Getting it out there

Given the choice, would the average scientist prefer to find a cure for tuberculosis or find a really effective way of getting it to people? It is the concentration on the former that Ok Pannenborg, a senior health advisor at the World Bank, highlighted this morning at Bamako 2008 in a plenary session on research for health challenges.

Health systems research, he said, is unsexy. Health systems are seen as “amorphous, abstract and vast”. How can anyone go about researching such things?

The key, he said, is not to see it as disease versus health systems research, or even disease research alongside health systems research – but focusing on better health systems for the treatment of disease.

Research, he said, is an indispensible tool for improving health systems, from identifying and understanding problems to developing and evaluating new ways of doing things.

But it’s not just in health systems that finding out how to best deliver things to people is key. Health is not just about healthcare, said Michael Marmot, chair of the WHO Commission on the Social Determinants of Health, in a video presentation during a later session.

Research into the social determinants of health has shown what can lead to poor health. It’s acting on this evidence which is the next step, said Marmot. We know that clean water is good for people’s health, let’s find a way of getting it to people.

Katherine Nightingale, SciDev.Net

One Response to Getting it out there

  1. THD says:

    One of the main differences is that working on finding a cure (once it is found) is perceived as more actionable than conducting health systems research. There are lots of good ways to do health systems research today compared to 30 years ago and the field has advanced a lot. What has not changed is the willingness of MOH or government entities to enact changes suppored by health systems research – which can be on a massive scale involving many moving parts and changes in human behaviour (e.g. changing physician payment incentives) compared to administering a drug. It is really difficult to compare the two as they sometimes are on opposite ends of the micro-macro spectrum, but not always.

    What would be interesting to see is a debate on the resources + timeline it takes to
    discover a drug (billions of dollars in resources + decades of research) to changes that have been implemented to healthy systems (whether at a local or larger level). When looking at it from these limited dimensions of time + resources we may find that health systems investment is much better than drug discovery.

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