HEALTH: Knowledge Can Be Effective Treatment

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Nov 11 2004 (IPS) - Research into medical cures is one thing, but the time has come for research into the systems that can get the treatment to people, a new report by the World Health Organisation (WHO) says.

Effective research could prevent half the world’s deaths from current causes with simple and cost-effective interventions, says the report ‘Knowledge for Better Health: Strengthening Health Systems’ launched in London Thursday.

A health system is defined as including all actors, organisations, institutions and resources whose primary purpose is to improve health.

The report was produced by a team of 12 internationally prominent health researchers in both developed and developing countries. It was based-on a wide-ranging consultative process and on previous reviews of global health research, WHO says.

”At the moment knowledge is not being turned into action that will lead to health improvement,” Dr Tikki Pang, WHO director for research policy and cooperation who coordinated the 143-page report told IPS on phone from Geneva.

Research in the health field has usually meant finding new drugs and vaccines, Dr Pang said. ”The next thing is to make sure that these wonderful products reach the people who need them most.”

Research into strengthening health systems remains ”underfunded and unappreciated,” Dr Pang said. ”We need now also a very different kind of research to stem cell research.”

This kind of research must involve people in developing countries participating more closely in such studies, he said. Research in the medical field is focused too closely at present in ”academic centres in rich countries.”

One example of such research could be to ”develop a mechanism to finance health systems so that treatments can be delivered equitably,” Dr Pang said. ”In a lot of sub-Saharan Africa people have to dig into their pockets to pay for health care.”

The report has been launched to inform a meeting on health systems research to take place in Mexico Nov. 16 to 20. Ministers of health from more than 30 nations as well as representatives of research institutions, academia, non-governmental organisations and pharmaceutical companies are expected to attend the meeting.

The meeting will focus on the ”know-do gap” and will also discuss research needed to achieve the health-related Millennium Development Goals (MDGs) by 2015.

The report makes several specific recommendations. Central to these, Dr Pang said, is the recommendation for governments to allocate two percent of health budget to strengthen health systems. At the moment this field attracts less than one-tenth of one percent in low-income countries, the report says.

The report recommends creation of ”knowledge exchanges” as a new approach for bringing together researchers and practitioners. It also recommends community-based interventions that would involve communities who should benefit from research in designing and implementing research to make it more effective.

In Africa, the report says, it is estimated that only between 2-15 percent of children slept under bed-nets in 2001, considered a simple, effective and proven method to prevent malaria.

Researchers found that in two Tanzanian districts, malaria alone accounted for 30 percent of all healthy years of life lost due to deaths in 1996-97. In response, government planners increased the budget for malaria prevention and treatment programmes from 10 percent to 26 percent by 2000-2001.

The research resulted in a better match between disease burden and health budget allocation, and the child mortality rate has been reduced by more than 40 percent since the late 1990’s.

As indication of research priority, the report says that only 0.7 percent of scientific studies published globally in 2000 were in the area of health systems research.

It says that only an estimated 10 percent of more than 70 billion dollars spent annually on health research by public and private sectors is used for research into 90 percent of the world’s health problems.

It says two percent of global health expenditure is in Africa, which carries 25 percent of the global burden of diseased, compared to 90 percent in developed countries with 20 percent of the world’s population.

”There is a sense that science can do more, especially for public health,” Dr Lee Jong-wook, WHO director-general said in a statement. ”There is a gap between today’s scientific advances and their application – between what we know and what is actually being done. Health systems are under severe pressure and there is an urgent need to generate knowledge for strengthening and improving them.”