WHO Strategy on Research for Health Review of RPC's Contribution to Global Work on the Research Strategy Dr. Abha Saxena On behalf of the Department of Research Policy & Cooperation IER/WHO/HQ TITLE from VIEW and SLIDE MASTER | 30 July, 20102 | Sustained Global interest 1990: Commission on Health Research for Development 1996: Ad Hoc Committee on Health Research Relating to Future Intervention Options 2000: International Conference on Health Research for Development (Bangkok) 2004: Ministerial Summit on Health Research (Mexico) 2008: Bamako Ministerial Forum on Research for Health TITLE from VIEW and SLIDE MASTER | 30 July, 20103 | Complex array of initiatives Member States looking to WHO for guidance and leadership TITLE from VIEW and SLIDE MASTER | 30 July, 20104 | Mandate Resolution WHA60.15 at 60th World Health Assembly requesting the DG… "to submit to the Sixty-Second World Health Assembly (2009) a strategy on the management and organization of research activities within WHO" TITLE from VIEW and SLIDE MASTER | 30 July, 20105 | WHO Strategy on Research for Healthon Research for Health WHO’s role in research….. and the role of research in WHO… z Recognizes research as central to progress in global health z Identifies 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. TITLE from VIEW and SLIDE MASTER | 30 July, 20106 | Evaluation Framework Implementation Planning INPUTS Rolling Dialogue: Virtual & Face-to-Face Emergent Themes Emergent Themes Working drafts IGWG Public health and innovation Regional offices Special Programmes, HQ CCs Executive Board Jan 09 EB124/4.9 Strategy development - a participatory process WHO Research Strategy – WHA 2010 100 Stakeholder Interviews Online & Face to face workshops Strategy+ annexes Advisory Committee on Health Research External & Internal Reference Groups TITLE from VIEW and SLIDE MASTER | 30 July, 20107 | Principles Quality - high-quality research that is ethical, expertly reviewed, efficient, effective, accessible to all, and carefully monitored and evaluated. Impact - priority for research with greatest potential to improve global health security, health-related development, redress health inequities and attain MDGs Inclusiveness - work in partnership, Member States and stakeholders, multisectoral approach, support and promote the participation of communities and civil society in the research process. TITLE from VIEW and SLIDE MASTER | 30 July, 20108 | Research overview - methods zDesigned questionnaire with departments 35 at HQ + Kobe and IARC zQuestionnaire completed for 2006/07, supplemented by annual reports and web information zSigned off by Director zMapped approximately to WHO clusters. zLimits: self reporting, what is research?, incomplete figures, no 'database' or GSM record for research. TITLE from VIEW and SLIDE MASTER | 30 July, 20109 | Definitions z Health Research - the development of knowledge with the aim of understanding health challenges and mounting an improved response to them. z Full spectrum of research: – measuring the problem; – understanding causes; – elaborating solutions; – translating the solutions or evidence into policy, practice and products; and – evaluating the effectiveness of solutions. z Secondary research is research that uses existing data through analysis and/or synthesis z Primary research is activity that generates new - primary - data. TITLE from VIEW and SLIDE MASTER | 30 July, 201010 | WHO Health Research Staff (n=37) and Expenditure $US 2006/07 (n=34) By Research Areas Research Area Total staff Research staff Staff % of total research staff Research Expenditure % research spend Information Evidence and Research 136 26 110 5% 2,947,012 1% Health Action in Crises 32 13 19 2% 5,700,000 3% Health Systems and Services 180 66 114 12% 8,418,800 4% Health Security and Environment 166 70 96 13% 8,860,000 4% Noncommunicable Diseases and Mental Health 174 54 120 10% 10,130,000 5% HIV/AIDS, TB, Malaria & NTDs 225 71 154 13% 16,250,000 8% TDR 43 38 5 7% 44,600,000 21% Family and Community Health 242 109 133 20% 66,698,891 31% International Agency for Research on Cancer 115 102 13 19% 51,400,000 24% WHO ( *NB % of total staff that are research staff) 1313 549 764 42%* 215,004,703 100% TITLE from VIEW and SLIDE MASTER | 30 July, 201011 | WHO Health Research Expenditure $USD millions 2006/07 n=34 2.95 5.70 8.42 8.86 10.13 16.2544.60 51.40 66.70 Information Evidence and Research Health Action in Crises Health Systems and Services Health Security and Environment Noncommunicable Diseases and Mental Health HIV/AIDS, TB, Malaria & NTDs TDR International Agency for Research on Cancer Family and Community Health TITLE from VIEW and SLIDE MASTER | 30 July, 201012 | Source of research funds utilized by WHO 2006/07 n=37 21% 40% 5% 7% 27% WHO, UN Agency or International Funding Initiatives Government Funding Agencies Academic Sources e.g. University Inst Private Sources e.g. industry and pharma NGOs, Foundations & Charities TITLE from VIEW and SLIDE MASTER | 30 July, 201013 | RESEARCH FUNDING DISTRIBUTED BY WHO (n=35) Scale: (0-33) Low Involvement (34-66) Some Involvement (67-100) Strong Involvement 0 15 30 45 60 Contract Research Research Grants (calls for proposals) Funding for Institutions & Programmes Fellowships & Awards (individuals) TITLE from VIEW and SLIDE MASTER | 30 July, 201014 | Strategic spread of WHO research activities at an organizational level (n=35) Scale: (0-33) Low involvement (34 -66) Some involvement (67 - 100) Strong involvement 0 20 40 60 80 100 Basic Science Research Clinical Research Population Based Research Health Services/ Systems Research Policy & Advocacy Research TITLE from VIEW and SLIDE MASTER | 30 July, 201015 | 10 20 30 40 50 60 70 80 90 100 C O M M I S S I O N R E S E A R C H WHO Research: Conduct/Commission: Primary/ Secondary* $66.7mFamily & Community Health $2.9mInformation Evidence & Research $5.7mHealth Action in Crises Health Systems & Services $8.4m $8.9mHealth Security & Environment $16.3mHIV/AIDS, TB, Malaria & NTDs $10.1mNoncommunicable Diseases & Mental Health TDR $44.6m Primary Research Secondary Research % 100 90 80 70 60 50 40 30 20 10 % C O N D U C T R E S E A R C H Figures represent research spend 2006/07 USD$ million $215mWHO summary *IARC excluded TITLE from VIEW and SLIDE MASTER | 30 July, 201016 | KEY TO COLOURS (SPEND USD$ million 06/07): Information Evidence & Research (3) Health Action in Crises (6) Noncommunicable Diseases & Mental Health (10) Family & Community Health (67) Health Systems & Services (8) Health Security & Environment (9) HIV/AIDS, TB, Malaria & NTDs (16) IARC (51) TDR (45) Research at WHO – HQ 2006/07 SECONDARY RESEARCH PRIMARY RESEARCH CONDUCTED OR MANAGED BY WHO COMMISSION ED BY WHO The size of each circle is relative to the research expenditure in 2006/7 USD$ million for the areas listed below Note: a circle in the centre represents an equal distribution of activity TITLE from VIEW and SLIDE MASTER | 30 July, 201017 | Capacity – strengthening health research systems Working with Member States and partners: • Technical assistance, tools and guidelines • Comprehensive health information systems to inform national research priorities • Standardized indicators to enable self-reporting • Institutional capacity, regional and global networks, WHO Collaborating Centres, to report and share good practice; • WHO - maximize the impact of research capacity- strengthening efforts through improved alignment research programmes and activities TITLE from VIEW and SLIDE MASTER | 30 July, 201018 | Working with Member States and partners: Advocacy Convene high-level consultations to identify and build consensus around priorities Synthesize data on gaps in research challenges at national and global levels Report on global research priorities and alignment of resources with research agendas Develop comprehensive research agendas for specific priority areas and develop resource- mobilization plans for such research agendas; WHO - establish mechanisms for reviewing the portfolio of research agendas, decision criteria for initiation, course corrections and exit strategies of programmes. Priorities – meeting health needs TITLE from VIEW and SLIDE MASTER | 30 July, 201019 | Standards – good research practice Working with Member States and partners: • Systematic method for selecting, developing, implementing and evaluating new standards • 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. TITLE from VIEW and SLIDE MASTER | 30 July, 201020 | Translation – evidence into practice Working with Member States and partners: •Promote translation activities for evidence informed decision making •Promote effective technology transfer models •Creation of and compliance with international standards on health informatics for research •Promote greater access to research results; •Develop and articulate a WHO position on open access to research outputs. TITLE from VIEW and SLIDE MASTER | 30 July, 201021 | Organization – strengthen the research culture • Establish governance structures to lead, manage, coordinate and maintain accountability for research within WHO; • Develop and implement a WHO Code of Good Research Practice; • Enhance professional staff competencies; • Improve access to WHO-affiliated research by developing a publicly accessible repository; • Review and improve performance in research partnerships • Improve communications on the Organization’s involvement in research, • Monitor and evaluate this strategy. TITLE from VIEW and SLIDE MASTER | 30 July, 201022 | RESEARCH STRATEGY Research Policy and Cooperation ICTRP and GRC Secretariat of the ERC EVIPNET TITLE from VIEW and SLIDE MASTER | 30 July, 201023 | Capacity Building, Norms & Standards Regional Offices, Country Offices Technical Units Research Ethics Review Committee ERC Guidance, Templates, Checklists ERC Secretariat TITLE from VIEW and SLIDE MASTER | 30 July, 201024 | The WHO Research Ethics Review Committee z 26 member ERC, established by the Director-General z 16 WHO Staff, 10 external members z 1 Chair, 2 vice-Chairs z 11 women, 15 men z 11 members from developed countries, and 15 from developing countries Research Ethics Review Committee ERC TITLE from VIEW and SLIDE MASTER | 30 July, 201025 | WHO Manual z In order to provide ethics review of all research supported by WHO, the Director-General has established the Research Ethics Review Committee. z WHO support – financial, technical or otherwise TITLE from VIEW and SLIDE MASTER | 30 July, 201026 | Review of new proposals 2004-2008. 143 175 121 96 115 24 17 39 13 17 0 50 10 0 15 0 200 250 2004 2005 2006 2007 2008 Years Tota l num b e r of pr opos a l s s u b m i tte d Proposals reviewed Proposals not reviewed* TITLE from VIEW and SLIDE MASTER | 30 July, 201027 | Type of review – 2004 - 2008 71 58 30 69 94 33 51 76 18 47 68 26 54 79 16 0 20 40 60 80 100 Regular Expedited Exempt * 2004 * 2005 * 2006 * 2007 * 2008 TITLE from VIEW and SLIDE MASTER | 30 July, 201028 | TITLE from VIEW and SLIDE MASTER | 30 July, 201029 | Audit Report Ethics review in regional and country offices z The global ACHR has expressed concern about ethics review of research supported by the WCOs. z The WHO Manual does not mention ethics review of research supported by WCOs z Considerable research IS being supported by WCOs, especially following the Country Focus Initiative. z Limited training or briefing of WCO staff on ethics review issues. A requirement for such training/briefing is there. z Secretariat of the WHO ERC is the appropriate unit to address the issue of research supported by WCOs. TITLE from VIEW and SLIDE MASTER | 30 July, 201030 | Harmonization of ethics review at the Regional Offices z WPRO – Terms of Reference finalised. SOPs drafted. Committee being established. z AFRO – ERC constituted, initial discussions completed, SOPs are ready – needs RD approval z AMRO – ERC functional, meeting regularly. SOPs have been finalised z EMRO – Committee re-established, SOPs finalised. Waiting to hold their first meeting z EURO – Discussions ongoing on the structure and relationship with WHO ERC z SEARO – No ERC at Regional Office. Research Review Committee, and designated local ethics committees Regional Offices, Country Offices TITLE from VIEW and SLIDE MASTER | 30 July, 201031 | Normative Functions WHO related z Harmonization of guidelines – ERC, SERG, ETH Working Group z Harmonization of ethics review across WHO – strongly supported by DG – SERG – Scientific and Ethical Review Group for HRP – Regional Offices Norms & Standards TITLE from VIEW and SLIDE MASTER | 30 July, 201032 | z Ministerial Forum at Algiers and Bamako – Plenary and parallel sessions on research ethics – Develop strong governance structures for strengthening research ethics at country level. – Establish and promote transparency and accountability z Develop Norms and Standards in research ethics – Internally – Good Research Practices, Code of conduct – Globally – Develop norms and standards for accreditation of Ethics committees – Development of Training Tools – audience, course content, interactive CD or web-based (ERC pilot) Expert Advisory Panel on Guidelines, Research Methods and Ethics (GRME) Normative Functions – Global level Norms & Standards TITLE from VIEW and SLIDE MASTER | 30 July, 201033 | Capacity Building TITLE from VIEW and SLIDE MASTER | 30 July, 201034 | Accreditation z No global norms and standards exist z Several countries (Brazil, S. Africa, USA, UK) following their own system – not a universal phenomenon. z FERCAP – a network of ethics committees in the Asia- Pacific region, supported by TDR, but independent of it. Has initiated a recognition programme. Not a WHO recognition. z Expert Committee on accreditation 2009? TITLE from VIEW and SLIDE MASTER | 30 July, 201035 | Standards – good research practice Working with Member States and partners: • Systematic method for selecting, developing, implementing and evaluating new standards • 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. TITLE from VIEW and SLIDE MASTER | 30 July, 201036 | ICTRP Timelines z September 2008 Meeting of Working Group on Best Practice for Clinical Trials Registration met in Geneva. Nine registries worked on minimum standards for key registration procedures. z October 2008 Primary registries announced in Germany and Japan z October 2008 revision of the Declaration of Helsinki z November 2008The Bamako Call to Action called on national governments to "To develop, set, and enforce standards, regulations, and best practices for fair, accountable, and transparent research processes", including "the registration and results reporting of clinical trials". z December 2008 Primary registry announced in Iran z December 2008 Bridging introduced to ICTRP search portal (links multiple records on the same trial together) z December 2008 Data from the registries in China, India, Germany and the Netherlands added to the ICTRP search portal TITLE from VIEW and SLIDE MASTER | 30 July, 201037 | z WHO Primary Registries meet specific criteria for content, quality and validity, accessibility, unique identification, technical capacity and administration. WHO Primary Registries meet the requirements of the ICMJE. z The WHO Primary Registries are: – Australian and New Zealand Clinical Trials Registry (ANZCTR) – Chinese Clinical Trial Register (ChiCTR) – German Clinical Trials Register (DRKS) – Iranian Registry of Clinical Trials (IRCT) – ISRCTN – Japan Primary Registries Network – The Netherlands National Trial Register (NTR) – Sri Lanka Clinical Trials Registry (SLCTR) TITLE from VIEW and SLIDE MASTER | 30 July, 201038 | Status of the ICTRP web site z The general ICTRP web site has around 6000 visitors, and 30000 hits, per month (an average of 4.9 hits per session). z We are in the process of translating the site into all official languages and hope this will be complete by the 3rd quarter of 2009. TITLE from VIEW and SLIDE MASTER | 30 July, 201039 | ICTRP SEARO z Primary registries in SEARO are: – Sri Lanka Clinical Trials Registry (SLCTR) • 36 trials on ICTRP Search Portal – Clinical Trials Registry - India (CTRI) • 239 trials on ICTRP Search Portal New regulations by the Drug Controller General of India making the registration of clinical trials mandatory. TITLE from VIEW and SLIDE MASTER | 30 July, 201040 | 0 200 400 600 800 1000 1200 1400 Bangladesh Bhutan Democratic People's Republic of Korea Democratic Republic of Timor-Leste India Indonesia Maldives My anmar Nepal Sri Lanka Thailand Registered trials not recruiting 52 0 1 0 805 67 0 3 21 32 386 Registered trials recruiting 24 0 2 0 506 36 0 1 8 26 200 Banglad esh Bhutan Democra tic People's Democra tic Republic India Indonesi a Maldives Myanmar Nepal Sri Lanka Thailand Number of trials on the ICTRP Search Portal for SEARO countries (17th July 2009) TITLE from VIEW and SLIDE MASTER | 30 July, 201041 | Translation – evidence into practice Working with Member States and partners: •Promote translation activities for evidence informed decision making •Promote effective technology transfer models •Creation of and compliance with international standards on health informatics for research •Promote greater access to research results; •Develop and articulate a WHO position on open access to research outputs. TITLE from VIEW and SLIDE MASTER | 30 July, 201042 | TITLE from VIEW and SLIDE MASTER | 30 July, 201043 | Ministerial Summit on Health Research, Mexico City, November 2004 Ministers of Health urge WHO to develop and support mechanism to bridge knowledge to practice MALAYSIA pioneer September 2004 TITLE from VIEW and SLIDE MASTER | 30 July, 201044 | 58 th World Health Assembly, Geneva, May 2005 Urges Member States TITLE from VIEW and SLIDE MASTER | 30 July, 201045 | Bamako Global Ministerial Forum on Research for Health - TRANSLATION TITLE from VIEW and SLIDE MASTER | 30 July, 201046 | "All countries need to step up efforts to increase investment in health research(...). At the same time, full use should be made of scientific evidence, and we should also work to bridge gaps between decision- making and scientific research." Chen Zhu, Minister of Health, People's Republic of China TITLE from VIEW and SLIDE MASTER | 30 July, 201047 | “If you are poor, actually you need more evidence before you invest, rather than if you are rich.” TITLE from VIEW and SLIDE MASTER | 30 July, 201048 | WHO Core function R e s e a r c h P r o b l em s To help bridge the Know-Do Gap in Global Health! K n o w l e d g e TITLE from VIEW and SLIDE MASTER | 30 July, 201049 | How to better use research results? What mechanisms, tools, methodologies, processes… * Empowerment: promoting the sustainable development of individual and institutional capacity TITLE from VIEW and SLIDE MASTER | 30 July, 201050 | What is EVIPNet: z Social network to support the advancement of knowledge and practice in evidence to policy links (global, regional, national know-how) z Country focused, sustainable mechanism inserted in the policy-making and implementation pathway z Regional and Global scale TITLE from VIEW and SLIDE MASTER | 30 July, 201051 | "EVIPNet 101." HOW TO START: Fundamental building blocks needed to establish sustainable "knowledge translation platforms" in Low and Middle Income Countries TITLE from VIEW and SLIDE MASTER | 30 July, 201052 | EVIPNet BUILDING BLOCKS Country teams and regional and global support structures Research synthesis & Policy briefs Capacity development & empowerment Country dialogues (safe harbor) Monitoring and evaluation - Development of new methodologies TITLE from VIEW and SLIDE MASTER | 30 July, 201053 | How does EVIPNet work? z Country teams and regional and global support structures TITLE from VIEW and SLIDE MASTER | 30 July, 201054 | How does EVIPNet work? z Country teams and regional and global support structures z Research synthesis and Policy briefs – 1:3:25 pages format TITLE from VIEW and SLIDE MASTER | 30 July, 201055 | How does EVIPNet work? z Priority setting z Country dialogues (Sudan Policy Forum, Dr.Mekki Kanani) z Capacity and skills development z Monitoring and evaluation z Development and refinement of methodologies TITLE from VIEW and SLIDE MASTER | 30 July, 201056 | EXAMPLE: 1st EVIPNet Policy Brief Workshop - Addis Ababa, February 2008 - z 8 policymakers and 7 researchers from 9 countries z Learning by doing, producing, and evaluating together to better work together TITLE from VIEW and SLIDE MASTER | 30 July, 201057 | Challenges: …in the making of z How to include "civil society" (who?) z Commit policy makers; decision makers (not post facto; not to do research) z Challenges of doing this in LMICs : need to tailor make - One size does not fit all. z How to harness "front line" experience, tacit knowledge (Country dialogues?) TITLE from VIEW and SLIDE MASTER | 30 July, 201058 | EVIPNet Portal www.evipnet.org Internet Interactive Public Portal Intranet Private Collaborative Space TITLE from VIEW and SLIDE MASTER | 30 July, 201059 | z From global evidence to local application-"Going the other half": helping to contextualize WHO Guidelines z All evidence is context specific Challenges: TITLE from VIEW and SLIDE MASTER | 30 July, 201060 | z EVIPNet consists of linked but distinct country based and regional networks z EVIPNet Africa (launched in 2006) member countries- Burkina Faso, Cameroon, Central African Republic, Ethiopia, Mali, Mozambique, Zambia and Regional East Africa Community- REACH (Tanzania, Uganda, Kenya, Rwanda and Burundi) z EVIPNet Asia (launched in 2005) member countries- China, Lao PDR, Malaysia, Philippines, Vietnam TITLE from VIEW and SLIDE MASTER | 30 July, 201061 | z EVIPNet Americas (launched in 2007) member countries- Bolivia, Brazil, Chile, Colombia, Costa Rica, Mexico, Mexico-US Border PAHO field office, Paraguay, Puerto Rico, Trinidad & Tobago z EVIPNet Eastern Mediterranean (launched in 2009 with first regional meeting) potential member countries- Egypt, Iran, Jordan, Libya, Lebanon, Morocco, Oman, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, Yemen TITLE from VIEW and SLIDE MASTER | 30 July, 201062 | Structure of EVIPNet z EVIPNet is supported by the WHO regional offices and by small regional secretariats responsible for promoting regional coordination z The WHO Research Translation unit serves as the global secretariat of EVIPNet and is situated within WHO HQ in the Department of Research, Policy and Coordination TITLE from VIEW and SLIDE MASTER | 30 July, 201063 | z EVIPNet global steering group follows up, coordinates and supports global level activities (e.g. fundraising, advocacy, overall strategy development) z A regional steering group is also present in each EVIPNet region z A Global resource group composed of international experts in evidence- to- policy and knowledge translation (KT) provides strategic guidance to EVIPNet, including direct technical support to country teams TITLE from VIEW and SLIDE MASTER | 30 July, 201064 | What is New? z Regional Research Ethics Workshop - 2009 z Cochrane Collaboration z Research Management Workshop for Bhutan, Maldives and Timor-Leste – 2010 z World Health Report 2012 – "Research for Health"
WHO Strategy on Research for Health Review of RPC's Contribution to Global Work on the Research Strategy Dr. Abha Saxena On behalf of the Department of Research Policy & Cooperation IER/WHO/HQ Thirty-first session of WHO-SEA Advisory Committee on Health Research Kathmandu, Nepal 21 st -23 rd July 2009 TITLE from VIEW and SLIDE MASTER | 30 July, 20102 | Sustained Global interest 1990: Commission on Health Research for Development 1996: Ad Hoc Committee on Health Research Relating to Future Intervention Options 2000: International Conference on Health Research for Development (Bangkok) 2004: Ministerial Summit on Health Research (Mexico) 2008: Bamako Ministerial Forum on Research for Health TITLE from VIEW and SLIDE MASTER | 30 July, 20103 | Complex array of initiatives Member States looking to WHO for guidance and leadership TITLE from VIEW and SLIDE MASTER | 30 July, 20104 | Mandate Resolution WHA60.15 at 60th World Health Assembly requesting the DG… "to submit to the Sixty-Second World Health Assembly (2009) a strategy on the management and organization of research activities within WHO" TITLE from VIEW and SLIDE MASTER | 30 July, 20105 | WHO Strategy on Research for Healthon Research for Health WHO’s role in research….. and the role of research in WHO… z Recognizes research as central to progress in global health z Identifies 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. TITLE from VIEW and SLIDE MASTER | 30 July, 20106 | Evaluation Framework Implementation Planning INPUTS Rolling Dialogue: Virtual & Face-to-Face Emergent Themes Emergent Themes Working drafts IGWG Public health and innovation Regional offices Special Programmes, HQ CCs Executive Board Jan 09 EB124/4.9 Strategy development - a participatory process WHO Research Strategy – WHA 2010 100 Stakeholder Interviews Online & Face to face workshops Strategy+ annexes Advisory Committee on Health Research External & Internal Reference Groups TITLE from VIEW and SLIDE MASTER | 30 July, 20107 | Principles Quality - high-quality research that is ethical, expertly reviewed, efficient, effective, accessible to all, and carefully monitored and evaluated. Impact - priority for research with greatest potential to improve global health security, health-related development, redress health inequities and attain MDGs Inclusiveness - work in partnership, Member States and stakeholders, multisectoral approach, support and promote the participation of communities and civil society in the research process. TITLE from VIEW and SLIDE MASTER | 30 July, 20108 | Working with Member States and partners: • Promote translation activities for evidence informed decision making • Promote effective technology transfer models • Creation of and compliance with international standards on health informatics for research • Promote greater access to research results; • Develop and articulate a WHO position on open access to research outputs. Working with Member States and partners: Advocacy Convene high-level consultations to identify and build consensus around priorities Synthesize data on gaps in research challenges at national and global levels Report on global research priorities and alignment of resources with research agendas Develop comprehensive research agendas for specific priority areas and develop resource-mobilization plans for such research agendas; WHO - establish mechanisms for reviewing the portfolio of research agendas, decision criteria for initiation, course corrections and exit strategies of programmes. Working with Member States and partners: • Technical assistance, tools and guidelines • Comprehensive health information systems to inform national research priorities • Standardized indicators to enable self- reporting • Institutional capacity, regional and global networks, WHO Collaborating Centres, to report and share good practice; • WHO - maximize the impact of research capacity-strengthening efforts through improved alignment research programmes and activities Working with Member States and partners:Working th Member States and partner • Systematic method for selecting, developing, implementing and evaluating new standards • 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. TITLE from VIEW and SLIDE MASTER | 30 July, 20109 | Organization – strengthen the research culture • Establish governance structures to lead, manage, coordinate and maintain accountability for research within WHO; • Develop and implement a WHO Code of Good Research Practice; • Enhance professional staff competencies; • Improve access to WHO-affiliated research by developing a publicly accessible repository; • Review and improve performance in research partnerships • Improve communications on the Organization’s involvement in research, • Monitor and evaluate this strategy. TITLE from VIEW and SLIDE MASTER | 30 July, 201010 | Research overview - methods zDesigned questionnaire with departments 35 at HQ + Kobe and IARC zQuestionnaire completed for 2006/07, supplemented by annual reports and web information zSigned off by Director zMapped approximately to WHO clusters. zLimits: self reporting, what is research?, incomplete figures, no 'database' or GSM record for research. TITLE from VIEW and SLIDE MASTER | 30 July, 201011 | Definitions z Health Research - the development of knowledge with the aim of understanding health challenges and mounting an improved response to them. z Full spectrum of research: – measuring the problem; – understanding causes; – elaborating solutions; – translating the solutions or evidence into policy, practice and products; and – evaluating the effectiveness of solutions. z Secondary research is research that uses existing data through analysis and/or synthesis z Primary research is activity that generates new - primary - data. TITLE from VIEW and SLIDE MASTER | 30 July, 201012 | WHO Health Research Staff (n=37) and Expenditure $US 2006/07 (n=34) By Research Areas Research Area Total staff Research staff Staff % of total research staff Research Expenditure % research spend Information Evidence and Research 136 26 110 5% 2,947,012 1% Health Action in Crises 32 13 19 2% 5,700,000 3% Health Systems and Services 180 66 114 12% 8,418,800 4% Health Security and Environment 166 70 96 13% 8,860,000 4% Noncommunicable Diseases and Mental Health 174 54 120 10% 10,130,000 5% HIV/AIDS, TB, Malaria & NTDs 225 71 154 13% 16,250,000 8% TDR 43 38 5 7% 44,600,000 21% Family and Community Health 242 109 133 20% 66,698,891 31% International Agency for Research on Cancer 115 102 13 19% 51,400,000 24% WHO ( *NB % of total staff that are research staff) 1313 549 764 42%* 215,004,703 100% TITLE from VIEW and SLIDE MASTER | 30 July, 201013 | WHO Health Research Expenditure $USD millions 2006/07 n=34 2.95 5.70 8.42 8.86 10.13 16.2544.60 51.40 66.70 Information Evidence and Research Health Action in Crises Health Systems and Services Health Security and Environment Noncommunicable Diseases and Mental Health HIV/AIDS, TB, Malaria & NTDs TDR International Agency for Research on Cancer Family and Community Health TITLE from VIEW and SLIDE MASTER | 30 July, 201014 | Source of research funds utilized by WHO 2006/07 n=37 21% 40% 5% 7% 27% WHO, UN Agency or International Funding Initiatives Government Funding Agencies Academic Sources e.g. University Inst Private Sources e.g. industry and pharma NGOs, Foundations & Charities TITLE from VIEW and SLIDE MASTER | 30 July, 201015 | RESEARCH FUNDING DISTRIBUTED BY WHO (n=35) Scale: (0-33) Low Involvement (34-66) Some Involvement (67-100) Strong Involvement 0 15 30 45 60 Contract Research Research Grants (calls for proposals) Funding for Institutions & Programmes Fellowships & Awards (individuals) TITLE from VIEW and SLIDE MASTER | 30 July, 201016 | Strategic spread of WHO research activities at an organizational level (n=35) Scale: (0-33) Low involvement (34 -66) Some involvement (67 - 100) Strong involvement 0 20 40 60 80 100 Basic Science Research Clinical Research Population Based Research Health Services/ Systems Research Policy & Advocacy Research TITLE from VIEW and SLIDE MASTER | 30 July, 201017 | 10 20 30 40 50 60 70 80 90 100 C O M M I S S I O N R E S E A R C H WHO Research: Conduct/Commission: Primary/ Secondary* $66.7mFamily & Community Health $2.9mInformation Evidence & Research $5.7mHealth Action in Crises Health Systems & Services $8.4m $8.9mHealth Security & Environment $16.3mHIV/AIDS, TB, Malaria & NTDs $10.1mNoncommunicable Diseases & Mental Health TDR $44.6m Primary Research Secondary Research % 100 90 80 70 60 50 40 30 20 10 % C O N D U C T R E S E A R C H Figures represent research spend 2006/07 USD$ million $215mWHO summary *IARC excluded TITLE from VIEW and SLIDE MASTER | 30 July, 201018 | KEY TO COLOURS (SPEND USD$ million 06/07): Information Evidence & Research (3) Health Action in Crises (6) Noncommunicable Diseases & Mental Health (10) Family & Community Health (67) Health Systems & Services (8) Health Security & Environment (9) HIV/AIDS, TB, Malaria & NTDs (16) IARC (51) TDR (45) Research at WHO – HQ 2006/07 SECONDARY RESEARCH PRIMARY RESEARCH CONDUCTED OR MANAGED BY WHO COMMISSION ED BY WHO The size of each circle is relative to the research expenditure in 2006/7 USD$ million for the areas listed below Note: a circle in the centre represents an equal distribution of activity TITLE from VIEW and SLIDE MASTER | 30 July, 201019 | RESEARCH STRATEGY Research Policy and Cooperation ICTRP and GRC Secretariat of the ERC EVIPNET TITLE from VIEW and SLIDE MASTER | 30 July, 201020 | Capacity Building, Norms & Standards Regional Offices, Country Offices Technical Units Research Ethics Review Committee ERC Guidance, Templates, Checklists ERC Secretariat TITLE from VIEW and SLIDE MASTER | 30 July, 201021 | The WHO Research Ethics Review Committee z 26 member ERC, established by the Director-General z 16 WHO Staff, 10 external members z 1 Chair, 2 vice-Chairs z 11 women, 15 men z 11 members from developed countries, and 15 from developing countries Research Ethics Review Committee ERC 143 175 121 96 115 24 17 39 13 17 0 50 10 0 15 0 200 250 2004 2005 2006 2007 2008 Years Tot a l num be r of pr opos a l s s ubm i t t e d Proposals reviewed Proposals not reviewed* TITLE from VIEW and SLIDE MASTER | 30 July, 201022 | TITLE from VIEW and SLIDE MASTER | 30 July, 201023 | Harmonization of ethics review at the Regional Offices z WPRO – Terms of Reference finalised. SOPs drafted. Committee being established. z AFRO – ERC constituted, initial discussions completed, SOPs are ready – needs RD approval z AMRO – ERC functional, meeting regularly. SOPs have been finalised z EMRO – Committee re-established, SOPs finalised. Waiting to hold their first meeting z EURO – Discussions ongoing on the structure and relationship with WHO ERC z SEARO – No ERC at Regional Office. Research Review Committee, and designated some ethics committees to provide the ethics review Regional Offices, Country Offices TITLE from VIEW and SLIDE MASTER | 30 July, 201024 | Normative Functions – Global level Ministerial Forum at Algiers and Bamako – Develop strong governance structures for strengthening research ethics at country level. – Establish and promote transparency and accountability z Develop Norms and Standards in research ethics – Internally – Good Research Practices, Code of conduct – Globally – Develop norms and standards for accreditation of Ethics committees – Development of Training Tools – audience, course content, interactive CD or web-based (ERC pilot) Expert Advisory Panel on Guidelines, Research Methods and Ethics (GRME) Norms & Standards TITLE from VIEW and SLIDE MASTER | 30 July, 201025 | Accreditation z No global norms and standards exist z Several countries (Brazil, S. Africa, USA, UK) following their own system – not a universal phenomenon. z FERCAP – a network of ethics committees in the Asia- Pacific region, supported by TDR, but independent of it. Has initiated a recognition programme. Not a WHO recognition. z Expert Committee on accreditation 2009? TITLE from VIEW and SLIDE MASTER | 30 July, 201026 | Standards – good research practice Working with Member States and partners: •Systematic method for selecting, developing, implementing and evaluating new standards •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. TITLE from VIEW and SLIDE MASTER | 30 July, 201027 | ICTRP Timelines z September 2008 Meeting of Working Group on Best Practice for Clinical Trials Registration met in Geneva. Nine registries worked on minimum standards for key registration procedures. z October 2008 Primary registries announced in Germany and Japan z October 2008 revision of the Declaration of Helsinki z November 2008 The Bamako Call to Action called on national governments to "To develop, set, and enforce standards, regulations, and best practices for fair, accountable, and transparent research processes", including "the registration and results reporting of clinical trials". z December 2008 Primary registry announced in Iran z December 2008 Bridging introduced to ICTRP search portal (links multiple records on the same trial together) z December 2008 Data from the registries in China, India, Germany and the Netherlands added to the ICTRP search portal TITLE from VIEW and SLIDE MASTER | 30 July, 201028 | z WHO Primary Registries meet specific criteria for content, quality and validity, accessibility, unique identification, technical capacity and administration. WHO Primary Registries meet the requirements of the ICMJE. z The WHO Primary Registries are: – Australian and New Zealand Clinical Trials Registry (ANZCTR) – Chinese Clinical Trial Register (ChiCTR) – German Clinical Trials Register (DRKS) – Iranian Registry of Clinical Trials (IRCT) – ISRCTN – Japan Primary Registries Network – The Netherlands National Trial Register (NTR) – Sri Lanka Clinical Trials Registry (SLCTR) TITLE from VIEW and SLIDE MASTER | 30 July, 201029 | Status of the ICTRP web site z The general ICTRP web site has around 6000 visitors, and 30000 hits, per month (an average of 4.9 hits per session). z In the process of translating the site into all official languages and hope this will be complete by the 3rd quarter of 2009. TITLE from VIEW and SLIDE MASTER | 30 July, 201030 | ICTRP SEARO z Primary registries in SEARO are: – Sri Lanka Clinical Trials Registry (SLCTR) • 36 trials on ICTRP Search Portal – Clinical Trials Registry - India (CTRI) • 239 trials on ICTRP Search Portal New regulations by the Drug Controller General of India making the registration of clinical trials mandatory. TITLE from VIEW and SLIDE MASTER | 30 July, 201031 | 0 200 400 600 800 1000 1200 1400 Bangladesh Bhutan Democratic People's Republic of Korea Democratic Republic of Timor-Leste India Indonesia Maldives My anmar Nepal Sri Lanka Thailand Registered trials not recruiting 52 0 1 0 805 67 0 3 21 32 386 Registered trials recruiting 24 0 2 0 506 36 0 1 8 26 200 Banglad esh Bhutan Democra tic People's Democra tic Republic India Indonesi a Maldives Myanmar Nepal Sri Lanka Thailand Number of trials on the ICTRP Search Portal for SEARO countries (17th July 2009) TITLE from VIEW and SLIDE MASTER | 30 July, 201032 | Translation – evidence into practice Working with Member States and partners: •Promote translation activities for evidence informed decision making •Promote effective technology transfer models •Creation of and compliance with international standards on health informatics for research •Promote greater access to research results; •Develop and articulate a WHO position on open access to research outputs. TITLE from VIEW and SLIDE MASTER | 30 July, 201033 | TITLE from VIEW and SLIDE MASTER | 30 July, 201034 | Ministerial Summit Mexico City 2004 Ministers of Health urge WHO to develop and support mechanism to bridge knowledge to practice 58 th WHA Geneva, May 2005 Bamako Global Ministerial Forum on Research for Health TITLE from VIEW and SLIDE MASTER | 30 July, 201035 | "All countries need to step up efforts to increase investment in health research(...). At the same time, full use should be made of scientific evidence, and we should also work to bridge gaps between decision- making and scientific research." Chen Zhu, Minister of Health, People's Republic of China TITLE from VIEW and SLIDE MASTER | 30 July, 201036 | What is EVIPNet: z Social network to support the advancement of knowledge and practice in evidence to policy links (global, regional, national know-how) z Country focused, sustainable mechanism inserted in the policy-making and implementation pathway z Regional and Global scale TITLE from VIEW and SLIDE MASTER | 30 July, 201037 | "EVIPNet 101." HOW TO START: Fundamental building blocks needed to establish sustainable "knowledge translation platforms" in Low and Middle Income Countries TITLE from VIEW and SLIDE MASTER | 30 July, 201038 | EVIPNet BUILDING BLOCKS Country teams and regional and global support structures Research synthesis & Policy briefs Capacity development & empowerment Country dialogues (safe harbor) Monitoring and evaluation - Development of new methodologies TITLE from VIEW and SLIDE MASTER | 30 July, 201039 | EVIPNet Portal www.evipnet.org Internet Interactive Public Portal Intranet Private Collaborative Space TITLE from VIEW and SLIDE MASTER | 30 July, 201040 | Challenges: …in the making of z How to include "civil society" (who?) z Commit policy makers; decision makers (not post facto; not to do research) z Challenges of doing this in LMICs : need to tailor make - One size does not fit all. z How to harness "front line" experience, tacit knowledge (Country dialogues?) TITLE from VIEW and SLIDE MASTER | 30 July, 201041 | z EVIPNet consists of linked but distinct country based and regional networks z EVIPNet Africa (launched in 2006) member countries- Burkina Faso, Cameroon, Central African Republic, Ethiopia, Mali, Mozambique, Zambia and Regional East Africa Community- REACH (Tanzania, Uganda, Kenya, Rwanda and Burundi) z EVIPNet Asia (launched in 2005) member countries- China, Lao PDR, Malaysia, Philippines, Vietnam TITLE from VIEW and SLIDE MASTER | 30 July, 201042 | z EVIPNet Americas (launched in 2007) member countries- Bolivia, Brazil, Chile, Colombia, Costa Rica, Mexico, Mexico-US Border PAHO field office, Paraguay, Puerto Rico, Trinidad & Tobago z EVIPNet Eastern Mediterranean (launched in 2009 with first regional meeting) potential member countries- Egypt, Iran, Jordan, Libya, Lebanon, Morocco, Oman, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, Yemen TITLE from VIEW and SLIDE MASTER | 30 July, 201043 | Structure of EVIPNet z EVIPNet is supported by the WHO regional offices and by small regional secretariats responsible for promoting regional coordination z The WHO Research Translation unit serves as the global secretariat of EVIPNet and is situated within WHO HQ in the Department of Research, Policy and Coordination TITLE from VIEW and SLIDE MASTER | 30 July, 201044 | What is New? z Regional Research Ethics Workshop - 2009 z Cochrane Collaboration z Research Management Workshop for Bhutan, Maldives and Timor-Leste – 2010 z World Health Report 2012 – "Research for Health"
Thirty-first session of WHO South-East Asia Advisory Committee on Health Research Kathmandu, Nepal, 21-23 July 2009 SEA/ACHR/31/10 18 July 2009 Agenda Item 3.3.1 REVIEW OF GLOBAL WORK OF WHO ON HEALTH RESEARCH: REVIEW OF GLOBAL WORK AND UPDATE WHO STRATEGY ON RESEARCH FOR HEALTH CONTENTS 1. Global ACHR: ...........................................................................................2 2. Research for health strategy.....................................................................3 3. ICTRP.......................................................................................................4 4. ERC ..........................................................................................................5 5. EVIPNET ..................................................................................................6 REVIEW OF GLOBAL WORK OF WHO ON HEALTH RESEARCH: REVIEW OF RPC'S CONTRIBUTION TO GLOBAL WORK OF WHO ON HEALTH RESEARCH WHO from its inception has focused on research, which is mandated in its constitution, and has been a leading player in the global effort to strengthen ties between research and health development. The Department of Research Policy and Cooperation (RPC) works to strengthen the informational, scientific and ethical foundations of health research. It aims to contribute to health systems development and to health improvement, particularly in the world's poorer countries. The Department does this through promoting: Research Policy and Standards: this includes coordinating the development and implementation of the WHO strategy on research for health • Research quality and transparency: this includes the International Clinical Trials Registry Platform, the Guidelines Review Committee and the Ethics Review Committee • Research Translation and Utilization: this includes the EVIPNet Programme The Department is also the secretariat for the Advisory Committee on Health Research - The role of which is to provide the Director-General with the scientific advice in relation to WHO's research programme. A discussion of the work of the various teams within RPC is given below, under the following headings: 1 How is their work and activity relevant to SEARO, any research capacity strengthening or relevant activities that are being carried out by RPC HQ for the benefit of member countries, different types of future collaborative activities that may be available to the Member Countries and what are some of the resources/resource base that can be tapped by the Member Countries for improving the research management practices? 1. Global ACHR 1 : The Global ACHR takes into account regional perspectives in its work, through: (i) Inclusion of experts representing various regions (ii) Inviting the Chairs of the Regional ACHR to the Global ACHR meetings. The Chairs of the Global ACHRs in addition to providing a feedback on the activities that the Regional ACHR is supporting, also have opportunities to contribute to the work of the Global ACHR. It is to be noted that the role of the ACHR is advisory and it does not formally endorse particular documents and reports, nor does it have its own activities. Some examples of how the global ACHR discussions are relevant to the Regions are illustrated in the examples below, taken from the draft minutes of the last ACHR meeting: • The regional ACHR Chairs focused on (along with the global ACHR) how to increase harmonization and coherence among the regions. In this context, the SEARO ACHR Chair reviewed a number of strategic initiatives being led or supported by the SEARO ACHR, such as the development of 1 The terms of reference of the global ACHR are to advise the Director-General on the general orientation of WHO's research; to advise on the formulation of global priorities for health research in the light of the policies set by the World Health Assembly and the Executive Board and on the basis of regional priorities evolved in response to the health problems of the countries; to review research activities, monitor their execution and evaluate their results, from the standpoint of scientific and technical policy; to formulate ethical criteria applicable to these research activities; to take a prominent part in the harmonization of WHO's research efforts as between the country, regional and interregional levels, and in their effective global synthesis; 2 a plan of action to address re-emerging infectious diseases. He emphasized that the SEARO ACHR is very committed to working collaboratively with the ACHRs in EMRO and WPRO given similarities in their contexts and in the challenges they face. • During discussions on enhancing cooperation with the Cochrane Collaboration, it was agreed that WHO will use the Cochrane Collaboration, which has the capacity to conduct training programs on the development and use of systematic reviews to run training programs in relation to strategies designed for improving quality of care, particularly in low- and middle-income countries. • Discussion on the role of WHO collaborating centres - the role of WHO CCs was clarified (yet again). The priorities for 2009 are aligning work plans with WHO programme’s needs; reducing further the number of ‘pending’ centres; and 3) supporting network activities. 2. Research for health strategy The World Health Assembly, in 2007, adopted resolution WHA60.15, in which the Director-General was requested to submit to the Sixty-second World Health Assembly a strategy for the management and organization of research activities within WHO, and to convene a ministerial conference on health research in Bamako, in November 2008. The WHO strategy on research for health has been presented to the 124th WHO Executive Board and was approved on 26 January 2009 (See Annex 1 for a pictorial representation of the Strategy). It was due to be discussed at the World Health Assembly in May 2009. However, due to the outbreak of influenza A (H1N1) the agenda was shortened and this item was postponed and will be on the agenda for the Health Assembly in May 2010. The paper focuses on the management and organization of research activities within WHO and on support provided to countries in organizing health research when required. • The regional offices of PAHO, AFRO and EMRO have all taken the 'global' document and are using it to frame the creation of regional 3 research for health strategies. RPC can provide assistance and advice to SEARO in the design and undertaking of this work. • SEARO and RPC are planning a basic research capacity building workshop in the first part of 2010 for 3 member states in the region which have little/no research capacity (Bhutan, Maldives, Timor- Leste).(outcome of an "Intercountry Workshop for Research Management" held in Bali, Indonesia in June, 2008 organized by SEARO). • Research for Health is the topic for the World Health Report for 2012 - this is a great opportunity to highlight the successes and the challenges from each region. The development of a regional strategy for research will provide a good basis for advocacy and the mobilization of resources in the region. Regional strategies might look at the development and strengthening of research and innovation networks and the creation of regional critical research mass where capacity in individual member states is low. 3. ICTRP The mission of the WHO International Clinical Trials Registry Platform is to ensure that a complete view of research is accessible to all those involved in health care decision making. This will improve research transparency and will ultimately strengthen the validity and value of the scientific evidence base. • The WHO Registry Network provides prospective trial registries with a forum to exchange information and work together to establish best practice for clinical trial registration. Administrators of seven registries in the WHO Registry Network make up the Working Group on Best Practice. Sri Lanka and India from SEARO are members of this group. • ICTRP launched a website - Clinical trials in children. The aim of the site is to improve awareness and make it easier to access accurate, up to date, understandable information relevant to the conduct of clinical trials in 4 children. The content will evolve over time in response to the feedback received from visitors to the site. • ICTRP is advised by the Scientific Advisory Group, and an International Advisory Group, both of which have members from one SEARO country. 4. ERC The WHO Research Ethics Committee (ERC) is a Committee established by the Director-General to provide review and approval of all research projects supported by WHO. The work of the Committee is supported by a secretariat, which is situated within RPC. In addition, the secretariat has been tasked with capacity strengthening within the Organization and at the country level, with harmonization of ethics review procedures across the Organization, and with establishing norms and standards. • Harmonization: One of the challenge facing WHO is the lack of harmonized ethics review procedures across the Organization. The varying quality of ethics review provided by national/local ethics committees, and the varying roles and responsibilities of National Ethics Committees means that WHO cannot rely on them for providing a review of the research supported by it. Harmonization of procedures at WPRO, AMRO, AFRO are on-going - all of which regions are in the process of establishing their own ethics committees. There is an opportunity to work with SEARO as well. What is less clear is how to deal with research supported by WHO Country Offices, and more work needs to be done on that aspect. • Capacity strengthening - a regional workshop for national research ethics committees is planned for October 2009. We are also in the process of developing training tools for building capacity in research ethics, and you have bmfore you two of the recent products. 2 2 Casebook on Ethical Issues in Health Research (in print); Research ethics committees: basic concepts for capacity-building (published by ETH) 5 • Establishing Norms and Standards: Experts from different regions including from SEARO (with the help of SEARO office) have been identified to be part of a WHO panel of experts on Guidelines, Research Methods, and Ethics (GRME). In 2009, it is hoped that the first meeting will be held at HQ, at which issues related to Norms and Standards for ethics committees will be discussed. 5. EVIPNET Policy and decision making in public health can be a risky undertaking, as health policies developed and implemented by governments affect large populations. Studies have shown that policies influenced by sound scientific evidence and best practices can significantly improve the achievement of positive public health outcomes. 3 When it comes to low- and middle-income countries (LOICs), the stakes are even higher. Several prominent health ministries have stated that if they ignore evidence on the root cause of problems or what works best to address these problems, they risk wasting those precious resources and falling short of improving the health situation of populations. This has sharp consequences particularly for the poorest. Thus, "if you are poor, actually you need more evidence before you invest, rather than if you are rich.” 4 • The Evidence-Informed Policy Network (EVIPNet) is a WHO initiative that promotes systematic use of evidence in policy-making in low-and-middle- income (LMICs). It originated from a demand by policymakers to improve the use of research results in policymaking 5 • EVIPNet works to strengthen the capacity of a total of 30 country teams in four regions (AFRO, AMRO, EMRO, WPRO). These regions have taken 3 See, among others, Lavis JN, Posada FB, Haines A, Osei E. “Use of research to inform public policymaking”. Lancet 2004; 364:1615-20. 4 Hassan Mshnda video documentary of REACH at http://uk.youtube.com/watch?v=nqnYEvtmdQc. 5 EVIPNET had its origins during the discussions at the 2004 Mexican Summit on Health Research on how to bridge the "know-do-gap," received a mandate by the 2005 World Health Assembly for WHO to assist in the development of more effective mechanisms to bridge this divide, and has the leadership of the WHO ACHR Sub-committee on Research Use (ACHR-SURE), which advises WHO on how to develop innovative methodologies for research translation to policy that are specific for LMICs 6 the initiative of selecting countries that will help test EVIPNet methodologies, tools, and processes for a five-year period. • The country teams are composed of both policymakers and researchers appointed by the Minister of Health of their respective countries. Country teams join a regional and a global network to help share best practices and experiences. However, each country team uses high quality research evidence to develop policies according to their own context (e.g. according to human and financial resources, state of health systems, legislation, cultural values). • In SEARO, Thailand and India are countries with a large experience in Knowledge Translation 6 (KT) applied to health systems. Their experience in KT would be of great help to countries in other regions as well. • EVIPNet can help SEARO to (a) identify best KT practices in the region; (b) establish country level KT mechanisms and strengthen existing capacities; (c) help to produce Policy Options Briefs 7 informed by research evidence; and (d) promote country policy dialogues with the participation of policymakers, researchers and other stakeholders to better adjust and validate the policy options briefs to the specific needs of the country. • An example of how EVIPNet works is the EVIPNet Policy Brief Workshop that took place in Addis Ababa 2008, with 8 policymakers and 7 researchers from 7 Sub-Saharan countries. 6 Research to policy practices, methodologies and mechanisms are also known as Knowledge Translation (KT) 7 Policy briefs are user-friendly documents presented in different formats, according to the needs of policymakers to respond to country priorities 7 Annex 1 O:\EIP\RPC\ACHR\31 ACHR\ Final documents\SEA-ACHR-31-10_review of global work on health research_10 July 09 at 1100 hrs 8