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Correcting the 10/90 Gap in health research : A tool against world poverty 

Correcting the 10/90 Gap in health research : A tool against world poverty . Presentation by Louis J. Currat Executive Secretary Global Forum for Health Research 16 July 2002. The problem.

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Correcting the 10/90 Gap in health research : A tool against world poverty 

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  1. Correcting the 10/90 Gap in health research : A tool against world poverty  Presentation by Louis J. Currat Executive Secretary Global Forum for Health Research 16 July 2002

  2. The problem • USD 73 billion investments in health research (1998), of which less than 10% for 90% of the world’s health problems. • Because of the vicious circle between poor health and poverty, correction of this gap could make a major contribution to the fight against poverty. Attention to this problem started in 1990 only! • Commission on Health Research for Development (civil society intitiative)

  3. Urgency to correct the 10/90 gap in health research Because: • central importance of health research for health • central importance of health for development • central importance of health to fight poverty • central importance of development and a reduction of poverty for global security

  4. Disease burden for major diseases (as % of total years lost to diseases, etc.) 1998 2020 • Pneumonia (ALRI) 6.0 3.1 • Perinatal conditions 5.8 2.5 • Diarrhoeal diseases 5.3 2.7 • HIV/AIDS 5.1 2.6 • Unipolar major depression 4.2 5.7 • Heart disease 3.8 5.9 • Cerebrovascular disease 3.0 4.4 • Malaria 2.8 1.1 • Road traffic accidents 2.8 5.1 • Tuberculosis 2.0 3.1

  5. Disease burden due to selected risk factors (as % of total DALYs) • Malnutrition 15.8 • Water/sanitation 6.7 • Unsafe sex 3.7 • Alcohol 3.3 • Indoor air pollution 3.3 • Tobacco 3.1 • Occupational hazards 2.6 • Hypertension 1.5 • Physical inactivity 1.0 • Illicit drugs 0.5 • Outdoor air pollution 0.4

  6. Global Forum for Health ResearchCharacteristics • Started in January 98 • Legal status: Foundation • Objective: help correct the 10/90 gap • Partnership organization (no membership) • Part of “Civil Society Organizations”

  7. Constituencies of the Global Forum • Government policy-makers • UN & multilateral aid agencies • Bilateral aid agencies • Foundations • International & national NGOs • Women’s organizations • Research institutions • Private enterprises (pharmas) • Media

  8. Foundation Council 2002 • Mexican Center for Research and Studies • WHO/WB/UNDP Tropical Diseases Research • Academy of Medical Sciences, Russia • Swedish International Development Cooperation Agency • WHO/EIP Cluster • International Planned Parenthood Federation • Norwegian Agency for Development Cooperation • IDRC, Canaca • Richard Feachem, Chairperson • ARROW, Malaysia • IFPMA, Geneva • SDC, Switzerland • Rockefeller Foundation • WHO Advisory Committee on Health Research • Indian Council of Medical Research • International Women’s Health Coalition • Tanzanian National Institute of Medical Research • University of the Philippines • World Bank

  9. Central objective of the Global Forum for Health Research Help correct the 10/90 gap in health research • by focusing research efforts on diseases and determinants representing the heaviest burden on the world’s health • by facilitating collaboration between the public and private sectors

  10. Nature and role ofthe Global Forum(in the overall health research collaborative system) • network of networks linking institutions with impact on 10/90 gap • catalyst (no substitute for the efforts of others) • independent and neutral platform • promoter of participation in joint efforts • informal contact point between partners • non bureaucratic decision-making mechanism (quick response to opportunities; seed money financing)

  11. Global Forum for Health ResearchStrategies 1998-2002 1. Organize annual Forum Meeting focusing on the 10/90 gap 2. Measure the 10/90 gap and develop priority-setting methodologies 3. Support networks/partnerships in key health research areas 4. Support research capacity efforts in lower-income countries 5. Integrate gender issues in the correction of the 10/90 gap 6. Disseminate information on the 10/90 gap 7. Measure results

  12. Strategy 1Organize Annual Meeting focusing on the 10/90 gap Objective To review past achievements and define future actions in helping to correct the 10/90 gap Forum 5 : October 2001 (700 participants) Forum 6 : November 2002, Arusha, Tanzania

  13. . Strategy 2 Measure the 10/90 gap and develop priority-setting methodologies

  14. Measuring the 10/90 gap (work in progress) Total public and private sources: 1992: USD 56 billion 1998: USD 73 billion Breakdown: 50% public sector 42% private sector 8% private non-profit sector

  15. Priority-setting in health research(importance of civil society organizations) 1. Individual, family and community determinants 3.Level of other sectors than health 4. Level of the central government HEALTH 2. Level of health ministry, health research institutions, health systems and services

  16. Strategy 3 Support networks in key areas of health research Do we need networks??? We already have : • Public sector (based on public interest) • Private sector (based on market incentives) • Civil society organizations The problem is that none of the above can, alone, solve the “public bads” (such as bad health)

  17. Strategy 3 Examples of supported networks • Alliance for Health Policy and Systems Research • Medicines for Malaria Venture • Cardiovascular Health in Developing Countries • Sexual Violence against Women • Child Health and Nutrition Research • Public/Private Partnerships for Health Under preparation: • Road traffic injuries • Child abuse

  18. Example: Medicines for Malaria Venture (CSO) • Start: November 1999 as a Foundation • Secretariat: reporting to the Foundation Council • Governance: Foundation Council, composed of nine members from public and private institutions including two from WHO • Objective and Plan of action: first research projects have been selected and are being financed (USD 8million/year at present) • Networking: one of the five strategies of the Roll-Back Malaria programme led by WHO

  19. Example : Cardiovascular Health in Developing Countries (CSO) (including Tobacco) • Start: November 1998 • Secretariat: S. Reddy, All India Institute of Medical Sciences • Governance: Partnership Council (12 members, including IOM/USA, WHO, World Heart Federation, policy-makers, Global Forum, research institutions) • Plan of action 2001-2002: priorities are access to knowledge, surveillance system, etiological research, health promotion, hypertension, tobacco, capacity dev • Networking: with all interested institutions • Budget: USD 0.2 million (core Secretariat)

  20. Strategies (continued) 4. Support research capacity efforts in lower-income countries 5. Integrate gender issues in the correction of the 10/90 gap 6. Disseminate information on the 10/90 gap 7. Measure results

  21. Conclusions on health, development and the Civil Society Organizations 1. Correcting the 10/90 gap : a major contribution to growth, development and the fight against poverty. HEALTH PAYS! Health as an ECONOMIC sector in development. 2. Correcting the 10/90 gap is possible : it requires the individual and concerted efforts of thousands of institutions. 3. In these efforts, the role of CSOs is crucial, together with the public and private sectors.

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