Science for health diplomacy: complex problems need complex solutions

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SPEED READ

– Almost any major problem in global health – from discovering new drugs to developing vaccines, to finding solutions to environmental changes that can affect health in vulnerable countries – requires research and innovation solutions that are beyond the scope of individual countries, organisation, or companies

– In the case of research and innovation for health, there are few, if any, functional platforms where multiple players can negotiate towards creating constructive solutions, or share global resources better. That is where COHRED wants to play a role

– Following the merger with the Global Forum for Health Research, COHRED will develop its ‘Global Action’ or ‘Science for Health Diplomacy’ arm to generate national, regional or global agreements or agreements involving a complex array of partners, enabling sustainable and usually complex solutions for complex global health problems

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An interdependent world

Global health diplomacy is a relatively new concept, that can be loosely defined as “the processes by which government, multilateral and civil society actors attempt to position health in foreign policy negotiations and to create new forms of global health governance”. Or, to go with the words of the World Health Organization, “[g]lobal health diplomacy brings together the disciplines of public health, international affairs, management, law and economics and focuses on negotiations that shape and manage the global policy environment for health. The relationship between health, foreign policy and trade is at the cutting edge of global health diplomacy”.

Besides the ‘foreign policy and trade’ nuances, the reality is that almost anything that is relevant to major problems in global health – from discovering new drugs to developing vaccines, to finding solutions to environmental changes that can affect health in vulnerable countries – requires resources that are beyond the scope of individual countries, organisation, or companies.

Yet, there are currently very few platforms that can bring the many actors together in ways that lead to rapid and comprehensive research and innovation to the increasingly complex problems in global health. While there are successful examples, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the GAVI Alliance, or IAVI, these represent mostly once-off efforts that can not be easily replicated to deal with the research and innovation needs in global health. In fact, we see no such platforms anywhere. Just think about the research and innovation challenges raised by drugs for neglected diseases, new vaccine development, genomic research to improve health in low-income countries, innovation required to deal with food security in Africa before climate change causes a permanent disaster, and more. Where can we combine the experts in ‘big data’ collation and analysis together with governments of low-income countries? How can the research capacity in private health care industry be made available to improve public health services? To name just a few examples.

Credit: European Business Review
Credit: The European Business Review

A role for COHRED?

That is where COHRED is aiming to locate its ‘Global Action’ work that follows our merger with the previous Global Forum for Health Research. We aim to play a role, driving the development of a much-needed platform for low- and middle-income countries to help set more strongly the global health and health research agenda and start featuring what they can contribute to it, as opposed to the past, with the agenda being mostly set by donors from the north.

Think about Africa for a moment. If Africa, politically speaking, would be able to portray itself as a continent of a billion consumers instead of “54 problem countries with a one or two stars” – and if COHRED can contribute to this in the field of research and innovation for health, we can literally turn another page in dealing with global health. If this platform would enable African players to find practical solutions, for example in pharmaceutical production, we can support this new look of Africa. Let us say that we can do a rational ‘division’ of research and innovation – South Africa to focus on HIV/AIDS research and pharmaceutical production, Kenya could take on tuberculosis, Tunisia could take on to high-tech drugs for non-communicable diseases, and so on.

The same can of course apply to other parts of the world. A major middle-income country, like the Philippines, could for example bring together ASEAN countries to think about how research and innovation can support the regional efforts and how it can help set and contribute to the global agenda for research and innovation for health. But in the absence of a reliable platform in which these countries can negotiate, even at the sub-regional level, it is going to be complex to talk about a shared research health agenda or a specific disease to tackle.

Recently, COHRED was officially invited to attend the 32nd anniversary celebration of the Philippine Council for Health Research and Development (PCHRD) in Manila, in March. PCHRD is a forward-looking, partnership-based national body responsible for coordinating and monitoring research activities in the Philippines. Given the number and severity of the natural disasters that struck the archipelago in the past years – including typhoons, floods, earthquakes, the latest one being typhoon Haiyan, that last November exacted a deadly toll of over 6000 people in the country – this year’s anniversary theme will be “The Filipino Resilience in Crises: Connecting Health R&D and Emergency Health Management”. Needless to say, apart from economic, social and environmental implications, these events also have important impact on the well-being and health status of large sectors of society. The celebration will also offer the opportunity to sign the agreement on delivery of the next Global Forum for Health Research meeting – in its new outlook – with the Ministry of Science & Technology of the Philippines. The previous Forum was held in 2012 in Cape Town, South Africa.

Philippine Council for Health Research and Development
Credit: Philippine Council for Health Research and Development

Forum meetings, Colloquia meetings. Although different in size, targeted topics, and audience, both are instrumental to the attempt to help build bridges, so that we can use the capabilities of countries, financiers and institutions to bring them together around solutions. At the inter-regional and continental level there are many issues that can be sorted out, in term of science and technology, and require a place where people can meet and talk and come up with solutions. “Meetings, and the successful execution of them, have become unfairly undervalued in my view. Important progress can be made on difficult global health issues, both in front and behind the scenes at well designed gatherings. Well structured, planned events  give people who don’t usually interact the chance to meet,” said Danny Edwards, Manager at COHRED Think, a Unit within COHRED that combines ideas, insights and intelligence to find innovative solutions to challenges and answers to opportunities that make research and innovation work even better. “The meetings we have held at COHRED strive to make these sort of productive interactions possible. We’ve emphasised an informal atmosphere, more interactive sessions, Chatham House rules where necessary, and work hard to bring in a broad mix of public and private players. Through all this we create an environment where understanding can be reached, decisions made, and partnerships formed. All aimed towards greater research for health and development.”

Carel IJsselmuiden

7 thoughts on “Science for health diplomacy: complex problems need complex solutions”

  1. Your suggestion is good.I must however point out that there has been many platforms in the past made available to countries in ASia and south East Asia like SEAMEO-TROPMED and ASEAN inititatives which has helped and worked for some time.Unfortunately leadership is now lacking to continue with these initiatives.Also TDR/WHO played a major role in the past in capacity building-again lost out now due to lack of good leadership.Sugest you call for a meeting of those in the Region to revive Regional Collaboration and co-operation under Cohred.

    1. I have been doing research and taking projects,I agree with Surow A Adaw and PROFESSOR Dr. C.P.RAMACHANDRAN.
      There are many innovative ideas many a times they do not get proper exposure.Diplomacy in politics creates problems and strong actions solves those problems.

  2. Dear friends,

    the two definitions used for global health diplomacy in this paper are completely different: while WHO’s focuses on disciplines, yours?? focuses on actors and once again equates governments, which legally represent millions of people, with civil society organizations, which may (and often) represent tiny self-interest groups. As long as there is no clarity on the issue of representativeness, other considerations fall in a vacuum.

    All the best,
    Delia

  3. Global health diplomacy is the new bandwagon, but the complex problems requiring cross-cutting sustainable solutions are similar at the systems and organizational levels. How do they translate complex science into the art of delivering health services? This requires, among other essentials of building capacity and health systems, greater collaboration and integration at the inter-sectoral, inter-disciplinary and inter-national levels.
    Good governance begins with institution-building at the local and national levels, leading to stronger and sustainable regional associations like ASEAN, even before global health governance. This is depicted by the ASEAN emblem of a sheaf of rice stalks representing member states that are bound together for unity is strength – the sum of the parts adding to the whole!
    Doe ASEAN have the potential and capacity to connect actors and sectors to deliver health in regional disasters?
    What are the lessons of Aceh, Nargis and now Haiyan?

    Phua Kai Hong
    National University of Singapore

  4. I agree with Prof. Dr. C.P. Ramachandran. WHO South East Asia Region has been actively working on generating regional strategies and solutions to improve health challenges in the region by organizing many regional meetings, consultations, workshops, etc., including a Regional Conference of Parliamentarians on Strengthening of National Public Health Systems for Emerging Health Challenges in Bangkok, Thailand in 2011. This regional conference was meant to galvanize and motivate the participation of politicians in health systems development. However, due to the lack of leadership and reinforcement mechanism, not much has been done to change the situations. To this end, leadership of health sector and effective national support and reinforcement mechanisms are essential for the success in establishing an effective multi-sectoral cooperation for health improvement.

  5. Dear colleges
    You idea on “Science for health diplomacy” is great and long overdue. Essential Research for Health is what Africa needs, but how can we avoid donor setting agenda while we need their money. I think we not only need a global research forum to set agenda but also to source research funding.
    Having researched TB control among the nomads of marginalized north, I particularly like your mention of Kenya in light of TB.

    SUROW ADAN
    Research Scientist,
    Health Policy and Systems,
    Center for Public Health Research (CPHR),
    Kenya Medical Research Institute (KEMRI)

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