World Health Organization Information, Evidence and Research The Road to Bamako Tim Evans Assistant Director General, WHO Scaling Up Research and Learning for Better Health Divonne, June 2, 2008

World Health Organization Information, Evidence and Research Overview The historical context –The value of research –Some important antecedents The "Call to Action" The Ministerial Discussions

World Health Organization Information, Evidence and Research The value of research The health research system is the brains of the health system: it is a tool to organize, understand, operate and improve it Prawase Wasi

World Health Organization Information, Evidence and Research Value of Research for Health Describe the health situation Discover the causes of ill-health Development of solutions Delivery of solutions Determine impact

WHO Research for Health Strategy framework for research priorities Research on neglected priority needs Measurement of the problem – diagnosis Understand causes of the problem – determinants Development of solutions Translation and delivery of the solution Evaluation of the impact of the solution WHO research priorities framework identifies 5 types of research that are pertinent to any given health need.

World Health Organization Information, Evidence and Research Commission on Health Research for Development (1990) : Action Agenda Essential national health research (ENHR) in every country International partnerships Capacity building More financial resources for health research Mechanisms to monitor progress and generate support

World Health Organization Information, Evidence and Research Ad Hoc Committee on Health Research Relating to Future Intervention Options (1996) : R&D priorities … "Best Buys" –Products for neglected diseases –Child and maternal health –Microbial threats –Non-communicable diseases and injuries –Health care systems

World Health Organization Information, Evidence and Research International Conference on Health Research for Development, Bangkok (2000) : Key challenges for health research Adherence to values of ethics, equity and excellence Sustainable health research systems Favorable research environment Knowledge production and application

World Health Organization Information, Evidence and Research Ministerial Summit on Health Research, Mexico (2004) : Key messages More investments in health systems research Better management of health research Secure public confidence in science Stronger emphasis on turning knowledge into actions to improve people's health

World Health Organization Information, Evidence and Research 58 th World Health Assembly, Geneva, May 16-25, 2005

World Health Organization Information, Evidence and Research The Bamako Call to Action Based on consultations in all WHO regions in 2007/2008 Reflects: – the WHO Research Strategy –The World Health Assembly approved Global Strategy and Plan of Action on Public Health Innovation and Intellectual Property Identifies priority directions for research policy –Both the "what" and the "how" Priority areas of focus Capacities Standards - Translation Will be further revised over the next three days of Ministerial discussions

World Health Organization Information, Evidence and Research Ministerial Discussions Agenda Day 1 – Monday 17 November –Session 1 – Introductions Overview Report of WHO/AFRO Consultation in Algiers –Session 2 – Reports from other regional consultations Overview of the Call to Action

World Health Organization Information, Evidence and Research Ministerial Discussions (cont'd) Day 2, Tuesday November 18 3 sessions Focus: –a broad topical area of research Presentation: –Brief overview Panelists: –to provide inputs from Forum parallel sessions Moderated discussion: –" how can countries and international partners work more effectively on these issues? "

World Health Organization Information, Evidence and Research Ministerial Discussions (cont'd) Session :00-12:30 –Research for Health Product Innovation Session :50- 15:50 –Research for Global Health Security Session :20 – 18:20 –From Global Health Initiatives to Primary Health Care: Scaling up Research and Learning for Health Systems

World Health Organization Information, Evidence and Research Research for Health Product Innovation Longstanding focus of recommendations and action WHO Special Program on Tropical Disease Research 1976 Concerns in 1990s… "dry pipelines"; "market failures" Major global response: Product-development partnerships - many! Reconsidering rules and incentives –WTO/TRIPS – public health considerations –Advanced market commitments Commission on Public Health Innovation and Intellectual Property followed by Intergovernmental Working Group, Global Strategy and Plan of Action 2008

World Health Organization Information, Evidence and Research 2003 Map of Initiatives Addressing Communicable Diseases

World Health Organization Information, Evidence and Research IGWG on Public Health Innovation and Intellectual Property Global Strategy and Plan of Action, May Priority Setting for R&D 2Promoting R&D 3Building and Improving Innovative Capacity 4Transfer of Technology 5Application and Management of IP 6Improving Delivery and Access 7Promoting Sustainable Financing 8Establishing Monitoring and Reporting Systems

World Health Organization Information, Evidence and Research Research For Global Health Security A relatively new and quickly growing focus of research Reflects complex health challenges that are often driven by globalization: –Unpredictable crises/threats pandemics, humanitarian, food, energy, and financial –Largely predictable challenges - NCDs, social determinants of health, aging, lifestyle behaviors Demands research response that is cross- sectoral and cross-border and fast!

Commission on Social Determinants of Health Overarching Recommendations 1. Improve Living Conditions 2. Tackle the Inequitable Distribution of Power, Money, and Resources 3. Measure and Understand the Problem and Assess the Impact of Action.

World Health Organization Information, Evidence and Research From Global Health Initiative to Primary Health Care: Scaling up Research and Learning for Health System Specific focus of progress from Mexico Summit 2004 Reflects growing policy interest in health systems e.g. G8, UNGASS Draws on 12 parallel and special sessions of Bamako forum related to health systems research Recommendations from WHO High Level Task Force

Common systems constraints to scale up services for HIV, TB, malaria, and immunization HIV/UA assessment report Global Plan to stop TB World Malaria report GAVI/Norad report Inadequate financing HR crisis Affordable commodities Stigma, discrimination… Accountability Partnership alignment Inadequate financing Laboratory capacity HR crisis Quality drugs Drug efficacy Information system Inadequate financing HRH and Community services M&E HR crisis Inadequate financing Leadership and management Inter-agency coordination

C. Research for Primary Health Care

World Health Organization Information, Evidence and Research Ministerial Discussion (cont'd) Day 3 19 November 11:00 – 12:30 Final review of the Call to Action 13:50- 15:5- Reading of the Call to Action in the plenary