First Global Symposium on Health Systems Research - Science to Accelerate Universal Health Coverage 16-19 November 2010, Montreux, Switzerland Shenglan Tang World Health Organization Talking Points • Why a symposium? • Aims and Objectives • Universal Health Coverage Theme • Organization of the Symposium Common challenges 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 "The issue" …we face a formidable gap between innovations in health (vaccines, drugs and strategies for care) and their delivery to communities in the developing world… Madon et al. Science December 2007 Overarching Recommendations 1. High Profile Research Agenda 2. Engage decision-makers 3. Country leadership backed globally 4. Increase finance Learning to do better Symposium's Objectives • Review state of the art research • Identify priority research agenda • Facilitate research collaboration – Across disciplines, initiatives, and countries • Strengthen scientific rigour – Frameworks and concepts – Methods and measures • Build country capacity – individual, institutional, infrastructure – Especially in low- and middle-income countries. Not an end in itself • Symposium part of broader set of strategies and activities following up on the High Level Task Force Recommendations as endorsed at Bamako Ministerial Forum in November 2008 • An international conference on advancing health systems research in March 2010 co-sponsored by WHO, Dutch Government and other partners to follow up the Bamako recommendations on health systems research, and provide a useful venue to discuss the Symposium. The symposium’s theme: Universal Health Coverage • A common goal of health systems –1 st policy reform of PHC, – recommendation of CSDH – focus of WHR 2010 – inclusive of "scaling-up" and "universal access" agendas amongst disease-targeted programs • Draws together diverse research constituencies – financing, HR, disease programming, and M&E. • A strategic point of entry into the larger field of health system research – Strikes good balance between focus and breadth
Expected Outputs and Outcomes • The immediate outputs: 1. symposium proceedings on research progresses related to the theme of universal coverage, 2. background papers , and 3. a priority agenda for health systems research • Mid-term/long-term outcomes: 1. to create a broad scientific community with stronger research capacity, 2. develop and improve the credibility of evidence-based health systems research; and 3. to enable health systems research to inform the formulation of appropriate health policies on universal health coverage. Organization of the Symposium • Steering Committee consisting of major international organisations, private foundations, national governments, NGOs, etc • Scientific Committee consisting of lead researchers from developed and developing countries, health development professionals, representatives from civil societies, etc. • WHO-based secretariat consisting TDR, HRP, AHPSR, HSS etc Partners and Co-sponsorship • An increasing number of international organizations, donor governments, and private foundations are interested to co-sponsor the symposium with WHO. Among potential partners are – Global Fund, – Rockefeller Foundation, –CDC, – NORAD, DFID, Dutch Government, Chilean Ministry of Health, – TDR, HRP, AHPSR Who should attend? • Researchers from both developed and developing countries interested in health systems research • Health policy analysts • National health policy-makers • Representatives of multilateral international organizations • Donor governments and private foundations interested in funding health systems research in low- and middle-income countries • Representatives from international and national NGOs, civil societies, private health sector, among others. Importance for WHO • Strong links to corporate priorities • Opportunity to draw on diverse resources across the house • Fit with expectations for better alignment and collaboration amongst global partners in research
131 st Session of WHO South-East Asia Advisory Committee on Health Research TDR: Implementation of Ten-Year Vision and Strategy Shenglan Tang, Stewardship, TDR 231 st Session of WHO South-East Asia Advisory Committee on Health Research Outline of Presentation • New vision and strategy of TDR • Summary key technical achievements • Activities in the new functions: – Stewardship – Empowerment – Neglected research priorities 331 st Session of WHO South-East Asia Advisory Committee on Health Research TDR • Created 30 years ago • Missions: – To facilitate and promote research on Tropical Disease and train researchers from Disease Endemic Countries (DEC) • Review every 6 to 7 years • 2006 Review: – A successful program • More needs to be done 431 st Session of WHO South-East Asia Advisory Committee on Health Research Vision To foster: an effective global research effort on infectious diseases of poverty in which disease endemic countries play a pivotal role 531 st Session of WHO South-East Asia Advisory Committee on Health Research DEC's left behind in priority setting Growing regional variation Enhanced research capabilities in DEC's Global research environment for infectious diseases Epidemiological Changes Momentum through new players / initiatives Infectious disease burden remains high Rise in pharmaceutical product development Complexity and fragmentation Need for new TDR vision/strategy triggered by critical trends in global research environment 631 st Session of WHO South-East Asia Advisory Committee on Health Research Business Plan implementation Stewardship Empowerment Research on Neglected Priorities 1 2 3 Enhanced Access to Superior Interventions DEC leadership in Research Harmonised global Research efforts AccessInterventions Innovation for: 731 st Session of WHO South-East Asia Advisory Committee on Health Research • Stewardship for research on infectious diseases of poor populations • Empowerment of researchers and public health professionals from disease endemic countries • Research on Neglected Priority Needs to: Strategy to be delivered with Three Major Strategic Functions Foster innovation for products, emphasizing DEC engagement Foster research to develop and evaluate interventions in real-life settings Foster research for access to interventions 831 st Session of WHO South-East Asia Advisory Committee on Health Research Activities in the new Strategy TDR Business Plan 2008-2013 Fostering an effective global research effort on infectious diseases of poverty in which disease endemic countries play a pivotal role Stewardship Empowerment Research on Neglected Priority Needshttp://who.int/tdr http://who.int/tdr 931 st Session of WHO South-East Asia Advisory Committee on Health Research Stewardship for Research on infectious diseases of poverty • Role as facilitator and knowledge manager to support stakeholders on: – assessment of research and control needs – progress analysis, priority setting, and advocacy for research on infectious diseases of poverty, and – providing a neutral platform for stakeholders to discuss and harmonize their activities. • with participation and pivotal roles for DECs institutions and decision makers www.who.int/tdr/about/strategy/strategy_06_summary.htm 1031 st Session of WHO South-East Asia Advisory Committee on Health Research Stewardship for research on infectious diseases of poverty Knowledge Management Stakeholder dialogue Analysis Agenda setting Acquisition Sharing Translation Synthesis Consensus "Concertation" Consultation Local Regional Global Gaps Needs Core functions & key activities Advocacy 1131 st Session of WHO South-East Asia Advisory Committee on Health Research Diseases-specific and Thematic Reference Groups Diseases and Thematic Reference Groups concept • Develop strategic analytical framework for top level assessment of research, control needs and opportunities • Identification of top level research priorities and agenda • Ten Reference Groups • Creation of a 'THINK Tank' for infectious diseases of poverty Table 2. DRGS, TGRS and their host sites 1231 st Session of WHO South-East Asia Advisory Committee on Health Research TDR-wide Empowerment Research, Training, Networks, Leverage • New processes of review and support of trainees linked to institutional needs • Harmonising quality of short courses • Utilising more regional centres to undertake TDR activities • Continued strong publication outputs Regional coordinators Coordination and Implementation Centres 1331 st Session of WHO South-East Asia Advisory Committee on Health Research Research highlights – Access • Rectal artesunate plus referral at community level reduces mortality and severe neurological sequelae (Bangladesh being one of key study countries) – Lancet 2009,373 • Preliminary studies indicate house to house detection for Visceral Leishmaniasis (VL) is cost-effective 1431 st Session of WHO South-East Asia Advisory Committee on Health Research VL situation in Nepal • 1980: 1 st officially recorded case, Dhanusha district • Around 6.5 million (total pop. 28 m) at risk • Districts affected: Endemic: 12 Sporadic: 8 Outbreaks in new areas e.g Sindupalchowk • Annual VL cases around 1500 and 10-30 deaths recorded 1531 st Session of WHO South-East Asia Advisory Committee on Health Research TDR: VL Elimination Strategies • Early Diagnosis and Complete Case Management • Integrated Vector management and Vector Surveillance • Effective diseases and Vector Surveillance • Social Mobilization and Partnership building • Clinical and operational research 1631 st Session of WHO South-East Asia Advisory Committee on Health Research Build on potential to be partner of choice for key activities e.g. • Berlin Meeting on partnerships (govt. of Germany) • GSPA related upstream research associated with UN / co-sponsors (notably WHO, WIPO) • Health systems strengthening associated with UN / co-sponsors (notably WHO, UNICEF) • Operations Research (notably Global Fund) • Priority setting (notably EU) • Network development in DEC's (notably ISHReCA, RNAS) 1731 st Session of WHO South-East Asia Advisory Committee on Health Research Level of funding by countries and regions 2003-2008 AMRO EMRO $ 3 M AFRO $ 49 M SEARO $ 13M EURO $ 24 M WPRO $ 7M $ 9 M $ 12 M 1831 st Session of WHO South-East Asia Advisory Committee on Health Research Thank You
Thirty-first session of WHO South-East Asia Advisory Committee on Health Research Kathmandu, Nepal, 21-23 July 2009 SEA/ACHR/31/11 18 July 2009 Agenda Item 3.3.2 REVIEW OF GLOBAL WORK OF WHO ON HEALTH RESEARCH: UNDP/WORLD BANK/ UNICEF/WHO SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES (TDR)
UNDP/WORLD BANK/UNICEF/WHO SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES (TDR) Draft to be submitted by WHO HQ.