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Time for a paradigm shift

Date: Thursday 1 November 15.45–17.15
Source: Forum 11
Authors: Pia Rockhold, Senior Operation Officer, Disability and Development, Human Development Network, World Bank, Washington DC


Health research utilizes the natural and social sciences: empirical sciences based on hypothesis testing through observation or experiment. As such, scientific evidence is subject to and derived from our experiences or observations.

Scientific communities consist of researchers who share paradigms. They have similar educational backgrounds, have absorbed the same technical literature and drawn many of the same lessons from it. As a result, members of a given scientific community see themselves ­ and are seen by others ­ as responsible for the pursuit of a set of shared goals. Within such groups, communication is relatively full and professional judgments fairly unanimous.

Global health research consists of scientific communities with varying paradigms joined in the pursuit of a common goal: to address the `10/90' gap. Professional communication across group lines can be demanding and at times results in misunderstandings or unexpected disagreement. The global health research community aims to address global health challenges and enhance equitable access to health, decision-making and governance. With this objective in mind, communication, as well as information and knowledge management are essential to success.

During the past decades, the global resource allocations for health and health research have increased, but limited coordination of narrowly channeled funding for high-profile diseases has weakened the national health and research systems, largely hindering equitable growth and sustainable development. This, and the increased global focus on externally defined result frameworks and indicators, is likely to result in a further weakening of the national health and research systems.

It is time for a paradigm shift. In the pursuit of new values aiming at a more holistic approach to health, and as an integrated part of equitable development, global health research communities need to cease circular arguments in defense of their paradigms. The international community needs to harmonize its efforts in support of locally-owned national development plans and budgets, which enable low- and middle-income countries to take ownership of development, and invest in health and health research capacity-building, as an integrated part of the national programme for science, technology and innovation.