ESSENCE on Health Research

1. ESSENCEon Health Research Enhancing Support for Strengthening the Effectiveness of National Capacity Efforts

2. Conclusions (1) • ESSENCE is an initiative of research funders committed to finding efficient methods of strengthening research capacity for health in low income countries in Africa in a concerted way in the spirit of the Paris Agenda • Research inand by low income countries requires the presence of robust in-country research capacity • Sustainable research capacity strengthening for health is more than research project support involving individual training; it requires support to the basis for performing research as defined by funded institutions

3. Conclusions (2) • For alignment of efforts of funders to happen, there need to be strategies and implementation plans defined by institutions performing research for health • Harmonisation does not necessarily mean funders funding exactly the same thing, but agreeing to “simplify” where possible, for instance agreeing to joint reporting systems • Coherence in research capacity funding suggests working in concert to reduce fragmentation and above all “to do no harm”

4. ESSENCE for health research • Is a collaborative framework between funding agencies (development agencies, philanthropists, charities and multilateral initiatives) providing synergism to address research capacity needs. • It aims to improve the impact of investment in institutions and enabling mechanisms that address the identified needs and priorities within national strategies on research for health.

5. ESSENCE Focus • Funders of research for health • Research (and innovation) capacity strengthening • Low income countries in Africa

6. The Universal Declaration of Human Rights December 10th 1948, General Assembly of the United Nations Article 27 1) Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits. 2) Everyone has the right to the protection of the moral and material interests resulting from any scientific, literary or artistic production of which he is the author.

7. But does this translate to every low income country having the right to have capacity to produce and utilise scientific information Or is it enough for others to produce and give to them to use?

8. “Not all countries should have national airlines, some must use the expertise of those with resources. So why should all low-income countries have institutions of health research?” A provocative statement made by one of the Northern proponents of research for health • Perhaps not all need an airline, but low-income countries definitely need a cadre of people who can ask their own questions and have the tools to address getting the answers • Otherwise, who will ask the pertinent questions deemed relevant and of importance to the low income countries? • Unreasonable to think it will be those with other agendas, however well meaning

9. The tensions of research for health approaches in low-income African countries Different approaches justified by: • By and for • Defining the important problem of the countries and providing the know-how to be copied by the low-income countries through ”technology transfer” • If there is not the adequate capacity, who or what system can receive the transferred technology and sustain it? • Doing for • Basing the argument on urgent need to address the burning issues of today • Sustainability in question • In and by • It is only by having the research know-how in the countries where the problems exist, to do and utilise research done that sustainable research capacity can be achieved • This is a long term endeavour

10. Research capacity is more than human resources What then are the other elements?

11. National Research capacity entails National commitment to research National research policy & strategy Budget line for National research Skills for carrying out research Asking nationally relevant questions Capacity to generate own knowledge National research capacity Research University as a hub National research and ethics Capacity Capacity for analysis Capacity for evaluation Capacity to utilise external research/knowledge Innovation systems Culture of inquiry Agents of Change: Using evidence to question Capacity to be part of international research community

12. University Research capacity entails Well trained Researchers University policies and strategies Mechanisms to encourage & reward research Dedicated university budget for research Research University Mechanisms of research communication An Enabling Environment for research Capacity for local PhD examination University mechanisms for innovation Culture of inquiry Improved teaching- less didactic Skills for research management Research Leadership skills Access to scientific literature Access to Information Communication Technology

14. Africa is huge and capacity to do research diverse

15. Diversity in capacity for research for health in low income countries • Continued research capacity strengthening is an ongoing endeavour in all countries • Research capacity issues are under control in some countries but in others the challenges remain acute • It is important to distinguish the needs of countries (even those on the same continent) who have attained their targets for research capacity with those who are struggling to attain such targets • Emphasis of ESSENCE is on low income countries in Africa with weak research capacity for research for health

16. Reiterating the Paris Agenda In the context of research capacity strengthening

17. Paris Agenda For research it is relevant to note: • The Paris Declaration highlights the need for research in relation to development for providing the knowledge foundation and the expertise that make it possible for partner countries to analyse, formulate, negotiate, implement and evaluate their own development agenda. • Today these functions are often performed by external consultants and technical assistance, provided by the donors

18. Paris Agenda To change the situation the Paris Declaration states that partner countries should undertake to: • “Integrate specific capacity strengthening objectives in national development strategies and pursue their implementation through country-led capacity development strategies where needed.”

19. Paris Agenda - Alignment “Donors base their overall support on partner countries’ national development strategies, institutions and procedures” Currently support to research (for health) is mainly focused on: • research on issues of relevance to low-income countries (theme-based research), organised as projects, with a short- to medium-term perspective and closely connected to the agenda of the funding organisation Less funding goes to • The long-term commitment aimed at all levels of production and utilisation of research in a national or regional setting

20. Paris Agenda - Ownership • “Partner countries exercise effective leadership over their development policies and strategies and coordinate development actions”

21. Paris Agenda - Alignment • Development of partner countries’ capacity to negotiate collaborative research activities and to apply for research grants in line with their strategic orientation should be advocated • Donors involved in research cooperation with a country or regional/ international organisation ought to respect the rules and regulations for research, including research permits, research ethics, staff remuneration and institutional contracts

22. Paris Agenda - Harmonisation • “Donors’ actions are more harmonised, transparent and collectively effective” This requires support for • establishment of efficient mechanisms for management of external research funds; making it possible to channel funds through partner countries’ systems • production of uniform reporting formats at the supported institutions to be used by all donors.

23. Paris Agenda - Mutual Accountability • “Donors and partners are accountable for development results” • partner countries and regional organisations should be encouraged to invite all research donors/funders to joint review meetings

24. Coherence Funders should endeavour to adhere to the Paris agenda; We should • Be mindful that in an attempt to assist, we should not undermine and fragment the efforts of fragile institutions • At the least our actions should “do no harm” to partner country institutions

25. Basis for research for health • The basis for capacity for research for health also requires capacity in areas/disciplines of research of a broad nature. • These include fundamental science (Biology, Statistics, Bio-Physics, molecular biology etc.) as well clinical research and health systems research

26. ESSENCE is a response by funders to contribute to this

27. The Establishment of ESSENCE • ESSENCE was established after a meeting of funders in April 2008 in Stockholm entitled “Stockholm Meeting on Capacity Building for Research for Health”

28. ESSENCE • The initial executive group includes development cooperation agencies – the United Kingdom Department for International Development (DFID ), International Development Research Centre (IDRC), the Ministry of Foreign Affairs of the Netherlands, Norwegian, Agency for Development Cooperation (Norad), the Swedish International Development Cooperation Agency (Sida) – plus the Bill & Melinda Gates Foundation and the Wellcome Trust. NEPAD Science, Technology & Innovation have accepted an invitation to be part of the executive group • The ESSENCE secretariat is hosted in TDR (Special Programme for Research and Training in Tropical Diseases).

29. The organisations taking part in the Stockholm meeting • Bilateral funding agencies • Canada: IDRC + Global Health Research Initiative • The Netherlands: NWO/WOTRO (Research Council, Science for Global Development), + Ministry of Foreign Affairs, Netherlands Platform for Global Health Policy and Health Systems Research, • Norway: NORAD • Denmark: DANIDA/MFA + The Danish Research Network for International Health Department of International Health, Immunology & Microbiology University of Copenhagen, • Sweden: Sida + Ministry of Foreign Affairs • UK: DFID • Multilateral organisations • The World Bank + WHO, TDR + The Bamako Secretariat • Other funders (foundations, research funding bodies) • Bill & Melinda Gates Foundation + Howard Hughes Medical Institute + The Wellcome Trust + EDCTP • African representatives • ISHReCA + WHO/AFRO + WHO Region for Africa Sub-Regional Office in Harare, Zimbabwe,

30. ESSENCE • ESSENCE for health Research has started a process between the funders/development partners/donors (collectively referred to as “funders”) in the spirit of the Paris Agenda • ESSENCE is focused on how the funders can best align and harmonise and be coherent and learn from each other in the quest for supporting research capacity in Africa • ESSENCE will of course engage partner countries and institutions

31. ESSENCE • Is open for all funders, bilateral development agencies, philanthropists, charities etc. who support or are interested in supporting research capacity in low income countries in Africa

32. ESSENCE African countries RCS initiative A ESSENCE Secretariat World Bank EDCTP Executive Committee African countries INDEPTH RCS initiative C ESSENCE members DFID BMGF Sida NWO Sec. Norad IDRC African Dev. bank DANIDA Dutch NEPAD Wellcome RCS initiative B ISHReCA RCS initiative A WHO/AFRO Global Health Research Initiative African countries African advisors

33. Working in the spirit of the Paris Agenda Strategies for Harmonising, alignment and coherence in support for research capacity strengthening in low income countries in Africa

34. What ESSENCE is Not • It is not a research (R&D) projectbut it must be driven by research activities • Not a new initiative for disbursing research project fundsbut a mechanism of funders funding low-income African country strategies of research capacity in a concerted fashion • Not a ”budget support” arrangementbut could involve basket funding when possible • It is not trying to coordinate and define the research for health research performed, but seeking to find appropriate research capacity strengthening modalities in low income countries which if leveraged could have significant impact

35. ESSENCE The Objectives

38. How can ESSENCE work practically?

40. One Funder may address some institutional needs

41. Several Funders can better impact on overall institutional needs Funder Y contribution

42. Research capacity needs • Endeavouring to limit the fragmentation in the little research capacity strengthening that is supported

43. A concerted approach to research funding • Support for the conditions/foundation for research • Support for individual researchers • Support for research projects • Finding opportunities to work with other donors and funders in the spirit of the Paris Declaration for Aid effectiveness Individual researchers Foundation and Basis

44. How far have we come?

46. The response is the establishment of ESSENCE A strategy of funders to work together to support research capacity strengthening for health in low-income African Countries

47. Conclusion 3 ESSENCE aims address a number of points raised in the Global strategy and plan of action on public health, innovation and intellectual property • (2.3) improving cooperation, participation and coordination of health and biomedical research and development • (a) stimulate and improve global cooperation and coordination in research and • development, in order to optimize resources • (b) enhance existing fora and examine the need for new mechanisms, in order to improve the coordination and sharing of information on research and development activities • (c) encourage further exploratory discussions on the utility of possible instruments or • mechanisms for essential health and biomedical R&D, including inter alia, an essential health and biomedical R&D treaty • (d) support active participation of developing countries in building technological capacity • (e) promote the active participation of developing countries in the innovation process

48. Conclusion 4 ESSENCE aims to support in a concerted way • (3.2) Framing, developing and supporting effective policies that promote the development of capacities for health innovation • (a) establish and strengthen regulatory capacity in developing countries • (b) strengthen human resources in research and development in developing countries through long-term national capacity building plans • (c) encourage international cooperation to develop effective policies for retention of health professionals including researchers in developing countries • (d) urge Member States to establish mechanisms to mitigate the adverse impact of the loss of health personnel in developing countries, particularly researchers, through migration, including by ways for both receiving and originating countries to support the strengthening of national health and research systems, in particular human resource development in the countries of origin, taking into account the work of WHO and other relevant organizations.