Assessment of recommendations of the 5 past ACHR sessions 26 th – 30 th Dulitha N. Fernando.

ToR of the APW To develop tools to assess To develop tools to assess the quality of the ACHR recommendationsthe quality of the ACHR recommendations implementation of the recommendationsimplementation of the recommendations Conduct an assessment of the 5 past ACHR recommendations using the above Conduct an assessment of the 5 past ACHR recommendations using the above Prepare a report based on the findings Prepare a report based on the findings

ToR of the ACHR Advice the Regional Director on : Advice the Regional Director on : Formulation and implementation of health research policies and health research (HR) agendaFormulation and implementation of health research policies and health research (HR) agenda Coordination and harmonization of HR activities of national bodies with those of WHOCoordination and harmonization of HR activities of national bodies with those of WHO Development, management and improvement of HR information systemDevelopment, management and improvement of HR information system Collection, analysis and dissemination pof existing HR findingsCollection, analysis and dissemination pof existing HR findings

Method Review of available documents Review of available documents Using the tools developed, assessment of the recommendations : Using the tools developed, assessment of the recommendations : numbers, technical areas, clarity, relevance to countries of the region, follow up required etc.numbers, technical areas, clarity, relevance to countries of the region, follow up required etc. obtain information from relevant technical unitsobtain information from relevant technical units assessment at the country level ( not carried out due to issues related to feasibility)assessment at the country level ( not carried out due to issues related to feasibility) Summarize the observations re. the assessment of the recommendations Summarize the observations re. the assessment of the recommendations Obtain views from ACHR members using a tool developed for the purpose Obtain views from ACHR members using a tool developed for the purpose Prepare the report Prepare the report

Findings - summary Number of recommendations per session – ranged from Number of recommendations per session – ranged from Total number of recommendations - 5 sessions :55 Total number of recommendations - 5 sessions :55 Of them, Of them, 27( 49%) - on topics related to health research development27( 49%) - on topics related to health research development Others - : on selected technical areasOthers - : on selected technical areas

Of the recommendations, Of the recommendations, 35 : to be followed up at SEARO35 : to be followed up at SEARO 15 : follow up at country level15 : follow up at country level 05 : SEARO with HQ / countries05 : SEARO with HQ / countries

Recommendations related to research development General observations General observations A wide range of focus areasA wide range of focus areas Some degree of overlapSome degree of overlap Some recommendations include several follow up actionsSome recommendations include several follow up actions Some are stated in general terms, making follow up less clear.Some are stated in general terms, making follow up less clear.

Recommendations related to health research - Broad areas Activities supporting national health systems ( updating profiles of national health research systems, identifying strengths and weaknesses, knowledge dissemination etc.) Activities supporting national health systems ( updating profiles of national health research systems, identifying strengths and weaknesses, knowledge dissemination etc.) Strengthening country capacity for health research Strengthening country capacity for health research Strengthening research management capacities Strengthening research management capacities Resources for research Resources for research Links with HQ research programmes Links with HQ research programmes Research ethics Research ethics Collaborating centres Collaborating centres

Review of recommendations on research, focusing on : Relevance to countries of the region Relevance to countries of the region All recommendations are relevant to all countries, to varying extents.All recommendations are relevant to all countries, to varying extents. Clarity and ease of interpretation Clarity and ease of interpretation Varied with each recommendationVaried with each recommendation Writing style varied between different reportsWriting style varied between different reports Some are clearly stated ‘focused’ statements with others stated in more general termsSome are clearly stated ‘focused’ statements with others stated in more general terms Follow up required Follow up required Some require several follow up actions, spread over a period while others are “targeted “Some require several follow up actions, spread over a period while others are “targeted “ Most of them clearly indicate the follow up required, SEARO, Country or SEARO in collaboration with the country or with HQ units.Most of them clearly indicate the follow up required, SEARO, Country or SEARO in collaboration with the country or with HQ units.

Recommendations in technical areas 26 th Session Human Genetics(5 ) 26 th Session Human Genetics(5 ) 27 th Arsenic poisoning (2) 27 th Arsenic poisoning (2) Health Impact Assessment (2) Health Impact Assessment (2) CVD (2) 28 th TB (1) 28 th TB (1) Thalassaemia ( 5) Thalassaemia ( 5) 29 th EID (5) 29 th EID (5) 30 th Avian Influenza (1) 30 th Avian Influenza (1) Vaccine development (1) Vaccine development (1)

26 th ACHR -Recommendations on human genetics ( 5) Relevance – Contributes to a vast area of research. Relevant to all countries, Resource availability varies. Relevance – Contributes to a vast area of research. Relevant to all countries, Resource availability varies. Clarity : All 5 recommendations are clearly stated, no overlap Clarity : All 5 recommendations are clearly stated, no overlap Follow up : with SEARO. Required F.U. is feasible. Follow up : with SEARO. Required F.U. is feasible.

27 th ACHR Arsenic poisoning ( 2) Arsenic poisoning ( 2) Relevant to several countries of the region. Cause debilitating disease, high burden of disease, preventable Relevant to several countries of the region. Cause debilitating disease, high burden of disease, preventable Clarity and follow up : Two recommendations to be implemented at the country level. Areas of research grouped as : immediate, medium term and long term. Clarity and follow up : Two recommendations to be implemented at the country level. Areas of research grouped as : immediate, medium term and long term.

27 th ACHR – continued.. Health impact assessment (2) : Relevant to all countries of the region. Two recommendations – clearly stated, identified SEARO to take f.u. action Health impact assessment (2) : Relevant to all countries of the region. Two recommendations – clearly stated, identified SEARO to take f.u. action CVD (2) : relevant to all countries. Need for research on prevention and management. Clearly stated. WHO to work in partnership with relevant institutions to promote research CVD (2) : relevant to all countries. Need for research on prevention and management. Clearly stated. WHO to work in partnership with relevant institutions to promote research

28 th ACHR Tuberculosis – one recommendation which includes two components, one -which includes technical inputs and another, requiring financial inputs. Tuberculosis – one recommendation which includes two components, one -which includes technical inputs and another, requiring financial inputs. Thalassaemia – 5 recommendations made. Relevant to several countries of the region. 3 of the recommendations were to be f.u. at SEARO, one of them to be linked with collaborating centres. Thalassaemia – 5 recommendations made. Relevant to several countries of the region. 3 of the recommendations were to be f.u. at SEARO, one of them to be linked with collaborating centres.

29 th ACHR EID – 5 recommendations. Relevant to all countries of the region. Recommendations clearly stated. Identifies several inputs to be carried out by the countries and /or by the WHO. EID – 5 recommendations. Relevant to all countries of the region. Recommendations clearly stated. Identifies several inputs to be carried out by the countries and /or by the WHO. Two recommendations focus on SEARO support for countries in public policy analysis, others for SEARO to take follow up action. Two recommendations focus on SEARO support for countries in public policy analysis, others for SEARO to take follow up action.

30 th ACHR One on Avian influenza and another on vaccine development. One on Avian influenza and another on vaccine development. Relevant to all countries to varying extents Relevant to all countries to varying extents Less clarity. Less clarity. Each recommendation has several components which are inter related and covers a wide scope. Each recommendation has several components which are inter related and covers a wide scope.

Implementation of recommendations Sources of information Sources of information Report of the ACHR session that follows the session in which the recommendation is made Report of the ACHR session that follows the session in which the recommendation is made From relevant technical units at SEARO From relevant technical units at SEARO From countries – ( not feasible during this review, even though a tool was developed for the purpose) From countries – ( not feasible during this review, even though a tool was developed for the purpose) From 29 th ACHR : an Agenda item titled “Follow up of recommendations of the previous ACHR” was included. From 29 th ACHR : an Agenda item titled “Follow up of recommendations of the previous ACHR” was included.

Status of implementation Total of 12 recommendations made at the 26 th ACHR Total of 12 recommendations made at the 26 th ACHR Report of the 27 th ACHR – 4 have been implemented. Report of the 27 th ACHR – 4 have been implemented. Information from RPC and other technical units - follow up action has been taken in respect of all recommendations. Information from RPC and other technical units - follow up action has been taken in respect of all recommendations.

Status of implementation 27 th ACHR 27 th ACHR Of the 12 recommendations, no information on follow up of 5, including those on Arsenic poisoning. Of the 12 recommendations, no information on follow up of 5, including those on Arsenic poisoning. Of the other 7, two recommendations on CVDs have been implemented and on 5 others, the available information is inadequate to assess the status of implementation. Of the other 7, two recommendations on CVDs have been implemented and on 5 others, the available information is inadequate to assess the status of implementation.

28 th session 14 recommendations made 14 recommendations made Report presented at the 29 th ACHR session indicated that only 2 recommendations were implemented. Report presented at the 29 th ACHR session indicated that only 2 recommendations were implemented. Additional information shows that, for three others, follow up action has commenced and are on going. Additional information shows that, for three others, follow up action has commenced and are on going. The recommendation on vaccine policy has been followed up in 2009 with the establishment of sub committee of SEA-ACHR on vaccines and drug development The recommendation on vaccine policy has been followed up in 2009 with the establishment of sub committee of SEA-ACHR on vaccines and drug development Available information on the recommendations on Thalassaemia and TB are not adequate to make an assessment of the status of implementation. Available information on the recommendations on Thalassaemia and TB are not adequate to make an assessment of the status of implementation.

29 th ACHR 8 recommendations made. 8 recommendations made. 5 of them were related to EIDs, detailed information on their implementation is available. 5 of them were related to EIDs, detailed information on their implementation is available. Information from RPC indicate the implementation of the other three recommendations. Information from RPC indicate the implementation of the other three recommendations.

30 th ACHR 9 recommendations 9 recommendations Follow up action taken in respect of 6. Of them, follow up of 4 recommendations are on going. Follow up action taken in respect of 6. Of them, follow up of 4 recommendations are on going. Two others focus on broad based activities aimed at promoting health research in the region. There is no information to assess the implementation of these recommendations. Two others focus on broad based activities aimed at promoting health research in the region. There is no information to assess the implementation of these recommendations.

31 st ACHR – an overview A total of 12 recommendations were made A total of 12 recommendations were made ( some of them, with several components) ( some of them, with several components) Follow up meetings held: at the 1 st follow up meeting 8 recommendations were identified for early action. Follow up meetings held: at the 1 st follow up meeting 8 recommendations were identified for early action. Recommendations revised and included in the report of the 31 st ACHR ( published) Recommendations revised and included in the report of the 31 st ACHR ( published)

2 nd F.U. Meeting held - Presentations on Regional strategy and guidelines for developing a national health research strategy were presented. 2 nd F.U. Meeting held - Presentations on Regional strategy and guidelines for developing a national health research strategy were presented. Sub committee on drugs and vaccine development established Sub committee on drugs and vaccine development established Regional consultation on ‘strategy for health’ held in July Final draft ready. Regional consultation on ‘strategy for health’ held in July Final draft ready. Review of the regional policy on immunization – being undertaken. Review of the regional policy on immunization – being undertaken. Action to strengthen research capacity in three countries – commenced. Action to strengthen research capacity in three countries – commenced.

Summary Nearly half the recommendations are related to aspects relevant to health research. Nearly half the recommendations are related to aspects relevant to health research. Many recommendations include several follow up actions by different implementing agencies within and outside SEARO. Many recommendations include several follow up actions by different implementing agencies within and outside SEARO. Some recommendations are very specific and clear. Some recommendations are very specific and clear. Of the 55 recommendations, 35 were to be followed up at SEARO, 5 at SEARO in collaboration with relevant units at HQ and 15 at country level. Of the 55 recommendations, 35 were to be followed up at SEARO, 5 at SEARO in collaboration with relevant units at HQ and 15 at country level. Follow up action varied – some of them requiring “one time “ action while others - “ implementation over a period of time”. Follow up action varied – some of them requiring “one time “ action while others - “ implementation over a period of time”. Information on follow up action taken was not readily accessible Information on follow up action taken was not readily accessible Of the 55 recommendations, 35 have been implemented and some are ongoing. 4 – not implemented and4 – no information. Of the 55 recommendations, 35 have been implemented and some are ongoing. 4 – not implemented and4 – no information. On 12 recommendations – information inadequate to make an assessment of the status of implementation. On 12 recommendations – information inadequate to make an assessment of the status of implementation.

Considerations for the future Introduction of an agenda item titled ‘follow up of recommendations of the previous ACHR” has to be continued and monitored to ensure that the information provided is “comprehensive”. Introduction of an agenda item titled ‘follow up of recommendations of the previous ACHR” has to be continued and monitored to ensure that the information provided is “comprehensive”. Mechanism to disseminate the recommendations at SEARO and at country level – to be streamlined. Mechanism to disseminate the recommendations at SEARO and at country level – to be streamlined. Develop a mechanism to follow up at SEARO, through sharing of information with all relevant technical units and obtaining their views on the priority areas, within those recommendations. Develop a mechanism to follow up at SEARO, through sharing of information with all relevant technical units and obtaining their views on the priority areas, within those recommendations. Feasibility of implementing the recommendation at SEARO and at country level needs to be assessed. Feasibility of implementing the recommendation at SEARO and at country level needs to be assessed. A “forum” to be established to follow up at SEARO level. RPD unit to take the role of the Coordinator A “forum” to be established to follow up at SEARO level. RPD unit to take the role of the Coordinator

Financial requirements needed for implementation to be considered in biannual financial planning. Financial requirements needed for implementation to be considered in biannual financial planning. Develop a mechanism to follow up at country level. Suggested that ‘ the focal point for research’ at country level be strengthened and be provided with a clear set of responsibilities so that he/she could establish links with the country focal point, all other relevant research institutions and with RPC at SEARO. Develop a mechanism to follow up at country level. Suggested that ‘ the focal point for research’ at country level be strengthened and be provided with a clear set of responsibilities so that he/she could establish links with the country focal point, all other relevant research institutions and with RPC at SEARO.

31 st ACHR session – an overview A number of recommendations were made during the session. A number of recommendations were made during the session. WHO Representatives to play a key role WHO Representatives to play a key role Follow up meetings held. Follow up meetings held. Action taken to : established ACHR Sub Committee on vaccine and drugs development Action taken to : established ACHR Sub Committee on vaccine and drugs development Review the regional policy on vaccine development Review the regional policy on vaccine development Regionla strategy for researcj for health - initiated. Regionla strategy for researcj for health - initiated.

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