WHO STRATEGY ON PRIORITY SETTING
IN HEALTH-RELATED RESEARCH AGENDA
Robert Terry, Knowledge Manager
20th January 2017
Research on Research” in the Arab Region
The Case of Non-Communicable Diseases
WHAT IS TDR?
Established in 1975 and hosted by
the World Health Organization.
[2]
TDR
MAKING A DIFFERENCE
Catalyst, facilitator and advisor in
the global health research debate.
MORE THAN 40 YEARS OF RESEARCH
MAKING AN IMPACT
1975
1995
2017
MEDICINES, DIAGNOSTICS
AND VECTOR CONTROL
COMMUNITY AND
SOCIAL RESEARCH
ACCESS FOR THE
MOST VULNERABLE
 Multi-drug therapy for leprosy
 Community-led approach
 Guidelines for considerations of
 Mefloquin and Mefloquine plus
to onchocerciasis annual
mass treatment
sulphadoxine-pyrimathamine for malaria
 Ivermectin for onchocerciasis
 Leishmaniasis direct agglutination
diagnostic test
 Insecticide-impregnated tsetse fly
traps for sleeping sickness
[3]
2005
TDR
MAKING A DIFFERENCE
 Home management of
malaria by community
healthcare workers
 New social research
methodologies
gender and ethics in social science
 Integrated approach to diarrhoea,
malaria and pneumonia management
at the community level
 New tools and approaches to
improve implementation of needed
treatments and diagnostics
RESEARCH SUPPORT
about
100 PROJECTS
in more than
50 COUNTRIES
VECTORS, ENVIRONMENT
AND SOCIETY RESEARCH
INTERVENTION AND
IMPLEMENATATION RESEARCH
[4]
TDR
MAKING A DIFFERENCE
STRENGTHENING RESEARCH CAPACITY
3
GENERATIONS OF PUBLIC
HEALTH LEADERS
many directing disease control
and research efforts
[5]
TDR
MAKING A DIFFERENCE
SUPPORTING 6 REGIONAL TRAINING CENTRES
 Coordinating training courses across multiple countries
 Forming a network that includes satellite centres
 Fostering learning and collaboration within their
respective regions and also among each other
 Developing a massive open online course (MOOC) on
implementation research and a basic course on the
principles of this type of research
Astana Medical University,
Astana, Kazakhstan
Institut Pasteur de Tunis,
Tunisia
Centro Internacional de
Entrenamiento e
Investigaciones Médicas
(CIDEIM), Cali, Colombia
School of Public Health
University of Ghana
[6]
TDR
MAKING A DIFFERENCE
Research Institute of
Tropical Medicine (RITM),
The Philippines
Gadjah Mada University
Yogyakarta, Indonesia
SEVEN UNIVERSITIES PARTICIPATING IN TDR
POSTGRADUATE TRAINING SCHEME
 Increasing the numbers of scientists in
low- and middle-income countries trained in
implementation research and supporting the
development of this field of study
 Increasing the capacity of universities in these
countries to provide this curriculum, manage training
grant schemes and mentor students
 Expanding the reach of this type of education and
training in a systematic process
Universidad de Antioquia,
Medellin, Colombia
American University
of Beirut, Lebanon
BRAC University,
Dhaka, Bangladesh
University of Ghana,
Accra
University of Zambia,
Lusaka
University of Witwatersrand,
Jahannesburg, South Africa
[7]
TDR
MAKING A DIFFERENCE
Gadjah Mada University,
Yogyakarta, Indonesia
WHO and research priority setting
[8]
TDR
MAKING A DIFFERENCE
Principles
Quality - research that is
ethical, expertly
reviewed, efficient,
effective, accessible to
all, and carefully
monitored and evaluated.
Impact - priority for
research with greatest
potential to improve
global health security,
health-related
development
Inclusiveness partnership,
multisectoral approach,
support and promote the
participation of
communities and civil
society in research
[9]
TDR
MAKING A DIFFERENCE
Standards: Research priority setting checklist
One output from the strategy on research for health
1. Context:
Which contextual factors underpin the process:
What resources are available for the exercise?
What is the focus of the exercise (e.g. who is it
for?
2. Use of a comprehensive approach
5. Planning for implementation
Establish plans to translate the priorities to actual
research. Who will implement the research
priorities? And how?
6. Criteria
Select criteria to focus discussion around
setting research priorities.
Adopt or adapt an established method or develop own.
3. Inclusiveness
7. Methods for deciding priorities
Choose an approach to ranking or reaching
consensus on priorities.
4. Information gathering
8. Evaluation
Define when and how the priorities will be
reviewed. Research priority setting is not a
solitary exercise!
Decide who should be involved and why.
Balance/representation expertise and balanced
gender and regional participation?
Literature reviews, collection of technical data
(burden of disease or cost-effectiveness data),
broader stakeholder views, reviews or impact
analyses of previous priority setting exercises or
exercises from other geographical levels.
9. Transparency
Write a clear report: Who set the priorities?
How exactly were the priorities set?
https://health-policy-systems.biomedcentral.com/articles/10.1186/1478-4505-8-36
[10]
TDR
MAKING A DIFFERENCE
Value of setting national research priorities
Brazil’s top 10 investments in health research, 2004 -2009
US$ millions, 2004-9
120
100
80
60
40
20
0
Source: HPRS 9, 35, 2011
How research contributes to
universal health coverage
WHR 2013 presents 12 case
studies to illustrate:
• the range of methods from
observational studies to
randomized controlled trials
• the diversity of problems for
which research can offer solutions
• the nature of the research cycle
(questions, answers, more
questions)
• the relationship between study
design and strength of inference
• the link between research, policy
and practice
WHR 2013: Framework for research by purpose
Problem
Cause
• Size of the
problem
• Epidemiology
• Burden of
Disease
• Data collection
• Understanding
the data
• Disease
understanding
• Research
priorities
Solution
• Drug
• Device
• Diagnostic
• Vaccine
• Vector
• Basic Science
WHO strategy on Research for Health, 2010
Implementation
• Translation of
evidence into
policy,
practices and
programs
• Program
design
• Guidelines
Evaluation
• Framework
and tools for
evaluation
• Program,
policy,
practice
evaluation and
monitoring
Classifying research by purpose x disease (ICD11)
•Results of an analysis of all WHO reports on research since 2005
Drug 19%
Evaluation
21%
Problem
10%
Vaccine 15%
Screening/
Diagnostic 26%
Implementati
on
27%
Cause
19%
Vector control 7%
Solution
23%
Device 16%
Basic science 13%
Distribution of WHO Health R&D
Priorities According to Research Type
n=1306
WHO solution-focused health R&D
priorities categorized according to
health technology n=325
Other 4%
Selected WHO solution-focused R&D priorities categorized
according to health technology and disease – reports published
since 2005
Example of how a classification system might be used to compare portfolios
70%
60%
50%
Screening/
Diagnostic
80%
Vector Control
90%
Basic Science
100%
Other
30%
10%
0%
Drug
20%
Vaccine
40%
2011
[16]
TDR
MAKING A DIFFERENCE
A prioritized research agenda for prevention and
control of noncommunicable diseases (WHO 2011)
Summary
A. research for placing noncommunicable diseases in the global
development agenda and for monitoring;
B. research to understand and influence the multisectoral,
macroeconomic and social determinants of noncommunicable
diseases and risk factors;
C. translation and health systems research for global application
of proven cost-effective strategies; and
D. research to enable expensive but effective interventions to
become accessible and be appropriately used in resource
constrained settings.
[17]
TDR
MAKING A DIFFERENCE
A prioritized research agenda for prevention and
control of noncommunicable diseases (WHO 2011)
Summary
Major NCDs
• Cardiovascular disease (CVD)
• Cancer
• Chronic respiratory diseases
• Diabetes 30
NCD risk factors
• Tobacco control
• Nutrition, physical activity and
obesity
[18]
TDR
MAKING A DIFFERENCE
Cross-cutting domains
• Primary health care approach for
prevention and control of NCDs
• Social determinants and NCDs
• Genetics
• Promoting use of research findings to
policies and practice
• for prevention and control of
noncommunicable diseases.
• What are the factors that affect
research utilization?
Top 20 priority areas for NCD research