Bulletin of the World Health Organization

Health research systems: promoting health equity or economic competitiveness?

Bridget Pratt & Bebe Loff

Volume 90, Number 1, January 2012, 55-62

Table 1. The new model of health research and its alignment with product development public–private partnerships and international pharmaceutical trials

Features of research influenced by high-income government policies Features of product development public−private partnerships Features of international pharmaceutical trials
Leads to products that can be commercialized − basic, clinical and translational research Support basic and clinical research that leads to products that can be commercialized. Clinical trials are usually performed in developing countries38 Support clinical research that leads to products that can be commercialized. Trials are increasingly performed in developing countries39,40
Targets health needs that can be met by profitable, high-technology products Target health needs that can be met by high-technology products Target health needs that can be met by profitable, high-technology products. Target chronic and lifestyle diseases with large markets
Endpoint is the licensing of a new product Endpoint is the commercialization of products. Several product development public−private partnerships plan to create licensing agreements with manufacturers in developing countries, ensuring their products are available at low-cost38 Endpoint is the licensing of new products, though not necessarily in developing countries where trials were conducted. Host governments of trials are considered responsible for product availability and adoption39
Evaluates research activities and outputs according to their contribution to the national economy Research activities and outputs not evaluated according to their profitability. Contribute to the economies of high-income countries through the re-investment of funding35 Evaluate research activities and outputs according to their profitability. Aim to create a sizeable differential between product development costs and the revenue generated by product sales39
Demands educational structures that emphasize science and combine science and business training. Rely upon educational structures that emphasize science and combine science and business training Rely upon educational structures that emphasize science and combine science and business training
Does not strongly support research capacity strengthening for innovation in other countries May support clinical research capacity strengthening in other countries38 Do not support research capacity strengthening for innovation in other countries. Trials emphasize profitability, hypermobility and speed.39 They do not typically allocate funds for capacity-building or generate long-term relationships with research institutions in developing countries
Characterized by partnerships between government agencies, academia and industry Characterized by partnerships between public agencies, academia, private foundations and industry Rely upon the findings of publicly-funded basic research. Trials may be outsourced to academic medical centres