Will action on research for health be driven by efficiency or equity? Will research be fast or fair? This week in Bamako, Ministers and their representatives from 59 countries chose equity over efficiency.
The Global Ministerial Forum on Research for Health Research opened on Monday in Bamako, Mali. The Bamako declaration establishes that all countries should have national research capacity so that they may answer nationally relevant questions. Ministries of Health are called upon to dedicate 2 per cent of their budgets (reinforcing a World Health Assembly resolution in 2008), and donors are called upon to invest at least 5 per cent of development assistance for health to country-led research strategies. The declaration calls on global and regional partners to support national research priorities and capacities. Notably, the declaration does not ask the world’s top research institutions to make research for health a priority. Bamako has made a clear call for the development of equitable health research capacity, even if this is not – today – the most efficient way to answer research questions.
Those present for the discussions in Bamako, or in the regional consultations in Algiers, Bangkok, Copenhagen, Rio de Janeiro and Tehran, recognise that even the process of crafting the declaration was more fair than it was fast. The meetings gathered the input of diverse scientific communities, civil society, and health leaders from around the world. The hours of meetings and thousands of flights make it obvious that this was surely not the most efficient way to construct a statement calling for action on research for health. But the process of the crafting the declaration, like the process for health research in that document, has put equity over efficiency.
Visibly absent from the Bamako discussion was the Gates Foundation. Of more than 700 participants, from hundreds of organisations, there is not a single person from the Gates Foundation in the list of participants, or on the programme. Other players, with arguably less influence on the global health research agenda, actively participated and co-sponsored the meetings. Critical roles for the World Bank and regional development banks, UNESCO and WHO are identified, in developing national research capacity, inter-sectoral research and leadership for health research, respectively. The declaration makes no mention of the Gates Foundation.
Has Gates chosen an alternative process for health research? The Foundation’s overwhelming support for the research institutions of rich countries suggests that Gates has chosen efficiency over equity in the process of conducting research for health. In Bamako, the ministers spoke clearly. Will the world’s largest funding agency in global health research hear their call for equity in the organization and conduct of research for health?
November 27th, 2008 at 4:40 pm
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