Invitation to e-discussion on POVERTY, EQUITY AND HEALTH RESEARCH

We would like to invite HEN colleagues to participate in a special HIF-net
e-conference on 'Poverty, equity and health research', 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 [log in to unmask]

2. If you prefer, send your comments to [log in to unmask]
  As members of your list, and many others, we shall pull threads together 
for a
synthesis of the issues from different perspectives, 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 international
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: www.globalforumhealth.org.

By 'health research', we understand the whole spectrum from biomedical
research that creates new drugs, vaccines and diagnostics, to health
systems and policy research which ensures that health systems are better
informed and managed, to social science 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 participants. 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 contribute to
the discussions. Over the past few years, we have introduced different
mechanisms to reach out to listen to these other voices. Through a call
for abstracts, for example, we receive proposals for presentations that
enrich the annual meeting programme. In addition last year we created an
electronic magazine, 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 interdependence 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 expertise.

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

[HIF-net profile: Susan Jupp is Head of Communications and Information
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 research to combat the neglected diseases
and conditions that are major sources of ill health in developing
countries. http://www.globalforumhealth.org
[log in to unmask] ]

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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 emerging and re-emerging infectious
diseases; rapidly increasing levels of noncommunicable diseases and
injuries in developing countries; 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 understand how health is
influenced by a range of social determinants - remains vital if we are to
achieve the goals of narrowing 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, behavioural and operational
research, and research into the relationship between health and the
cultural, economic, physical, political, 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 people's different
positions within social hierarchies - including but not limited to the
hierarchy of poverty and wealth. Epidemiological evidence shows that most
of the global burden of disease 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;
social exclusion; health systems; environments; food security; water and
sanitation; children's early life environment; education; housing;
employment and working conditions; and the effects of community and social
structures ('social capital') on health.

Today health equity gaps are growing between and within countries, 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. Overcoming 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 vulnerable
communities requires action on the broader social determinants 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 management 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 policies, health
systems and the relationships between them. A well-functioning health
system therefore needs to incorporate research 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 insufficient 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 challenges to
global health. At the same time, a range of major scientific 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 building 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 nations 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 systems, social sciences and
behavioural research) to meet the needs of people everywhere and
especially the poor and marginalized?

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