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The role of NGOs in global health research for development

The role of NGOs in global health research for development

Global health research is essential for development. A major issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world’s greatest health problems. This imbalance is fostering major attempts at redirecting research to the health problems of low and middle income countries. Following the creation of the Coalition for Global Health Research – Canada (CGHRC) in 2001, the Canadian Society for International Health (CSIH) decided to review the role of non-governmental organizations (NGOs) in global health research. This paper highlights some of the prevalent thinking and is intended to encourage new thinking on how NGOs can further this role.

This paper was prepared by members of the Research Committee of the CSIH, with input from other members of the Society. Persons working in various international NGOs participated in individual interviews or group discussions on their involvement in different types of research activities. Case studies illustrate the roles of NGOs in global health research, their perceived strengths and weaknesses, and the constraints and opportunities to build capacity and develop partnerships for research.

NGOs are contributing at all stages of the research cycle, fostering the relevance and effectiveness of the research, priority setting, and knowledge translation to action. They have a key role in stewardship (promoting and advocating for relevant global health research), resource mobilization for research, the generation, utilization and management of knowledge, and capacity development. Yet, typically, the involvement of NGOs in research is downstream from knowledge production and it usually takes the form of a partnership with universities or dedicated research agencies.
There is a need to more effectively include NGOs in all aspects of health research in order to maximize the potential benefits of research. NGOs, moreover, can and should play an instrumental role in coalitions for global health research, such as the CGHRC. With a renewed sense of purpose and a common goal, NGOs and their partners intend to make strong and lasting inroads into reducing the disease burden of the world’s most affected populations through effective research action.

Each country needs to be able to generate knowledge relevant to its own situation, to allow it to determine its particular health problems, appraise the measures available for dealing with them, and choose the actions likely to produce the greatest improvement in health. This should not be seen as the exclusive preserve of universities or research councils, but equally of health/public services, non-governmental organizations, etc.” [1].
1 Introduction
Non-governmental organizations (NGOs) have been defined by the World Bank as ‘private organizations that pursue activities to relieve suffering, promote the interests of the poor, protect the environment, provide basic social services, or undertake community development’. NGO activities can be local, national or international. NGOs have contributed to the development of communities around the world and are important partners of many governments – while remaining independent from governments. According to the Human Development Report [2], there were in 2002 over 37,000 NGOs in the world, a growth of 19.3% from 1990. Their purposes differ but overall two categories dominate: economic development and infrastructure (26%) and research (23%) http://www.globalpolicy.org/ngos/role/intro/growth2000.htm. NGOs are generally regarded as valued partners in health research for development, research being viewed as a broad process involving not only the production of knowledge, but also up-stream and down-stream activities needed for its relevance and effectiveness, such as priority setting and knowledge translation. NGOs have made and continue to make substantive contributions through supporting relevant and effective research. In her address at the First Steering Committee Meeting of the International Conference on Health Research for Development in 1999, the (then) Director General of the World Health Organization (WHO), Dr. Gro Harlem Brundtland, voiced her appreciation of NGOs as a partner with WHO in health research [3].

There are several views on what is meant by global health and global health research. In its simplest form, global health is population health on a global scale, and global health research is research which addresses the health of human populations around the globe. Global health also refers to ‘inherently global health issues’, that is, health-determining phenomena that transcend national borders and political jurisdictions, such as globalization and climate change. In setting global health research priorities, both the burden of disease and inherently global issues should be considered [4, 5]. The vision of health research as proposed by the Commission on Health Research for Development [6] is a systems approach driven by equity, focused on country needs and priorities, and within an interactive regional and global framework. This paper will address global health as it was defined in a Canadian consultation paper on global health research held in 2001 http://www.cghrc.ca/consult.html, that is, the health of individuals and societies in less developed, less resourced, poorer nations and regions of the world.
A major global health research issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world’s greatest health problems. This situation has been referred to as the 10/90 gap because only a meager 10% of all health research funding is being used to address 90% of the world’s burden of disease, suffered primarily in developing countries [7]. Because of this imbalance, there have been major attempts at redirecting research efforts and funds to the health problems of low and middle income countries.
One of the roles of health research is to ensure that the measures proposed to break out of the vicious cycle of ill health and poverty are based, as far as possible, on evidence, so that the resources available to finance these measures are used in the most efficient and effective way possible [8]

There are many different types of health research. At the 6th Global Forum on Health Research, held in Arusha, Tanzania in November 2002, Dr. Gerald Keusch, Director of the Fogarty International Center, listed the scope of health research as including: fundamental discovery research, pathogenesis research, epidemiology research, clinical research, product development research, translational and adaptational research, operational research, health services research, policy research and research on health systems [9]. NGOs involved in health research have primarily undertaken operational and action research, but many have also participated in other types of research such as epidemiological research, social science research, product development research, translational research, health services research, and policy research.

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