|Plenary session PL08, Wednesday, May 28 2008, 9:00-10:30, Room 2|
|Chair(s): Marcel Tanner, Director, Swiss Tropical Institute, Switzerland & Peter Suter, President, Swiss Academy of Medical Sciences, Switzerland|
|Shaping Innovative Research and Training in a Global World|
|Charles Kleiber, Former Secretary of State for Research and Education, Lausanne, Switzerland|
|Research, Training and Service Development to Address Global Health Challenges: What Should Be the Priorities of Universities?|
|David Sanders, Director, School of Public Health, University of the Western Cape, South Africa|
|Shaping the Research Agenda for Low-Income Countries|
|Charles Mgone, Executive Director, European and Developing Countries Clinical Trials Partnership Programme (EDCTP), The Netherlands|
|Pharmaceutical Innovation and Meeting the Needs of Global Access|
|Harvey Bale, Director General, IFPMA, Geneva, Switzerland|
Submitted by: Emma Greenaway (ICVolunteers); Contributors: Janina M. Mank (ICVolunteers)
How can we bridge the gap of inequality between donor and recipient, the developing and the developed, the researchers and the researched, to serve the health systems of tomorrow? The four speakers, despite coming from a diversity of backgrounds, made an important contribution to this forum by emphasizing the need for a mutual, supportive partnership between those at either extreme of the inequality gap. Ways of achieving this partnership are closely linked to research on health-related issues and training of a global health workforce, but there is no doubt that further research is crucial to arrive at effective outcomes on both the national and the international level.
Building the capacity of health care systems to respond to ever greater challenges and increasing demand, requires the development of effective and targeted research and training strategies. The four speakers addressed different aspects of this issue from their own varied perspectives.
Dr. Charles Kleiber, Former Secretary of State for Research and Education, Lausanne, Switzerland, emphasized the importance of linking academic development and capacity building on a global level by taking into consideration the challenges the health sector will have to face in the near future. Dr. Kleiber identified the factors that shape innovation as globalization and the interdependence this creates, a knowledge society characterized by its drive for competition and its constantly changing environment; as well as upcoming challenges in health (including income-dependent diseases as well as the current monopoly of the doctor) and in education research (global universities with international campuses). He thus recommended a rethink of current strategies on the factors mentioned, in order to build capacity, in particular at institutions in low-income countries, using globalization to enhance our educational experience, thereby encouraging 'brain circulation' rather than 'brain drain'.
Professor David Sanders, School of Public Health, University of the Western Cape, South Africa, focused his presentation on Sub-Saharan African countries which are facing a crisis in health care, greater health inequality, declining life expectancy and increasing mortality rates. Health care systems are under increasing pressure due to higher levels of extreme poverty and disease epidemics, such as the HIV/AIDS. Governments are failing to achieve even the minimum spending targets on health care recommended by the World Health Organization (WHO). In addition, health systems are suffering from increased fragmentation, competition, effects of 'brain drain' and stagnating global immunisation rates. This situation presents particular challenges for the future direction of public health research, education and training.
Public health training, research and funding must now focus on implementation: how to put existing knowledge into practice to make a difference. Research at the local level into the effectiveness of health care systems or institutions can identify implementation problems, enable local action to be taken, to bring about improvement and inform national and global advocacy campaigns.
Successful implementation and capacity building depends on increasing training in leadership and managerial skills, as well as extending in-service training to all public health workers by introducing distance learning programmes. Enhancing the capacity of southern institutions to implement research and training activities depends on increased financial support and developing South-South collaboration and more equitable North-South partnerships.
Dr. Charles Mgone, Executive Director, European and Developing Countries Clinical Trials Partnership, The Hague, spoke of the importance of an effective response from the health care research and training community to the many challenges faced by health care systems in low income countries. Long-term partnerships must be built with active partners working in synergy and coordinating their activities. These partnerships must recognise that ownership lies in the southern country and defining and planning of the research agenda must lie with them and not with their northern partners.
Building capacity within institutions in the South to carry out research programmes effectively depends on developing personnel and creating an enabling environment. Training should focus on developing leadership skills, good governance and financial and project administration. Greater networking and South-South mentorship will enable southern countries to learn from each other. Support for infrastructure, improved career pathways and sharing best practice all help to develop an environment in which research capacity can grow.
Dr. Guy Willis, Director of Communication, International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), successfully deputized the Federation's Director General by catching his audience's attention with the private sector's point of view on the establishment of a partnership between the recipient countries of vaccines and the producing industry. The considerable costs and amount of time spent on creating new vaccinations have to be met by guaranteeing property protection and profit if the private sector is to continue to act responsibly and is to be able to keep contributing towards improving health in the developing world.
Dr. Willis put forward the idea that research on new therapies and vaccines to address a diverse range of diseases, in particular for children, can be enhanced through voluntary licensing or a preferential price system for low-income countries thus planting the seeds for the future in research and training where health problems are often most acute.