[afro-nets] Invitation to e-discussion

[Neil Pakenham-Walsh <neilpw@doctors.org.uk>]

Invitation to e-discussion on POVERTY, EQUITY AND HEALTH
RESEARCH
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We would like to invite AFRO-NETS colleagues to participate in a
special HIF-net e-conference on 'Poverty, equity and health re-
search', from now until the end of August. HIF-net is an email
list that looks especially at issues of 'access to information
for health workers in developing countries.' It is a dynamic
list with over 1200 people of different disciplines. From now
until the end of August we are extending the scope of the list
to embrace wider issues of POVERTY, EQUITY AND HEALTH RESEARCH,
supported by the Global Forum for Health Research as part of
their preparations for the Global Forum's 2005 annual meeting,
Forum 9, in Mumbai, India, 12-16 September 2005.

The e-conference is introduced below by Susan Jupp from the
Global Forum for Health Research, together with a short paper
from Stephen Matlin, executive director of the Global Forum. The
paper is also available at:
http://www.globalforumhealth.org/filesupld/news/SAM%20intro%20for%20hif-net.pdf

There are two ways in which you may like to contribute:

1. Join HIF-net. If you would like to join, please send an email
with your name, affiliation and interests to hif-net@dgroups.org

2. If you prefer, send your comments to afro-nets@healthnet.org
As members of your list, and many others, we shall pull threads
together for a synthesis of the issues from different perspec-
tives, and will forward a summary to this list in the first week
of September.

We look forward to your contributions.

Fred Bukachi and Neil Pakenham-Walsh
HIF-net co-moderators
http://www.dgroups.org/groups/HIF-net/index.cfm

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INTRODUCTION

The Global Forum for Health Research is an independent interna-
tional foundation promoting more health research to combat the
neglected diseases and conditions that are major sources of ill
health in developing countries. See our website for details:
http://www.globalforumhealth.org

By 'health research', we understand the whole spectrum from bio-
medical research that creates new drugs, vaccines and diagnos-
tics, to health systems and policy research which ensures that
health systems are better informed and managed, to social sci-
ence and operational research to improve access and uptake and
to help us better understand what affects the health and the
choices of people in the community.

Each year, in a different region of the world, the Global Forum
holds an annual meeting bringing together 600 to 700 partici-
pants. This year the meeting will take place in Mumbai, India,
from 12 to 16 September and its theme is 'Poverty, equity and
health research'.

Even with this large number of participants, we know we are not
necessarily able to include all those who have something to con-
tribute to the discussions. Over the past few years, we have in-
troduced different mechanisms to reach out to listen to these
other voices. Through a call for abstracts, for example, we re-
ceive proposals for presentations that enrich the annual meeting
programme. In addition last year we created an electronic maga-
zine, RealHealthNews, which aims to bring good news on health
research from all over the world to a wider audience.

This year we would like to extend the outreach of our annual
meeting through an e-discussion, made possible by HIF-net.

Although the HIF-net community focuses particularly on issues of
access to healthcare information, there is an important interde-
pendence with the areas under discussion at Forum 9: poverty,
equity, health research. By opening up the HIF-net community to
this broader discussion and attracting more health researchers
to HIF-net, we hope to help bridge communication gaps between
researchers and other disciplines concerned with access and use
of health information.

The Global Forum has included in recent annual meetings a focus
on access to health information. As a subscriber to HIF-net for
several years, I am delighted to be able to solicit the views of
the HIF-net community and others with a broad range of exper-
tise.

Susan Jupp, Head of Communications and Information, Global Forum
for Health Research

[HIF-net profile: Susan Jupp is Head of Communications and In-
formation with the Global Forum for Health Research, based in
Geneva, Switzerland. The Global Forum for Health Research is an
independent international foundation promoting more health re-
search to combat the neglected diseases and conditions that are
major sources of ill health in developing countries.
http://www.globalforumhealth.org
mailto:susan.jupp@globalforumhealth.org ]

****************************************************************

POVERTY, EQUITY AND HEALTH RESEARCH by Stephen Matlin, Executive
Director of the Global Forum for Health Research

Despite unprecedented gains in life expectancy in many countries
during the last several decades, there is a growing crisis of
ill health, whose dimensions include global threats from emerg-
ing and re-emerging infectious diseases; rapidly increasing lev-
els of noncommunicable diseases and injuries in developing coun-
tries; and widening health gaps within and between countries.
Many of these challenges can be met by improving health systems
and by accelerated and more determined application of known and
proven interventions.

However, more health research - to create new knowledge and
technologies; to increase our capacity to apply these equitably
and effectively in different contexts and settings; and to un-
derstand how health is influenced by a range of social determi-
nants - remains vital if we are to achieve the goals of narrow-
ing the gaps and improving global health.

Health research encompasses the spectrum from the biomedical
sciences (such as creation of affordable and accessible drugs,
vaccines and diagnostics) to health policy and systems research,
social sciences, political sciences, health economics, behav-
ioural and operational research, and research into the relation-
ship between health and the cultural, economic, physical, po-
litical, social and policy environments.

Research on social determinants of health

Research is yielding important insights into factors that have a
major bearing on the health of individuals and groups - poverty,
inequities and other social determinants. What lessons can be
drawn from this research, how can it be applied to improving
health, and what further investigations are needed to support
implementation?

Health inequities are those inequalities in health status and
outcomes that are both unfair and avoidable. They reflect peo-
ple's different positions within social hierarchies - including
but not limited to the hierarchy of poverty and wealth. Epidemi-
ological evidence shows that most of the global burden of dis-
ease and the bulk of health inequalities between and within
countries are caused by social and economic factors: the social
determinants of health. The most important include poverty; so-
cial exclusion; health systems; environments; food security; wa-
ter and sanitation; children's early life environment; educa-
tion; housing; employment and working conditions; and the ef-
fects of community and social structures ('social capital') on
health.

Today health equity gaps are growing between and within coun-
tries, even as medical technology makes unprecedented strides.
Indeed, some technological advances have the potential to widen
the health gaps between the world's haves and have-nots. Over-
coming health inequities and breaking the cycle of poverty and
disease are urgent challenges for global health. To tackle
health inequities and address the health needs of poor and vul-
nerable communities requires action on the broader social deter-
minants of health.

Health research has a crucial role to play in this process. The
great challenge today is to move from describing the problems to
acting upon them - and then accurately measuring results.

Research on health systems

Health systems everywhere face major challenges in resources
(financial, institutional and human), organization and manage-
ment and in their responsiveness to policy and to the health
needs of the populations they serve. Research plays a key role
in providing evidence on what works, how to scale up systems and
how to narrow equity gaps in access and in health outcomes.

Research is vital to understanding and improving health poli-
cies, health systems and the relationships between them. A well-
functioning health system therefore needs to incorporate re-
search activities on a continuous basis.

Research and development of technologies for health

Despite the fact that the world now spends more than US$ 100
billion every year on health research, there are still insuffi-
cient priority and resources devoted to addressing many of the
global health challenges and especially those that predominantly
affect lower income countries.

The changing patterns of disease burden are presenting new chal-
lenges to global health. At the same time, a range of major sci-
entific advances in the last decade offer exciting opportunities
for prevention, diagnosis and treatment.

Build national capacity for health research in all countries

Forum 9 encourages the sharing of country experiences in build-
ing national health research capabilities. It will examine
- Successes and failures
- Methods and approaches
- The influence of political will on building and effectively
utilizing research capacity

It will also critically look at the capability of developing na-
tions to:
- Conduct research into social determinants of health
- Engage in effective health systems research
- Develop technologies and products that respond to national
health priorities.

QUESTIONS

What is your experience? What can you share?

1. What are the essential roles of health research in supporting
efforts by governments, donor agencies, research institutions
and other actors to
- identify health needs and inequities, including those based on
biological, environmental, social and other determinants
- create appropriate knowledge, tools and processes to address
these
- develop and implement evidence-informed and priority-linked
policies to improve health
- increase the effectiveness of targeting health programmes and
services to address issues of poverty and equity in health?
- promote health

2. What mechanisms can be developed to increase the resources
(financial, human, institutional) applied to health research
(encompassing the spectrum of biomedical, health policy and sys-
tems, social sciences and behavioural research) to meet the
needs of people everywhere and especially the poor and marginal-
ized?

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Please send your comments to
mailto:hif-net@dgroups.org
and/or
mailto:afro-nets@healthnet.org

Thank you.