Riding a wave of interest in research
Letter from TDR's Director
The global community is paying increased attention both to ‘upstream’ discovery research associated with technical innovation and to ‘downstream’ research concerns associated with how new interventions can be used more effectively within resource- constrained health systems of disease endemic countries. Both are key areas of focus for TDR in its new Ten Year Strategy, and TDR is thus wellpositioned to contribute to ongoing and upcoming policy dialogues and actions.
Among the events shaping the ‘upstream’ environment are the recently concluded meetings of the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property (IGWG) in Geneva. At the 61st meeting of the World Health Assembly, 19-24 May, government delegations from all over the world will debate a draft resolution that emerged from the latest IGWG session in early May. The draft IGWG document outlines a global strategy and plan of action on essential health research to address disease conditions that disproportionately affect developing countries (see: http://www.who.int/phi ).
TDR has played an active role in supporting the IGWG process, and, with its partners, also participated in some spin-off initiatives. A Geneva meeting on Priority Setting Methodologies in Health Research on 10-11 April was one such effort (see page 29). The meeting at WHO responded to an issue highlighted in the IGWG, the need to develop better research priority-setting practices. TDR also is laying plans with investigators from Africa for an African drug discovery network, in the context of TDR’s Lead Discovery for Drugs business line (BL 3). A meeting in Abuja, Nigeria in October 2008 will seek to establish that new network.
This summer, the strengthening of health systems will be high on the agenda of the 34th G-8 summit, 7-9 July in Toyako, Japan. Organizers are calling for a more “balanced” approach between disease specific strategies and system-based solutions. While vertical disease campaigns have generated global momentum on neglected diseases, they often result in a fragmented array of donor-supported programmes at country level. In strengthening health systems in poor countries, more “empirical analysis” of what works and what does not is thus important. These were themes of a recent Lancet article written by experts and advisers to the G-8 event.
TDR has a role to play in reconciling ‘vertical disease campaigns’ and “health systems” approaches. TDR-sponsored implementation research has gone beyond both paradigms, improving delivery of specific interventions and also strengthening health systems. A recent TDR-co-sponsored study into community-directed interventions (CDI) in onchocerciasis- endemic areas illustrates this ‘responsible vertical approach.’ Results of the study, showing great strides in integrated treatment of malaria as well as onchocerciasis, were highlighted at the International Conference on Primary Health Care and Health Care Systems in Africa, 28 April in Ouagadougou, Burkina Faso (see cover story). Now, together with UNICEF, TDR is looking at how to similarly improve integrated management of fever for malaria, pneumonia and diarrhoea.
TDR is also helping to support countries to undertake such research themselves. At a meeting in Geneva, 3-5 April, TDR and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) developed a framework for implementation and operations research in the context of health control programmes (see page 26). The draft framework is now open for comment on the TDR and GFATM websites, and for use by countries in the preparation of Round 8 of the GFATM requests for proposals.
Research on infectious diseases of poverty benefits from the wave of global interest in innovation and implementation. Our new TDR strategy leaves us in a position where we can respond to both ‘discovery’ and ‘delivery’ ends of the research continuum. However, we are in a fast-changing environment, and we have to be ready for new challenges. TDR’s Joint Coordinating Board (JCB), meeting 16-18 June in Brazil, will examine TDR’s progress to date, and assess how TDR might further respond to the renewed interest in research for health.
Dr Robert Ridley, TDR Director