This course proposes an overview of current global health challenges drawing on the insights of several academic disciplines including medicine, public health, law, economics, social sciences and humanities. This interdisciplinary approach will guide the student into seven critical topics in global health.
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Research, Development, Innovation and Technology for Global Health
This module addresses the lack of attention to research and development for medicines and technologies for diseases that disproportionately affect developing countries and all the issues related to drug development and intellectual property rights.
Institute of Global Health - Faculty of Medicine University of Geneva
Antoine Flahault
Professor of Public Health and Director of the Institute of Global Health (Faculty of Medicine, University of Geneva) and co-Director of Centre Virchow-Villermé (Université Paris Descartes) University of Geneva and Université Paris Descartes – Sorbonne Paris Cité
[MUSIC].
Hello everyone, in this presentation I'm going to be talking about global health
research development and innovation policies.
But firstly, I'd like to talk about some key issues in terms of global health
research development innovation, which I'll refer to as RDI.
So there are often gaps in drugs, vaccine, and technological development for
the health needs of poor and neglected countries.
And this partly explains the health differences,
the gaps between richer and poorer countries.
There are many neglected diseases when it comes to RDI,
and we already discussed a little bit about this in week two.
Medical and technological R&D is actually very important part of market economies.
But markets are not driven to meet the issues of neglected diseases.
So currently, R&D funding for neglected diseases is
largely provided by the public sector, around 64% by the public sector.
Otherwise, by philanthropic and pharmaceutical industry.
However, more recently there's been more private industry funding,
that's increased more actually.
Research and development for drugs is quite expensive and
the resulting products can also be expensive, hence a problem for
poorer countries, lower middle income countries.
So our question has been, how do we delink the costs
of RDI from the products that it's produced?
Other issue include the monitoring and evaluation of global health problems.
And for example, some countries don't have civil registration or
information on births and deaths.
So globally, around two-thirds of deaths,
or 38 million deaths, actually go unregistered.
So there's a lot of scope for development in terms of data and research and systems.
A couple of years ago there was a global strategy and
plan of action on public health innovation and intellectual property developed.
And there was a WHO consultative expert working group set up, or
CEWG, as it's referred to.
And they had a mandate to consider who we improve access to medicines and
technologies through RDI.
So their four key tasks were to develop a report on coordinating activity for
RDI and funds for RDI.
Separating the costs of medicines and technologies from the products of RDI.
Ensuring more equitable access to medicines and technologies through RDI.
And ensuring better access to medicines and vaccines for
diseases mainly affecting lower and middle income countries.
And from this mandate, they developed a report,
which recommended a global health research and development observatory.
A number of research and development demonstration projects.
Coordinating and financing health, research, development, and innovation.
As well as financing,
which was based on delinking the costs of RDI from the products.
And and international treaty on RDI, which was quite controversial.
At the last World Health Assembly in May 2013, a resolution was passed,
which endorsed the CEWG report and the development of a number of RDI
projects to address the gaps at global health RDI observatory.
Norms and standards to progress data collection on research and development.
Capacity building.
And improved coordination in RDI, amongst other things.
So what is required to progress research, development,
and innovation at a global level?
Firstly, we need clear priorities.
We need to identify transparent, comprehensive priorities for research and
development, and link these with coordinating RDI activity and funds for
research and development.
We also need to focus, not only on technological innovation, but
also social innovation, which refers to new ideas, models,
organization, collaborations and services.
So the way we do things as well, the processes.
We need cross sectoral and
interdisciplinary research in recognition of the social determinants of health and
the contribution of a number of sectors to health.
We need stakeholder participation, transparency and accountability,
particularly for ethical review processes in lower and middle income countries.
Capacity building for RDI, and better monitoring and evaluation.
Also, we need policies informed by evidence of health need.
We need effective knowledge translation.
So, researchers working closely with policy people.
We need a comprehensive research agenda.
Priority setting, which takes into account both technological and
political representation.
So how the community represented through political representation,
not just through scientific experts.
We also need collaborative public, private partnerships, and
collaboration at regional and
international levels to make the most of the opportunities for knowledge exchange.
And we need comprehensive global health metrics,
which refers to measures of tracking global health problems.
Also, recently, the last world health report, which was released about
a month ago, was on the research for universal health coverage.
And it called for increased investment and support for research, which specifically
looks at improving health coverage both within and between countries.
Also better collaboration between research and policy makers.
And researchers working more closely at the public health program level,
not just within academic environments.
It also talked about building research capacity and
developing a local force of well trained researchers.
And codes of good practice in research, as well as global and
national research networks.
Finally, here are the references again, and
I refer you particularly to the most recent World Health Report 2013,
on research for universal health coverage, as well as the CEWG report on RDI.
Thank you. [MUSIC]
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Rafael Ruiz De CastañedaInstitute of Global Health - Faculty of Medicine
Antoine FlahaultProfessor of Public Health and Director of the Institute of Global Health (Faculty of Medicine, University of Geneva) and co-Director of Centre Virchow-Villermé (Université Paris Descartes)
