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Bamako Call to Action urges new approach to research for health

22 Nov 2008

Susan Schneegans

Source: TropIKA.net

Adopted on 19 November – the final day of the Global Ministerial Forum on Research for Health hosted by the Government of Mali in Bamako – the Call to Action urges national governments to allocate at least 2% of budgets of ministries of health to research. In parallel, funders of research and innovation, together with international development agencies, are urged to invest at least 5% of development assistance funds earmarked for the health sector in research, according to country-led research strategies.

The reference to ‘country-led research strategies’ is significant, as donors until now have tended to move forward their own health and research priorities, thus shaping the agenda on behalf of recipient countries. The Call to Action stresses that ‘the global research for health agenda should be determined by national and regional agendas and priorities’. Endorsing the principle of “engagement” upheld by the Bamako Forum, the Call to Action also urges enabling “civil society and community participation in the entire research process, from priority setting to the implementation and evaluation of policies, programmes, and interventions”.

The signatories of the Call to Action recognize the need for greater equity in research for health, with ‘only a small proportion of spending on research [currently addressing] the health challenges that disproportionately affect the poor, marginalized and disadvantaged’. They appeal to all partners and stakeholders to implement the recommendations of the WHO Commission on the Social Determinants of Health, with an emphasis on those related to health equity. Launched last August, the report of the Commission, Closing the Gap in a Generation, asserts that health inequities are avoidable and that there is sufficient scientific evidence available today for policy-makers to act to reduce these, even if more research is still needed.

Social determinants of health include the level of education, good nutrition and access to safe drinking water and sanitation. The Call to Action reflects a shift to a broader-based intersectoral approach to research for health, linking it more closely with research on education, food, water and agriculture. It urges countries, ministries, international agencies and the private sector to work together more effectively to direct research at improving the health of poor people around the world.

In light of its broad mandate for education, the sciences, communication and culture, UNESCO is invited to promote research for health as an important intersectoral issue in its own capacity-building projects and as part and parcel of the policy advice it provides to governments.

With biomedical research being largely financed by the private sector today, the collaboration of the pharmaceutical industry and other private stakeholders has become essential. During a session in Bamako devoted to Research Leaders, the Wellcome Trust described how its Malaria Genetic Epidemiology Network was studying resistance to malaria in populations in 11 African and three Asian countries. Merck & Co. meanwhile told how it has contributed to the Onchocerciasis Control Programme in West Africa by donating drugs.

The question of ownership of research was a central concern in Bamako and during the preparatory meetings. National governments are urged to ‘give priority to the development of policies for research and innovation for health, especially related to primary health care, in order to secure ownership and control of their research for health agendas.’ Moreover, all partners and stakeholders are urged to ‘promote and share the discovery and development of, and access to, products and technologies addressing neglected and emerging diseases which disproportionately affect low- and middle-income countries’.

For its part, WHO is expected to play a leadership role, ensuring that “its strategy on research for health and the Global strategy and plan of action on public health, innovation and intellectual property are implemented in unison”, so that WHO can “lead by example in research for health policy and practice”.

Meanwhile, ‘the World Bank Group and regional development banks are called upon to deepen and expand their research for health as part of their economic and operational research programmes, with particular emphasis on health systems research and innovation, and national science and technology capacity building’.

The Call to Action also invites multilateral agencies to explore with Member States and partners the feasibility of establishing 18th November year as a World Day of Research for Health.

Read:

1. Bamako Call to Action (English): http://www.tropika.net/svc/specials/bamako2008/call-for-action/call
2. Appel à l’action de Bamako (French) http://www.tropika.net/specials/bamako2008/background-documents/Call_to_Action__Fr.pdf
3. Bamako 2008 Global Ministerial Forum on Research for Health http://www.bamako2008.org
4. Background to Forum on UNESCO website
5. Closing the Gap in a Generation, the report of the WHO Commission on the Social Determinants of Health
6. Research for Health, a position paper on WHO’s role and responsibilities in health research , ACHR45/05.16 Rev.1, 16 May 2006 http://www.who.int/rpc/meetings/position_paper.pdf
7. Global strategy and plan of action on public health, innovation and intellectual property, World Health Assembly, 61st session, May 2008 http://www.who.int/gb/ebwha/pdf_files/A61/A61_R21-en.pdf
8. The Paris Declaration, on alignment, harmonisation and management of aid for results, March 2005,on OECD website http://www.oecd.org/document/18/0,2340,en_2649_3236398_35401554_1_1_1_1,00.html

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