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EXPENDITURES ON HEALTH RESEARCH IN AFRICAN COUNTRIES, 2005. Prepared for the Algiers Ministerial Summit on Health Research June 2008. Monitoring financing for health research:. Current status? US$125.8 billion -- world spending in 2003
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EXPENDITURES ON HEALTH RESEARCH IN AFRICAN COUNTRIES, 2005 Prepared for the Algiers Ministerial Summit on Health Research June 2008
Monitoring financing for health research: • Current status? • US$125.8 billion -- world spending in 2003 • US$4.1 billion -- low- and middle- income countries (LMIC) spending in 2003 • Very limited data on African countries • Why track financial flows? • At institutional level – to apply knowledge on flow of funds, to enhance negotiations and research management • At country level – to better influence the level and use of funds, to obtain the best impact from health research, to document within National Health Accounts • At global level – to advocate support for research that impacts on the health of LMIC
This presentation reports on findings: • Health research expenditures estimate, Africa 2005 • Health research funding by source • Research expenditures by expense item • Research expenditures by research topic • Other findings • Main data source: Health Research System Institution Survey in 44 African Countries (WHO 2007)
Location of Sample Institutions: Health Research Systems Institution Survey, 2007 SAMPLES OF HEALTH RESEARCH INSTITUTIONS WITH EXP.DATA SAMPLES OF HEALTH RESEARCH INSTITUTIONS BUT NO EXP. DATA
Finding 1:At aminimum, spending for health research in Africa in 2005 is estimated at US$517.5 million. • Represents roughly 13% of the 2003 total spending in Low- and Middle- Income Countries for health research • US$4.1 billion – 2003 spending in LMICs (estimate by the Global Forum for Health Research) • Represents about 1.3% of the combined Total Health Expenditures (THE) of the 36 African countries covered
Finding 2:Funding sources for research institution activities reflect functions and operational structures. • Medical schools and hospitals research are partly funded by own internally generated funds. • These institutions, as service providers, receive fees for services rendered. • Government agencies’ research expectedly rely on government budgets • Hospitals, medical schools, independent research institutions and NGOs rely heavily on rest-of-the-world (row) or donor funds
88.5% 71.1% 71.3%
Analysis perspective: by type of institution across the region • Government agencies • Hospitals • Independent research institutions • Medical schools • Other institutions – NGOs, Charities • Other – universities, other business firms, pharmaceutical companies
Finding 3:Most research institutions do research activities in-house and through contracts to individual persons. • NGOs and other institutions spend more than 1/3rd of their resources on research contracts to individual persons • Only independent research institutions report significant contracting of research work to other research institutions • Management cost to total research spending: • about 2 percent (government agencies and hospitals) • 11 percent (independent research institutions)
45.4% 65.3% 96.8% 77.9% 71.2% 47.1% 61.7%
45.4% 65.3% 96.8% 77.9% 71.2% 47.1% 61.7%
Finding 4:Most research topics are given funding by at least one type of health research institution. • Research on conditions, prevention and treatment of TB, HIV/AIDS and malaria accounts for significant shares of expenditures of most institutions • Shares range from 1/10 of hospital expenditures to 1/3 of expenditures of government agencies, medical schools and other/NGOs • Research on innovative practices and product development is getting the least funding (only in hospitals)
Other Findings: • As a first-time effort, the conduct of the institution survey served two purposes • Provide new information, set "minimum" baseline and fill some data gaps • Provide insight and lessons about what needs to be improved in similar future surveys • Next steps • Further analysis to provide estimates at country level where sample appropriate • Inputs within a NHA sub-guide on estimating health research funding in LMIC
Other Findings: • Issues that need to be addressed to improve data quality and response rate particularly to the Financial Module of the survey • Respondent issues • Are institutions in fact keeping track of what they do in financial terms? • Are institutions willing to share financial data? • How can sharing of financial data be promoted? • Questionnaire design issues • How can the design of the Financial Module questionnaire be improved to encourage and facilitate its accomplishment & integration within NHA tools? • Is there a better or simpler way to track health research performer expenditures by research topic?