ABSTRACT
This text main objective is to discuss development and health from the perspective of the influence of global health governance, using as the tracer the dimension of research, development, and innovation policies in health, which relate to both important inputs for the health system, like drugs and medicines, vaccines, diagnostic reagents, and equipment, and innovative concepts and practices for the improvement of health systems and public health. The authors examine the two main macro-processes that influence development and health: the post-2015 Development Agenda and the process under way in the World Health Organization concerning research and development, intellectual property, and access to health inputs. The article concludes, first, that much remains to be done for the Agenda to truly represent a coherent and viable international political pact, and that the two macro-processes related to innovation in health need to be streamlined. But this requires democratization of participation by the main stakeholders - patients and the general population of the poorest countries - since this is the only way to overcome a "zero sum" result in the clash in the current debates among member State representatives. Resumo: O objetivo central deste texto é discutir desenvolvimento e saúde sob a ótica da influência da governança da saúde global, utilizando como traçador a dimensão das políticas de pesquisa, desenvolvimento e inovação em saúde, que se referem, de um lado, a insumos importantes para o sistema de saúde - como fármacos e medicamentos, vacinas, reativos para diagnóstico e equipamentos e, de outro, a conceitos e práticas inovadoras para o aperfeiçoamento dos sistemas de saúde e da saúde pública. Examina os dois principais macroprocessos que influenciam o desenvolvimento e a saúde: a Agenda do Desenvolvimento para o pós-2015 e o processo sobre pesquisa e desenvolvimento, propriedade intelectual e acesso a insumos em saúde em curso na Organização Mundial da Saúde. Conclui que muito há que ser feito para que a referida Agenda possa representar um pacto político internacional coerente e viável, e que os dois macroprocessos relacionados com a inovação em saúde precisam ser agilizados, mas para isto torna-se necessária a democratização da participação dos maiores interessados - os pacientes e, de modo geral, a população dos países mais pobres - pois só desta maneira será superada a "soma zero" em que se encontra o embate entre os representantes de Estados-membros nos debates atuais.
Subject(s)
Diffusion of Innovation , Global Health , Health Policy , Internationality , Technology Assessment, Biomedical , HumansABSTRACT
Abstract: This text main objective is to discuss development and health from the perspective of the influence of global health governance, using as the tracer the dimension of research, development, and innovation policies in health, which relate to both important inputs for the health system, like drugs and medicines, vaccines, diagnostic reagents, and equipment, and innovative concepts and practices for the improvement of health systems and public health. The authors examine the two main macro-processes that influence development and health: the post-2015 Development Agenda and the process under way in the World Health Organization concerning research and development, intellectual property, and access to health inputs. The article concludes, first, that much remains to be done for the Agenda to truly represent a coherent and viable international political pact, and that the two macro-processes related to innovation in health need to be streamlined. But this requires democratization of participation by the main stakeholders - patients and the general population of the poorest countries - since this is the only way to overcome a "zero sum" result in the clash in the current debates among member State representatives.
Resumen: El objetivo central de este texto es discutir el desarrollo y la salud, desde la óptica de la influencia de la gobernanza de la salud global, utilizando como eje vertebrador la dimensión de las políticas de investigación, desarrollo e innovación en salud, que se refieren, por un lado, a insumos importantes para el sistema de salud -como fármacos y medicamentos, vacunas, reactivos para diagnóstico y equipamientos y, por otro, a conceptos y prácticas innovadoras, para el perfeccionamiento de los sistemas de salud y de la salud pública. Se examinan los dos principales macroprocesos que influencian el desarrollo y la salud: la Agenda del Desarrollo para el pos-2015 y el proceso sobre pesquisa y desarrollo, propiedad intelectual y acceso a insumos en salud, en curso dentro de la Organización Mundial de la Salud. Se concluye que se deben realizar muchos esfuerzos para que la referida agenda pueda representar un pacto político internacional coherente y viable, asimismo, los dos macroprocesos relacionados con la innovación en salud necesitan agilizarse, pero para esto es necesaria la democratización de la participación de los mayores interesados: los pacientes y, de manera general, la población de los países más pobres, pues sólo de esta forma será superada la "suma cero" donde se encuentra el embate entre los representantes de estados miembros en los debates actuales.
Resumo: O objetivo central deste texto é discutir desenvolvimento e saúde sob a ótica da influência da governança da saúde global, utilizando como traçador a dimensão das políticas de pesquisa, desenvolvimento e inovação em saúde, que se referem, de um lado, a insumos importantes para o sistema de saúde - como fármacos e medicamentos, vacinas, reativos para diagnóstico e equipamentos e, de outro, a conceitos e práticas inovadoras para o aperfeiçoamento dos sistemas de saúde e da saúde pública. Examina os dois principais macroprocessos que influenciam o desenvolvimento e a saúde: a Agenda do Desenvolvimento para o pós-2015 e o processo sobre pesquisa e desenvolvimento, propriedade intelectual e acesso a insumos em saúde em curso na Organização Mundial da Saúde. Conclui que muito há que ser feito para que a referida Agenda possa representar um pacto político internacional coerente e viável, e que os dois macroprocessos relacionados com a inovação em saúde precisam ser agilizados, mas para isto torna-se necessária a democratização da participação dos maiores interessados - os pacientes e, de modo geral, a população dos países mais pobres - pois só desta maneira será superada a "soma zero" em que se encontra o embate entre os representantes de Estados-membros nos debates atuais.
Subject(s)
Humans , Technology Assessment, Biomedical , Global Health , Internationality , Diffusion of Innovation , Health PolicyABSTRACT
BACKGROUND: The fast growth of global health initiatives (GHIs) has raised concerns regarding achievement of coherence and synergy among distinct, complementary and sometimes competing activities. Herein, we propose an approach to compare GHIs with regard to their main purpose and operational aspects, using the Special Programme for Research and Training in Tropical Diseases (TDR/WHO) as a case study. The overall goal is to identify synergies and optimize efforts to provide solutions to reduce the burden of diseases. METHODS: Twenty-six long-established GHIs were identified from among initiatives previously associated/partnered with TDR/WHO. All GHIs had working streams that would benefit from linking to the capacity building or implementation research focus of TDR. Individual profiles were created using a common template to collect information on relevant parameters. For analytical purposes, GHIs were simultaneously clustered in five and eight groups according to their 'intended outcome' and 'operational framework', respectively. A set of specific questions was defined to assess coherence/alignment against a TDR reference profile by attributing a score, which was subsequently averaged per GHI cluster. GHI alignment scores for intended outcome were plotted against scores for operational framework; based on the analysis of coherence/alignment with TDR functions and operations, a risk level (high, medium or low) of engagement was attributed to each GHI. RESULTS: The process allowed a bi-dimensional ranking of GHIs with regards to how adequately they fit with or match TDR features and perspectives. Overall, more consistence was observed with regard to the GHIs' main goals and expected outcomes than with their operational aspects, reflecting the diversity of GHI business models. Analysis of coherence indicated an increasing common trend for enhancing the engagement of developing country stakeholders, building research capacity and optimization of knowledge management platforms in support of improved access to healthcare. CONCLUSIONS: The process used offers a broader approach that could be adapted by other GHIs to build coherence and synergy with peer organizations and helps highlight the potential contribution of each GHI in the new era of sustainable development goals. Emerging opportunities and new trends suggest that engagement between GHIs should be selective and tailored to ensure efficient collaborations.
