Studying gender inequality won't fix health without the political will

Claudio Schuftan, an advocate for the right to health based in Vietnam, sounded a pessimistic note yesterday in a discussion on research into the social determinants of health.

As participants discussed the best ways to ensure that research into poor living conditions and gender inequality is treated as a rigorous science, Schuftan asked us whether we “were living in a dream world”. His point was that the scientific community talks of the need for more evidence – but what about the political will?

This is an obvious point but one worth making again amidst calls for more evidence-based policies. First, we have a lot of evidence already for what works and what doesn’t. Second, all the evidence in the world will not convince a policymaker who does not see the political will to alter health-care policies.

This was the point that Carlos Morel, director of the Center for Technological Development in Health at FIOCRUZ in Brazil, made when I spoke to him about translating innovation from Cuba to the rest of the world.

Morel said that there would be little point in Cuba transferring knowledge to countries that don’t have the capacity to use that information. Cuba’s political dictatorship – in essence, its unswerving political will – is what ensured that it first developed a robust health system on which to build more advanced scientific institutions, he said.

Africa needs to find a way now to imbue its own democracies with that strong political will for healthcare reform.

Priya Shetty, www.scidev.net, priya4876@gmail.com

“Forget about using science to achieve political goals; it doesn’t even work.”

Christopher Whitty (Credit: LSHTM/Anne Koeber)

That was the stark message delivered by Chris Whitty (right), recently appointed head of research at the UK Department for International Development (DFID), to the two-day meeting taking place in London this week on “New Frontiers in Science Diplomacy“.

Whitty, a malaria specialist who was appointed in January (see UK’s DFID appoints research chief) and emphasised that he was speaking in a personal rather than an official capacity, delivered what he described as a “hymn of praise” for the role of science in international development.

He listed some of the “wonderful things” that science was capable of doing to help to mitigate the effects of poverty around the world, while adding that “it has been massively overlooked by those involved in international development for many years”.

But he was scornful of efforts to use scientific and technical assistance to achieve broader political goals such as increasing influence or even contributing to social stability, both of which he included among “less good reasons” to engage in science in developing countries.

“They are less good because they don’t work,” he said.

One idea he criticised was that training scientists was a valuable way of buying influence with a country’s scientific community. The historical record showed that highly trained scientists often left their countries of origin to continue their work overseas.

“Another idea is that science can promote social stability,” said Whitty. “The evidence is the reverse. Science can be a transformative influence. But transformation can lead to turbulence, which itself can lead to conflict.”

Even the idea that science should be promoted because it was an unalloyed good had its problems. “This is clearly not correct. For example, there is some good south-south collaboration on nuclear issues that does not bring joy to the rest of the world.” No names were mentioned; but no names were needed.

The reason for engaging in science in developing countries should have a single, clear, purpose, he suggested: “to transform the lives of the poor”. A simple enough message. But one that placed a large question mark over the desirability of seeking to use science for diplomatic ends, particularly in the context of relationships with the developing world.

David Dickson, SciDev.Net.

[BAMAKO] Ministers from across the developing world say they want to take control of their own health research agendas as part of a wish list presented at the Global Ministerial Forum on Research for Health yesterday (19 November).

Launching the much-awaited ‘Call to Action’ at the closing event of the Forum they said they want to prioritise policies dealing with research for health and improve coordination between ministries so that their respective countries can have more ownership of research.

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[BAMAKO] Tricky decisions about research priorities should not be left in the hands of academics, according to a speaker at the Global Ministerial Forum on Research for Health.

Instead, policymakers, recipient communities and those who implement policies — an often-neglected group — should be setting the agendas, Irene Akua Agyepong, regional director of the Ghana Health Service told the conference in Bamako, Mali.

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[BAMAKO] Several key African countries have done “very little” to invest in health research since pledging to do so at a world meeting of health and science ministers in Mexico four years ago, say critics.

But others – including Tanzania, Rwanda and Mali – have made significant progress in investing in their health research.

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