Presentation on theme: "World Health Organization"— Presentation transcript:
1World Health Organization 28 March 2017WHO Strategy on Research for Health Rob Terry – Project Manager, RPC
2WHO Strategy on Research for Health World Health OrganizationWHO Strategy on Research for Health28 March 2017WHO’s role in research for health…..and the role of research in WHO…Recognizes research as central to progress in global healthIdentifies how WHO can work with Member States and partners to harness knowledge, science and technology to produce research evidence and tools to improve health outcomes.
3Sustained Global interest World Health Organization28 March 20171990: Commission on Health Research for Development1996: Ad Hoc Committee on Health Research Relating to Future Intervention Options2000: International Conference on Health Research for Development (Bangkok)2004: Ministerial Summit on Health Research (Mexico)2008: Bamako Ministerial Forum on Research for HealthTracks the milestone reports within the last two decades
4Complex array of initiatives World Health Organization28 March 2017Complex array of initiativesMember States looking to WHO for guidance and leadershipNot all of these have a research component but it reinforces the point that there is a strong interest and support for global health initiative but this has created a complicated environment, duplication of efforts and an array of (competing) funding sources .Suggests there is a need for greater alignment.Member States looking for WHO to provide leadership and guidance.
5World Health Organization 28 March 2017MandateResolution WHA60.15 at 60th World Health AssemblyMay 2007requesting the DG…"to submit to the Sixty-Second World Health Assembly (2009) a strategy on the management and organization of research activities within WHO"5
6Strategy development - a participatory process EvaluationFrameworkImplementationPlanningINPUTSRolling Dialogue: Virtual & Face-to-FaceEmergentThemesSharePointEmergent ThemesWorking draftsIGWGPublic healthandinnovationRegional officesSpecialProgrammes, HQCCsExecutiveBoardJan 09EB124/4.9Strategy development - a participatory processWHOResearchStrategy – WHA 2009100StakeholderInterviewsOnline &Face to faceworkshopsStrategy+annexesAdvisoryCommitteeon HealthExternal& InternalReferenceGroups
7Guidance from the Director General World Health Organization28 March 2017Guidance from the Director General"….not spread our resources too thin…know our comparative advantage …stick with activities that WHO is uniquely well-suited to perform""make evidence have the right impact… strengthen the legitimacy, quality and efficiency of our policy development processes""...ensure that the best practices that science can devise are being followed""….integrate WHO's research activities to more strategically address a common health research agenda"The guidance from the DG demonstrates the leadership from the top and the reality that WHO has to identify its unique role and play to its strengths
8What we heard from the consultation Bridge gap between policy makers and researchers.Champion cause that evidence is needed to address priority public health needs“Get out of the health box”- links with economic, social, cultural factors. How these factors shape health outcomes and how health impacts on them.Translate research questions and findings into terms (e.g. cost savings) that policy makers and practitioners find persuasiveFocus on application or implementation of existing know-howBuild, in pragmatic ways, local capacity (individuals and institutions) to develop and use relevant evidence
9What we heard from the consultation Conducted according to sound standards and ethical principlesWell communicated and used locallyUse a shared, broader definition of research: Application, Implementation and Evaluation.WHO to support and guide countries; decision making and accountability is countries' responsibility.Evidence-based policy vital in WHO’s work and core public health function
10World Health Organization 28 March 2017WHO Strategy on Research for Health
11Research for health – Three principles World Health Organization28 March 2017Quality - WHO commits itself to high-quality research that is ethical, expertly reviewed, efficient, effective, accessible to all, and carefully monitored and evaluated.Impact - WHO gives priority to research and innovation that has the greatest potential to improve global health security, accelerate health-related development, redress health inequities and help to attain the Millennium Development Goals.Inclusiveness - The Secretariat undertakes to work in partnership with Member States and stakeholders, to take a multisectoral approach to research for health, and to support and promote the participation of communities and civil society in the research process.Three principles which inform the whole approach to WHO and research for health.NB The definition of Secretariat means the whole of the WHO from HQ, to Regional Offices and country representatives.
12World Health Organization 28 March 2017ORGANIZATIONStrengthen the research culture across WHOSTANDARDSPromote goodresearch practiceTRANSLATIONStrengthen linksbetween research,policy and practiceCAPACITYSupport thedevelopment ofrobust national healthresearch systemsPRIORITIESChampion researchthat addresses priorityhealth needsWHO STRATEGY ON RESEARCH FOR HEALTHVISIONdecisions and actions to improve health and enhance health equity are grounded in evidence from research.MISSIONWHO, Member States and partners work together to harness knowledge, science and technology to produce research evidence and tools to improve health5 GoalsFive interrelated goals have been defined for WHO to achieve the strategy’s vision of research for healthOrganization – this involves the strengthening of the research culture across WHOPriorities – this concerns the reinforcement of research (at national, regional and global levels, and within WHO) in response to priority health needsCapacity – this relates to the provision of support to the strengthening of national systems for health researchStandards – this concerns the promotion of good practice in research, drawing on WHO’s core function of setting norms and standardsTranslation – this involves the strengthening of links between the policy, practice and products of research.
13World Health Organization 28 March 2017Working with Member States andpartners, WHO will:Establish governance structures to lead, manage, coordinate and maintain accountability for research within WHO;Develop and implement a WHO Code of Good Research Practice;Strengthen existing mechanisms for good research practice;Enhance professional staff competencies;Improve access to WHO-affiliated research by developing a publicly accessible repository;Improve performance in research partnerships by:i) reviewing partnership admin processes; andii) proactively seeking to engage with partners across all sectors that impact on research for health;Improve communications on the Organization’s involvement in research, monitoring and evaluation of this strategy.What success will look like:WHO staff better understand, value and use evidence in planning, implementing and evaluating programmes and activities and in setting norms and standards;All research supported by WHO adheres to the Organization’s Code of Good Research Practice and is subject to scientific review and, where appropriate, ethical review; every guideline and recommendation is evidence-based and every article is peer reviewed;WHO’s role in research and the role of research within WHO are clearly communicated;WHO is widely regarded as a credible, evidence-based organization; a leader in supporting or performing high- quality research; a champion of the need for research and for being an effective partner in facilitating high- quality research at global, regional and country level;WHO commits sufficient resources to support core functions necessary for the implementation of the strategy.Code of goodResearch practiceWHO a more effectivepartner in researchThe intention of this slide is NOT to list all the activities and you can draw one or two examples particularly those that will be pertinent to the previous discussions.The animation brings up the headline message for each goal. A code of good research practice covers:Planning and conducting the researchManagement of research data and primary materialsSupervisionPublication and dissemination of research findingsAuthorshipPeer reviewConflicts of interestCollaborative research across institutionsApplying and exploiting the resultsMisconduct in ResearchInitially for WHO and its staff but could form the basis for a move towards a global standard.
14World Health Organization PrioritiesWorld Health Organization28 March 2017Working with Member States andpartners, WHO will:Ensure mechanisms are in place to synthesize data on gaps in research relating to current health and health system challenges at national and global levels;Convene high-level consultations to identify and build consensus around priorities;Produce a report every four years on global research priorities with an assessment of the alignment of financial and human resources with research agendas;Develop comprehensive research agendas for specific priority areas and develop resource-mobilization plans for such research agendas;Advocate support for research areas;Strengthen the coherence of WHO research activities by establishing mechanisms for periodically reviewing the portfolio of research agendas, including decision criteria for initiation, course corrections and exit strategies of programmes.What success will look like:greater awareness of, and action on, research priorities at a national level;greater awareness of, and action on, research priorities at a regional and global level;improved cooperation and coordination among research funders and other key partners to align global resources to meet priority health research needs;more robust agendas for research on specific priority areas that are facilitated by WHO. Greater coherence and clarity on how WHO is supporting/actively engaged in these specific agendas.Convene high-levelConsultation of fundersBetter alignment of fundersaround priority areasThis should be a strong theme in Bamako – about how to maximize the impact with what we have, improve the partnerships that exist and ensure resources are focussed in the best possible way to achieve a beneficial health impact.
15World Health Organization CapacityWorld Health Organization28 March 2017Working with Member States andpartners, WHO will:Strengthen advocacy for the value of research and for the development of robust national health research systems;Develop tools and guidelines for strengthening national capacity;Promote the development of comprehensive health information systems to inform national research priorities;Develop and use standardized indicators to enable self- reporting of the performance of national health research systems and monitor global progress;Facilitate technical assistance to support the strengthening of national health research systems;Develop institutional capacity, regional and global networks, involvement of WHO Collaborating Centres, to report and share good practice;Maximize the impact of research capacity- strengthening efforts through improved alignment of WHO’s research programmes and activities.What success will look like:Greater investment in research for health by countries and from other sectors;All countries, especially low- and middle-income ones, have national research strategies;External stakeholders align their research investments with national research strategies;WHO guidelines on research capacity-strengthening, including indicators for measuring progress, have been developed and are being used;WHO reports progress periodically on national research capacity and activities through its governing bodies and information databases;Networks of researchers and communities of practice are actively exchanging experiences and identifying good practices in strengthening research capacity;WHO’s research capacity-strengthening efforts in- country are aligned with country needs, resulting in higher-quality, better-coordinated research activities.All countries have nationalhealth research strategiesAdvocate for strong NHRSThis will be a strong them in Bamako about each Member State setting the research for health agenda that is right for them in their region and globally.
16World Health Organization StandardsWorld Health Organization28 March 2017Working with Member States andpartners, WHO will:Develop a systematic method for selecting, developing, implementing and evaluating new standards and norms in line with priorities in research for health;Develop norms and standards, in line with the guiding principles of this strategy, for best practice in the management and use of research;Continue to facilitate the development of and set standards for publicly accessible registries of clinical trials;Engage in technical cooperation with Member States to enable them to adapt, implement and monitor adherence and compliance to the norms and standards for research.What success will look like:Public support and trust for health and medical research is strengthened;WHO has implemented an improved method for selecting, developing, implementing and evaluating its work on norms and standards related to research;Greater awareness, acceptance, implementation and compliance with standards for the management and use of research leading to an improved quality, efficiency, transparency, accountability and equity in the research process;Improved acceptance and compliance with ethical principles in the conduct of research, and standards established for accreditation of ethics committees;Registration of clinical trials according to WHO standards is adopted by all countries.Better awareness,acceptance & complianceWhich standards?Standards are difficult and require a lot of resource to get right. We need a more transparent system to ensure we put our energies into the generation of standards that are needed and will have the most beneficial impact.Health informatics and the need for a common standard for the collection, storage and sharing of health data is a good example and highlighted in the Translation goal.
17World Health Organization TranslationWorld Health Organization28 March 2017Working with Member States andpartners, WHO will:Identify promising translation activities, promote their use to support decision-making based on the best available research evidence;Promote the use of effective technology transfer models and the evaluation of promising models to support the timely creation of new products and services in Member States;Work towards the creation of and compliance with international standards on health informatics for research;Develop, strengthen and evaluate mechanisms for the systematic development of evidence summaries and guidance for citizens, patients, clinicians, managers and policy-makers in Member States;Systematically analyze barriers and encourage the development or modification of existing mechanisms to promote greater access to research results;Develop and articulate a WHO position on open access to research outputs.What success will look like:Decision-makers act as informed consumers of research; Researchers are more responsive to the demand side;institutional mechanisms are in place for capturing and sharing lessons learned from research on the demand for research and how evidence is used in policy and practice at country level;Research to understand the translation of evidence into policy and practice is in place and recognized;internationally agreed standards are created and widely applied for the collection, storing and sharing of health informatics;repositories inclusive of WHO research literature are established, well populated, regularly updated and well used;Reliable, relevant, appropriate and timely information is freely available to both producers and users of research in a format and language they understand;WHO plays a more prominent role in identifying effective health interventions and strategies, and promoting their implementation in Member States.Identify best translationactivitiesResearch informs policy &policy informs researchTranslation was mentioned very often as a key area that needs further research and particularly by those people that use research outputs but are not undertaking research themselves.This is not a passive exercise it needs real effort to get the evidence in the right format so it is understood and valued by policy makers and practitioners.Effort is also need to ensure where policy need can appropriately influence the research agenda.
18World Health Organization 28 March 2017ORGANIZATIONStrengthen the research culture across WHOSTANDARDSPromote goodresearch practiceTRANSLATIONStrengthen linksbetween research,policy and practiceCAPACITYSupport thedevelopment ofrobust national healthresearch systemsPRIORITIESChampion researchthat addresses priorityhealth needsWHO STRATEGY ON RESEARCH FOR HEALTHVISIONdecisions and actions to improve health and enhance health equity are grounded in evidence from research.MISSIONWHO, Member States and partners work together to harness knowledge, science and technology to produce research evidence and tools to improve health5 GoalsFive interrelated goals have been defined for WHO to achieve the strategy’s vision of research for healthOrganization – this involves the strengthening of the research culture across WHOPriorities – this concerns the reinforcement of research (at national, regional and global levels, and within WHO) in response to priority health needsCapacity – this relates to the provision of support to the strengthening of national systems for health researchStandards – this concerns the promotion of good practice in research, drawing on WHO’s core function of setting norms and standardsTranslation – this involves the strengthening of links between the policy, practice and products of research.
19A framework for research for health priorities World Health Organization28 March 2017Research on neglected priority needsMeasurement of the problem – diagnosisUnderstand causes of the problem – determinantsDevelopment of solutionsTranslation and delivery of the solutionimpact of the solutionEvaluation of theThe term "research for health" reflects the fact that improving health outcomes requires the involvement of many sectors and disciplines. As identified in the work of the Global Forum for Health Research, research of this type seeks to perform the functions of understanding the impact on health of policies, programmes, processes, actions or events originating in any sector; of assisting in developing interventions that will help prevent or mitigate that impact; and of contributing to the achievement of the Millennium Development Goals, heath equity and better health for all. Research for health covers the full spectrum of research, which spans the following five generic areas of activity:measuring the magnitude and distribution of the health problemunderstanding the diverse causes or the determinants of the problem, whether they are due to biological, behavioural, social or environmental factorsdeveloping solutions or interventions that will help to prevent or mitigate the problemimplementing or delivering solutions through policies and programmesevaluating the impact of these solutions on the level and distribution of the problem. The term "health problem" is used in this strategy to refer to a major cause of ill-health or health inequity, whether actual or prospective. It includes the following: diseases such as HIV/AIDS or mental illness; risks to health such as obesity, poverty or climate change; and obstacles to effective systems performance, such as unsafe care or inequitable financing of health services.
20Research and Training in Tropical Diseases (TDR) World Health Organization28 March 2017Neglected priority needsMeasurement of the problem – diagnosisUnderstand causes of the problem – determinantsDevelopment of solutionsTranslation and delivery of the solutionTDRSelected drug development and field interventions (TB/HIV, helminths, other NTD )Innovate vector control interventionsEvidence for antimalarial policy and accessVisceral leishmaniasis eliminationIntegrated community-based interventionsLead discovery for drugs(screening/optimizing drug leads for tropical diseasesInnovation and access in diagnosisTDR Research business linesimpact of the solutionEvaluation of theThese two examples (next slide) show how this framework describe the strategic approach and priority setting that currently exists in two programmes that WHO is a partner in.For TDR the main emphasis is catalysing efforts to develop and deliver solution in areas of neglected tropical diseases.
21World Health Organization Research strategy on Foodborne Disease Burden, its impact and on effective interventionsWorld Health Organization28 March 2017Research on neglected priority needsMeasurement of the problem – diagnosisUnderstand causes of the problem – determinantsDevelopment of solutionsTranslation and delivery of the solutionPriority No 1No global burden of FBD estimates currently existPriority No 2Determinants of burden partially known but not synthesizedSolutions fairly well described but not always evidence-based – this might have to be revisited after strategy has been executed in its entiretyPriority No 4Solutions often not linked to evidence – this requires re-examination and new applicationPriority No 3Food Safety standard setting, control and interventions are well described but impact often not knownFOSimpact of the solutionEvaluation of theFor Food Safety the priority is measuring the scale of the problem and a standard approach to doing this as well as evaluating the impact of existing responses.
22Links to Bamako and the Global Strategy Plan of Action (from the IGWG) World Health Organization28 March 2017WHOStrategyGlobal Strategy Plan of Action – No. elementsBamako Ministerial ForumCall for Action by MinistersPriorities1- priorities2 - cooperation7- sustainable fundingSet priorities2% health budget for researchCapacity3 – capacity R&D for productsBuild institutional capacityRegional CooperationBuild capacity in science through educationStandards6 – ethical review, QAClinical trialsOpen access to research outputs, products and technologiesTranslation2 – strengthen national health researchPromote translation - 5% of funding to support thisResearch in all policiesThe three areas were developed using different approaches but what this table summarizes is the synergies between the WHO strategy (as a result of consultation) and the outcome of the Intergovernmental Working Group's global strategy and plan of action on public health, innovation and intellectual property and the agenda and Call to Action here at Bamako.It seems there is an agreed approach to move forward the research for health agenda by focussing on priorities, capacity, standards and translation. Of these it is capacity that is mentioned most frequently – how can this be done particularly in low and middle income countries.
23World Health Organization Implementation28 March 2017Approval by Member States at EB and WHA in 2009Review, discussion of governance, financingA strategy for implementation; detailed plan neededDecentralized implementation-key role for Regional Offices to implement strategy after alignment with agendas, plans and strategiesIncorporation into work plans, country cooperation strategy
24World Health Organization Evaluation28 March 2017Evaluation framework developed to give impact-focussed approach for assessing achievement of vision, mission and goalsFramework components: inputs/activities, outputs, outcomes and impactsIndicators for each component defined for tracking purposesReport on progress to governing bodies in 2012
25World Health Organization 28 March 2017"Through the research strategy, whatcan WHO do to help democratize R&Dso that knowledge is not just for the rich and is equitably used to improvehealth for all peoples?"Dr Anarfi Asamoa-BaahWHO Deputy Director-GeneralNovember, 2007
26World Health Organization Many thanks28 March 2017Further information can be obtained from:SharePoint:Robert TerryProject Manager - WHO Research Strategy,Research Policy & Cooperation (RPC/IER),World Health OrganizationTel No :Mob No:AcknowledgementsThe WHO strategy on research for health was developed with support from :The Bill and Melinda Gates FoundationThe Wellcome TrustThe Department of Health, UK