Fostering sustainable investment in research for health

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SPEED READ

– The Council on Health Research for Development (COHRED) and its partners have recently held an international meeting aimed at identifying opportunities, possible solutions and strategies for moving towards sustainable investment in research for health in low- and middle-income countries.

– The final meeting report offers an overview of innovative financing mechanisms for health research and development, also commenting on the relevance and feasibility of applying such mechanisms in low resource contexts. Recommendations for taking steps towards developing integrated innovation systems, shifting from funding to investment, and engaging in advocacy for research for health financing have also been issued.

– The creation of an ‘African research space’ was recognised as a major driver for optimising African research development while maximising local and global investments. To support this, COHRED has recently launched COHRED Africa in Gaborone, Botswana. COHRED Africa expects to make its technical, advocacy and think tank contributions to science and innovation for health in Africa – and, where appropriate, globally as well.

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Financing health research in a changing landscape

“Healthcare demands in Africa are changing. Ensuring access to clean water and sanitation, battling ongoing communicable diseases and stemming the tide of preventable deaths still dominate the healthcare agenda in many countries. However, the incidence of chronic disease is rising fast, creating a new matrix of challenges for Africa’s healthcare workers, policy makers and donors.” These words, from a recent Economist Intelligence Unit’s report on the future of healthcare in Africa, give a precise idea of the challenges African countries, and more in general low- and middle-income countries (LMICs), will have to face in order to tackle the public health needs of an ever-growing population.

As most stakeholders agree, for health systems in LMICs to be able to cope with existing and future challenges, it is of absolute importance to increase investments in research and development (R&D). But who should pay for health-related R&D in Africa and LMICs? How to mobilise research funding? Can innovative financing mechanisms be identified to help meeting the growing health burden through investing in R&D?

To address these crucial issues, last June, in the framework of the seventh EDCTP Forum in Berlin, Germany, COHRED, in partnership with the West African Health Organisation (WAHO) and the New Partnership for Africa’s Development (NEPAD) Agency, held a meeting on “Sustainable Investment in Research for Health”. Attended by 35 participants from both the public and private sectors and representing European and African institutions, the meeting aimed at identifying opportunities, possible solutions and strategies for moving towards sustainable investment in research for health.

Nigeria research centre

Integrated innovation systems must be in place

“To help reduce the burden of disease, meet constitutional obligations and spur economic growth, African countries need to increase their investments in health research and innovation”, recently remarked John Ouma-Mugabe, Professor of Science and Innovation Policy at the University of Pretoria, South Africa, in a policy brief.

However, most African countries still rely heavily on external donors and partnerships to fund local research, with the result that research activities do not necessarily respond to development needs of local population but rather of those inhabiting developed countries. In addition, the volume of R&D is significantly insufficient. To break this dependence-poor R&D budget loop and to focus efforts and resources on domestic health demands and priorities, African countries will need to promote innovation, attract investments, and raise funds. Tapping into the possibilities offered by innovative financing mechanisms to either mobilise new revenue or improve the use of existing funds, will certainly play a pivotal role in addressing such complex problems.

Besides overviewing innovative financing mechanisms and assessing the relevance and feasibility of applying such mechanisms in low resource contexts, meeting participants discussed in depth aspects seen as essential for creating the environment in which research financing can happen and the funds eventually raised be spent in a productive way. Accordingly, the issuing meeting report carries recommendations for taking steps towards developing integrated innovation systems, shifting from funding to investment, and engaging in advocacy for research for health financing.

Highlighted actions that should be taken around these issues include, but are not limited to, foster political will and interest through understanding what priorities governments have and showing how research can respond to these; show the actual investments made in research to demonstrate tangible return on investment; create integrated research and innovation platforms to make efficient use of existing resources and thereby incentivise investment; strengthen accountability and transparency to attract potential investors through strong financial and administrative systems; engage the media as an advocate by maximising opportunities to communicate research findings through research-savvy journalists and media-savvy researchers; widen the scope of the audience to include, for example, a range of stakeholders and sectors, such as finance, business, information technology and so on, showing return on investment and thus making health research attractive to all.

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Jacintha Toohey (above), Policy Project Adviser COHRED, and Carel IJsselmuiden (down), Executive Director, The COHRED Group, at the launch of COHRED Africa in Gaborone, Botswana,6 November 2014

Towards an ‘African research space’

Another key point discussed at length during the Berlin meeting was centered on the recognition that moving towards a shared research space would have the benefit of optimising African research development while maximising local and global investments. Although it is still a matter of discussion whether creation of this space – either in the form of a network, an organisation, or a virtual space – should be first implemented at a regional level or immediately be continent-wide, a number of steps were identified as critical in its creation:

– Map the landscape to understand what is already in place and how it can be utilised or improved.

– Harmonise stewardship through tapping into regional leadership bodies and establishing common regulation processes and research agendas.

– Engage all stakeholders through open dialogue and continuous feedback, both during the creation of this space and its operation.

– Secure consistent funding by identifying a range of funding mechanisms to ensure sustainability of the research space.

– Leverage Africa’s potential by creating a strong cohesive whole to stimulate innovation and give it an equal place at the global table.

To support this, COHRED itself has formally launched COHRED Africa in Gaborone, Botswana, three years after appointing the first staff. COHRED Africa is the basis for all our work done in Africa – but – also it will have its own expertise to contribute to COHRED’s global clients and activities. In the company of high level representatives of Botswana, Swaziland, Malawi, Kenya and the African Development Bank, many colleagues with whom COHRED has worked over the years and continues to do so, key partners such as the EDCTP and Pfizer, COHRED Africa expects to make its technical, advocacy and think tank contributions to science and innovation for health in Africa – and, where appropriate, globally as well.

Sylvia de Haan and Carel IJsselmuiden

Note: find below a few examples of the press coverage on the launch of COHRED Africa and relevant discussion

Invest in research to attract funding, African governments told

Scientists contest the value of research

COHRED Africa office prioritises research ethics

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