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Random reflections on Bamako. Martin McKee. Who are we doing this for?. A global agenda?. Source: UNESCO, in: Stephen Matlin, Fostering innovation for global health. Another way of looking at it. Proportion of all scientific papers published in 2001 written by authors living there.
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Random reflections on Bamako Martin McKee
A global agenda? Source: UNESCO, in: Stephen Matlin, Fostering innovation for global health
Another way of looking at it Proportion of all scientific papers published in 2001 written by authors living there.
“Countries may not need a national airline but they do need a national research capacity” Hannah Akuffo
Where there is nothing... • How do we build health research capacity where there is nothing? • What do we do in countries where the governments are, at best disinterested in the health of their people and at worst hostile to it? • How can we create sustained investment, rather than ad hoc projects? • How can we allow young researchers to thrive and prosper (without emigrating)?
Research: generalisable or specific? • How do we get the right balance between research that solves the problems of people everywhere and those that solve the problems locally? • The challenges of context-specific research • Funding • Publication • Career progression
Making a difference: context specific research • Participatory research to improve survival of childhood malnutrition • Mothers knew what to do but didn’t have the resources to do it • Health care often poor, but could be improved • Key issue in facilities was leadership and management • Major determinant of project success was advocacy - producing a TV programme – “government requires to be pushed to exercise its duties” Dave Sanders
Seeing the big picture: research that is generalisable • Basic scientific research • Clinical trials • But only if the subjects are truly representative • Observational research where units of analysis are countries
“We need to change the gatekeepers of research” Fran Baum Do our existing review systems give us the research we need? Do they simply help us ask questions we already know the answers to? How can we take more risks?
Breaking down barriers • Basic and applied research • Human and animal research • “There is no point in trying to control rabies by focusing your attention on humans” ChokriBahloul • Academia and industry • “Its industry that makes drugs. Academics don’t do that” Mark Walport • More clinical trials taking place in developing countries is not a bad thing • Academia and civil society • Research and policy
Bringing about change “community paralysis” Miriam Were • Making the invisible visible • Challenging complacency • Holding politicians to account
Keeping it simple • “We need research that stops health systems making people poor and killing them” not • “ We need to develop an integrated, comprehensive health services research strategy that embraces quantitative and qualitative research and takes a multi-stakeholder perspective....”