countries. Yet suchinformation is hard to come by.

COHRED has been working intensively withcountries, institutions, researchers, media andresearch donors and sponsors over the past severalyears -listening to the needs of different healthresearch stakeholder groups. The informationneeds of these groups are extensive and varyingon the one hand – but similar on the other: basicresearch management information to enable themto improve their impact, synergy, collaboration,and focus. For example: • Researchers in both high and low and

middle income countries have expressed theneed for a detailed and searchableinformation on current research projects;institutional and personnel profiles;information on grants or calls for proposals;capacity building activities; networkingopportunities and ethical review processes;

• Research sponsors and donors require accessto countries’ ethical review processes, healthpolicies, strategic plans and research agendasand country clearance guidelines (forinternational researchers wanting to work in acountry); also they want to know what othersare funding in the same countries or regions;

• Governments have expressed the need forstatistical information: for example, thepercentage of research done on certain topics,external funding sources and levels to researchand training activities – globally, by topic orinstitution; and they want to know if theirnational health research priorities are beingaddressed and sufficient capacity is being built;

DAVID ABREU, CLAUDIA NIETO, CAREL IJSSELMUIDEN

The interactive platform formanaging health research in lowand middle income countries

The next phase of Health Research WebNow entering its third year of development, the Health Research Web service is evolvingto meet needs voiced by increasing stakeholder groups in health research. These includehealth research managers and policy makers; international development and donorcommunity; research ethics professionals, researchers, civil society organisations and themedia. The major change initiated in 2008 was the development of the HRWeb platformfrom a static, centrally controlled database to a more open service – broadly based oninteractive global cooperation for better knowledge.

39

• Media need access to contact details of keyplayers in the national health research systems,health research abstracts and data on disease-focused programmes or financial flows to beable to improve their reporting;

• Civil society organisations engaged withhealth research – from conducting it, tosupporting it, to communicating it – need toknow whom to contact; want to monitorprogress and assess responsiveness ofgovernments and international researchers tothe problems of the poor;

Faced with the absence of quick and reliableaccess to this kind of information, nationalauthorities have little or no evidence base tosupport their decisions in designing nationalhealth research policies and strategies. Thissituation also makes it impossible to conductcross-country comparisons, analyses of nationalhealth priorities – to see which researchinterventions are most effective.

To enable low and middle income countries to useresearch as a key tool to achieving internationalhealth goals, enhance health equity, and supportscience development through health research,COHRED is further developing the Health ResearchWeb (HRWeb) service. As deeper and broaderinformation on countries’ health research systemsis being progressively added, HRWeb is becominga platform for access and sharing of healthresearch information between all those active inlow and middle income countries and interested in‘research for health’.

HRWeb organises information from theperspective of countries – it providesinformation for ‘high level managementdecisions’. A key feature in HRWeb is that it isan attempt to break away from the traditionalmode of data collection – ‘by a few on themany’. Instead, using advances in technologyand global data sharing, HRWeb is evolving in auser-driven knowledge sharing platform inwhich COHRED’s main roles focus on platformdevelopment, editorial quality and encouragingpersonalised use of the information. In this way,countries – institutions – researchers (includingthe ‘diaspora’) have – for the first time – accessto a research management information systemthat will greatly improve their work and impactof their work.Major challenges include the use of web-basedsolutions in low-bandwidth areas, qualitycontrol and encouraging use of andcontributions to the HRWeb.

The wealth of information and flexibility providedwill give LMICs more insight in researchhappening in their countries; will encouragecollaboration between donors – for example insupporting complementary activities andhomogenising reporting requirements; insupporting researchers in finding colleagues,sources of support and networks that mayenhance their own research; and in promotingthe quality of ethical review for clinical trials ---all building on the same platform or ‘engine’. Weare indebted to the Ministry of Health in Brazilfor having provided the basis for this platform.

Essa

ys

In the past three years

Health Research Webhas evolved into an

interactive platform.

It will offer a growing

range of services,

including wiki-style

information sharing

and synthesis, social

networking and data

analysis.

Research ProjectRegistry

Research Governance and

Policies

ResearchFunding

ResearchPriorities

ResearchEthics Reviews

ResearchInstitutions

HRWeb

Health Research Web Interactive PlatformCurrent services 2009 - 2010

Health Research Web – Concept


Support for this vision and development has comedirectly from innovative funding sources such asthe SDC (IT in developing countries), IDRC(learning how to use web-based solutions in low-bandwidth countries in Africa) and EDCTP(mapping African ethics review and drugregulatory capacity). It has also receivedenthusiastic endorsement from ISHReCA (Initiativeto Strengthen Health Research Capacity in Africa)for whom an initial mapping of African researchinstitutions and institutional capacity is of keyimportance. And requests for active engagementwith HRWeb have come from: Senegal, Zambia,Vietnam, Kyrgyzstan, Philippines, etc).

Clearly, HRWeb is there to stay and still needssubstantial growth and development. Thisincludes new links to sources of information,relevant to ‘high level management decisions’such as the Evidence Informed Policy Network(EVIPNET), and others.

We welcome your inputs in whatever way thismay be. For information and support, pleasecontact the HRWeb team. http://www.cohred.org/HealthResearchWeb/)

The team working on HRWeb is: David Abreu,Claudia Nieto, Sylvia de Haan, Carel IJsselmuidenand Bruno Coelho. For further information:contact [email protected]

Corporate andfinancial information


Prof. Abbas BhuiyaSenior Social ScientistHead, Poverty and HealthProgramme & Social andBehavioural Sciences UnitPublic Health Sciences DivisionInternational Diarrhoeal DiseaseResearch Centre, Bangladesh(ICDDR,B); BANGLADESHMember of Selection andRecruitment Committee

Dr. Jo Ivey BouffordPresident,New York Academy of MedicineUSAChair: Budget and FinanceCommittee;Member of the ExecutiveCommittee

Dr. Don De SavignySwiss Tropical InstituteHead of Unit SWITZERLAND Clinical & InterventionEpidemiology;Public Health & EpidemiologyCANADA

Dr. Sambe DualeTechnical Director and InfectiousDisease Advisor,Africa’s Health in 2010 projectD.R. CONGO/USAMember of Fund raisingCommittee; Selection andRecruitment Committee

Ms. Annalize FourieHealth & Education AdvisorIrish AidSOUTH AFRICA

Prof. Carel IJsselmuidenDirector of COHREDSOUTH AFRICA/NETHERLANDSEx-officio member; Chair: Fund raising Committee

Dr. Suzanne Jacob SerruyaDirector,Brazilian Ministry of HealthBRAZIL

Prof. Marian Jacobs (Chair)Dean, Faculty of Health ScienceUniversity of Cape TownSOUTH AFRICAChair: COHRED Board; ExecutiveCommittee; Member of the fundraising Committee

Dr. Daniel MäusezahlSenior Health AdvisorSocial Development DivisionSwiss Agency for Development and Cooperation (SDC)SWITZERLAND

Prof. Stephen MatlinExecutive DirectorGlobal Forum for Health ResearchUNITED KINGDOMEx-officio member of the Board

Dr. Pascoal MocumbiHigh RepresentativeEDCTP - European and DevelopingCountries Clinical Trials PartnershipThe HagueMOZAMBIQUE

Dr. Donald SimeonDirectorCaribbean Health Research CouncilTRINIDAD & TOBAGO

Dr. Aissatou Toure Head, Laboratory of ParasiteImmunology Institute Pasteur DakarSENEGAL

Dr. Pem NamgyalMedical Officer/Vaccine PreventableDiseasesWHO/South East Asia RegionalOfficeIndiaBHUTAN

COHRED Board

43

Mr. David AbreuManager HR WebBrazil(From November 2008)

Ms. Jennifer BakyawaProject CoordinatorCommunication andResearch TranslationUganda

Dr. Francisco Becerra-PosadaSenior Consultant LatinAmericaMexico

Dr. Martine BergerSenior AdvisorFrance

Ms. Teresa CullenExecutive AssistantUnited Kingdom

Dr. Hassen GhannemSenior Consultant NorthAfrica and Middle EastTunisia

Ms. Sylvia de HaanHead, Project and ProgramsThe Netherlands

Mr. Michael DevlinHead, Knowledge Sharing,Advocacy andCommunicationUnited Kingdom

Ms. Selenge EnkhsaikhanAdministrative OfficerMongolia(From October 2008)

Ms. Nadia GiacobinoAdministrative OfficerSwitzerland(Until October 2008)

Prof. Carel IJsselmuidenDirectorSouth Africa/Netherlands

Dr. Andrew KennedySenior Research OfficerUnited Kingdom

Ms. Margo Koulen - vanKasterenCommunicationsCoordinatorThe Netherlands (From April 2008)

Ms. Sandrine Lo IaconoResearch OfficerBelgium/France(Until May 2008)

Dr. Gabriela MontorziProcess OfficerArgentina

Dr. Jane Julie MurugiResearch OfficerKenya(From February 2008)

Ms. Claudia NietoResearch OfficerColombia

Ms. Sandra RealpeEthics OfficerSecretariat Global Forum onBioethics in Research*Colombia(Until November 2008)

Ms. Edlyn Jimenez-SantosEthics FellowSecretariat Global Forum onBioethics in ResearchPhilippines

COHRED staff

* The Global Forum on Bioethics inResearch Secretariat is hosted byCOHRED


European Commission

International Development Research Centre (IDRC), Canada

Irish Aid

The Netherlands

Swedish International Development Cooperation Agency

Department for Research Cooperation (Sida/SAREC)

Swiss Agency for Development and Cooperation (SDC)

Rockefeller Foundation

Other support of organisations or individuals

Mr. Derrick Wong, USA/FranceOrganisational Development

New York University Wagner Graduate School of Public Service.Research and Development

IANPHI - International Association of National Public Health Institutes

DBL - Centre for Health Research and Development, Denmark

CIAM - Public Health Research and Development Centre, The Gambia

Philippines Council on Health Research and Development

Malaysia Ministry of Health, Institute of Health Systems Research

DFID, Department for international development (UK), Research for Development Programme

UNICRI – United Nations Interregional Crime and Justice Research Institute

University of California San Francisco, UCSF Global Health Sciences

Aga Khan University Hospital, Nairobi, Kenya

Welcome Trust, UK

International Association of National Public Health Institutes, Atlanta, Georgia, USA

SARETI, South African Research Ethics Training Initiative, South Africa

Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom, London.

Financial support

45

Brazil

Burkina Faso

Cameroon

Caribbean

Guinea Bissau

Honduras

Kyrgyzstan

Lao People’s DemocraticRepublic

Malaysia

Mexico

Mongolia

Mozambique

Pacific Island countries

Philippines

South Africa

Tanzania

Tunisia

Uganda

Uzbekistan

Vietnam

Zambia

Country activities in 2008

Aga Khan University, Kenya

Athena Institute at the Free Universityof Amsterdam, the Netherlands

Caribbean Health Research Council(CHRC), Trinidad & Tobago

Centre for Health Research forDevelopment (DBL), Denmark

EMRO/WHO Eastern MeditteraneanRegional Office

European and Developing CountriesClinical Trial Partnership (EDCTP)

Evidence-Informed Policy Network forBetter Decision Making (EvipNet)

Fiocruz Institute, Brazil

Global Forum for Health Research

Government of Mali

The International Centre for DiarrhoealDisease Research (ICDDR,B),Bangladesh

InSalud, Mexico

Initiative to Strengthen Health ResearchCapacity in Africa (ISHReCA)

John Hopkins University, USA

Makerere University, Uganda

Ministry of Health, Brazil

Ministry of Health and Ministry ofScience and Tecnhology, Cameroon

Ministry of Health, Guinea Bissau

Ministry of Health, Malaysia

NicaSalud Network Federation,Nicaragua

Pan-American Health Organization(PAHO)

Public Health Research andDevelopment Centre (CIAM), The Gambia

Parasitological Department of theClinical Laboratories Hospital Escuela,Honduras

The New Partnership for Africa’sDevelopment (NEPAD)

Technopole Tunisia

United Nations Educational, Scientificand Cultural Organization (UNESCO)

University of Kwa-zulu Natal in SouthAfrica

World Bank

World Health Organization

Key partners in 2008


Financial Statement

REVENUE 2008

62%

40%

45%

15%

72%4%

2%

22%

31%

2%

Project grants

Core grants

Interest income

Other income

5%

Country

Regional

Global

Programmes

Governance

Fund raising

Organisational development

Funding Source CHF

Core grants

Ireland - Irish Aid Department of Foreign Affairs 912,060

Switzerland - Swiss Agency for Development and Cooperation 900,000

Canada - International Development Research Centre 155,610

Project grants

Netherlands - Dutch Ministry of Foreign Affairs 431,983

Europe - Commission of the European Communities 165,589

Switzerland - Swiss Agency for Development and Cooperation 120,000

Netherlands - Netherlands Organisation for Scientific Research 97,272

Canada - International Development Research Centre 91,848

Brazil - Ministry of Health 43,678

USA - Harvard University 18,975

United Kingdom - Wellcome Trust 14,480

Switzerland - World Health Organization 10,415

Interest income 66,361

Other income 151,443

Total 3,179,714

62%

40%

45%

15%

72%4%

2%

22%

31%

2%

Project grants

Core grants

Interest income

Other income

5%

Country

Regional

Global

Programmes

Governance

Fund raising


47

Programme Expenditure 2008 CHF

Country 778,157

Regional 291,532

Global 886,958

Total 1,956,647

EXPENDITURE 2008

Revenue and expenditure based on pre-audited financial statements. For full audit report, kindly contact COHRED.

62%

40%

45%

15%

72%4%

2%

22%

31%

2%

Project grants

Core grants

Interest income

Other income

5%

Country

Regional

Global

Programmes

Governance

Fund raising


Total Expenditure 2008 CHF

Programmes 1,956,647

Governance 103,241

Fund raising 43,813

Organisational development 602,590

Total 2,706,291


COHRED Record PapersPublication designed for rapid packaging and sharing of

COHRED and partners’ work in progress

www.cohred.org/publications/record_papers.html

Meeting of African Schools of Public HealthCOHRED Record Paper 7Authors: Carel IJsselmuiden, Thomas Nchinda, Jennifer Bakyawa

Best Practices in health research policy development.Lessons learned from an expert consultation. COHRED Record Paper 8Country experiences: Brazil, Mexico, Mongolia, Philippines,South Africa, Tunisia, Uganda, United Kingdom. COHREDRecord Paper 8Authors: Francisco Becerra-Posada, Andrew Kennedy, Carel IJsselmuiden

COHRED Health Research Watche-bulletin that provides synthesis and comments on current issues

on the international health research agenda.

www.cohred.org/briefing/COHRED_Briefing.htm

Research and development for medicines to be drivenby needs of low and middle income countries Briefing 10

African Ministers call for stronger health research forthe region; with focus on country priorities Briefing 11

Conference PapersPolicies and Priorities for health research in 19 AfricanLow Income CountriesAuthors: John Arudo, Ronald Kamau, Desiré Kamanzi andAndrew Kennedy2http://portal.unesco.org/education/en/files/58049/12246675435Arudo.pdf/Arudo.pdf

Governance and policy frameworks for health researchin 38 countriesAuthors: Mohir Ahmedov, Tashkent Medical Academy,Uzbekistan; Andrew Kennedy and Carel IJsselmuidenhttp://portal.unesco.org/education/en/files/58048/12246671755Ahmedov.pdf/Ahmedov.pdf

Alignment and Harmonization seriesAHA Study - Donor Alignment and Harmonization inrelation to National Health Research Priorities ‘AHA’study, synthesis report 2008 Authors in collaboration with partners: Carel IJsselmuiden,Sylvia de Haan, Sandrine Lo Iaconohttp://www.cohred.org/main/publications/AHA.php

AHA study, country report 2008 UgandaAuthors in collaboration with partners: Carel IJsselmuiden,Sylvia de Haan, Sandrine Lo Iacono, Caroline Nyamai Kisia http://www.cohred.org/AHA/files/resources/Cameroon_web.pdf

AHA study, country report 2008 Burkino FasoAuthors in collaboration with partners: Carel IJsselmuiden,Sylvia de Haan, Sandrine Lo Iacono http://www.cohred.org/AHA/files/resources/Burkina%20Faso_web.pdfFrench version:http://www.cohred.org/main/publications/AHA/Burkina_Faso_FR_low_res.pdf

AHA study, country report 2008 CameroonAuthors in collaboration with partners : Carel IJsselmuiden,Sylvia de Haan, Sandrine Lo Iaconohttp://www.cohred.org/AHA/files/resources/Cameroon_web.pdf

AHA study, country report 2008 MozambiqueAuthors in collaboration with partners: Carel IJsselmuiden,Sylvia de Haan, Sandrine Lo Iacono, Hashim Moomal,Cristiano Matshinehttp://www.cohred.org/AHA/files/resources/Cameroon_web.pdfPortuguese version:http://www.cohred.org/AHA/files/resources/Cameroon_web.pdf

AHA study, country report 2008 ZambiaIn collaboration with partners: Carel IJsselmuiden, Sylvia deHaan, Sandrine Lo Iacono, Caroline Nyamai Kisiahttp://www.cohred.org/AHA/files/resources/Zambia_web.pdf

Alignment and Harmonisation in Health Research inUganda, meeting report jointly organised by Ministry ofHealth, Uganda, Makerere University Kampala, Uganda andCOHRED.http://www.cohred.org/main/publications/informal_reports.php

COHRED 2008: Publications and Key Outputs

49

Journal articles National health research system mapping in 10 EasternMediterranean countries.Eastern Mediterranean Health Journal, Vol. 14, No. 3, 2008Authors: A. Kennedy, T.A.M. Khoja, A.H. Abou-Zeid, H. Ghannen and C.IJsselmuiden on behalf of the WHO-EMRO/COHRED/GCC NHRS Collaborative Group.

Primera Conferencia Latinoamericana sobreInvestigación e Innovación para la Salud, Río deJaneiro, Brasil, abril 15 – 18, 2008. In: Rev. Med. Hondur 2008, 76: 88-93. Authors: Jackeline Alger, Iván Espinoza Salvadó, Renato Valenzuela, Sylvia de Haan, Luis Gabriel Cuervo,Byron Arana, Xinia Gómez, Luis Tacsan, Mario Tristán

Country ownership and vertical programmes in health,health information and health researchWHO Bulletin, 2008; 86(6): C-D.Authors: Carel IJsselmuiden, Andrew Kennedy

Improving Research Contracting in InternationalCollaborative Health Research Authors: Sack DA, Brooks V, Behan M, Cravioto A, KennedyA, IJsselmuiden C, Sewankambo N.. Submitted forpublication WHO bulletin 2009 (in press).

Joint publications with partners1a Conferencia Latinoamericana sobre InvestigacióneInnovación para la Salud,Rio de Janeiro, Brasil, 15 al 18 abril, 2008Collaborative Paper, Conference Report, under jointauthorship of the six organising partners.

Changing Mindsets, Research Capacity Strenghteningin Low- and Middle-Income countries. Joint publicationof COHRED, Global Forum for Health Research, SpecialProgramme for Research and Traning in Tropical Diseases.Authors: Abdul Ghaffar, Carel IJsselmuiden and Fabio Zicker.Final publication ready, publication printed in 2009.

Responding to Global challenges. The role of Europeand of international science and technologycooperation.Article in Proceedings of European Commission EuropeanResearch Area Programme meeting. Responding to globalchallenges: the role of Europe and of international scienceand technology cooperation. October 2007, EUR 23614 ENAuthor: Carel IJsselmuidenhttp://ec.europa.eu/research/iscp/pdf/workshop_global_challenges_en.pdf

Manuals, tools, approaches to National HealthResearch StrenghteningNHRS Framework for developing a national healthresearch systemNHRS Development Guides in English, French, Spanish,Portuguese and Russian.

NHRS Assesment: Strenghtening National HealthResearch System NHRS Development Guide. Author: Andrew Kennedy

NHRS Policy Framework NHRS Development Guide. Authors: Andrew Kennedy andCarel IJsselmuiden


Information materialsYaoundé 2009: Strengthening health innovation: fromagendas to actionwww.yaoundeprocess.org

Yaoundé 2009: Renforce l’innovation en santé: desagendas à l’actionwww.yaoundeprocess.org

Governance, Policies, Priorities: the foundations of astrong national health research systemResearch Poster

A Call for Civil Society Engagement in Research forHealth, a joint statement and call for action.http://www.cohred.org/main/Assests/PDF/Bamako_web.pdf

Media and web articlesPerspectives on Research for Health (Web pageinteriviews with leaders in health research). Male circumcision reduces HIV acquisition by up to 60 per cent.Interview with David Serwadda, Dean of MakerereUniversity, by Jennifer Bakyawa, published in the MonitorNewspaper, Uganda.www.monitor.co.ug/artman/publish/features/Male_circumcision_reduces_HIV_acquisition_by_up_to_60_per_cent_76523.shtml

‘Circumcision to Prevent HIV’ is Giving People FalseInformationInterview with Dr Francis Mwesigye Runumi, acting Directorof Health Policy Planning and Management in the Ministryof Health, by Jennifer Bakyawa, published in the MonitorNewspaper, Uganda.http://allafrica.com/stories/200810150710.html

Perspectives on Research for HealthSpecial section on COHRED website, presenting views andperspectives of health research leaders in developingcountries.

Assessing Viet Nam’s National Health Research SystemDr. Le Thi Kim AnhDeputy Head of Department of Scientific Research, HanoiSchool of Public Health, Viet Nam

Key factors for promoting better ‘research for health’ Dr. Aissatou Toure Member of the Board of COHRED; Research Manager, Institute Pasteur, Senegal (Based on keynote speech inopening session of Bamako Ministerial Forum on researchfor Health)

Understanding, involving communities in an Africanhealth research agenda Dr. Wen KilamaFounder and Managing Trustee of the African MalariaNetwork Trust (AMANET).

Strengthening health research capacity for an Africanevidence baseEric Buch Health Adviser, NEPAD - the New Partnership for Africa'sDevelopment

A Health Research Agenda for East AfricaAndrew Kitua, Director General, National Institute forMedical Research in Tanzania

Council on Health Research for Development (COHRED)1-5 Route des MorillonsP.O. Box 21001211 Geneva 2SwitzerlandTel. +41 22 591 89 00Fax +41 22 591 89 10Email: [email protected]

In Latin AmericaContact: Dr. Francisco Becerra-PosadaP.O. Box 22 – 151TlalpanMexico DFMexico 14091Tel. +52 55 46 22 54 41Email: [email protected]

In North Africa and Middle EastContact: Dr. Hassen GhannemUniversity Hospital Farhat Hached4000 SousseTunisiaTel. +216 98 404 357Email: [email protected]

In East AfricaContact: Jennifer BakyawaMakerere University, College of Health SciencesKampalaUgandaTel. +256 414 373 730Email: [email protected]

COHRED is registered as 501 3 (c) charity organisation in the U.S.A.

supporting national health research systems in low and

Documents