the National Conference on Health Research Priority Setting
17 March 2006
Programme Director,
Representatives of the international organisations and donor agencies,
Representatives from various departments of government,
Researchers,
Policy makers,
Members of the civil society including community advisory boards,
Ladies and gentlemen,
It is with honour that I address this conference today and as you know,
health research is a vital part of our efforts to bring about improved health
status of our population.
This conference comes at a right time as we are involved in global
discussion on increasing access to HIV/AIDS prevention, treatment and care. As
we engage in this process of reviewing global progress towards achieving the
goals of the declaration of commitment on HIV/AIDS the issue of research,
monitoring and evaluation are coming out as critical in assessing the success
of our interventions.
We need also to remember the discussion at the summit on health research
held in Mexico City, which looked at the role of research in the attainment of
the millennium development goals.
The summit once again highlighted the challenge of inadequate investment
into research on diseases that are the main contributors to the burden of
disease in the world. There is gross misallocation of research funding with
less than 10 percent of global health research spending devoted to 90 percent
of the global burden disease. While the global burden of disease is
overwhelmingly in developing countries, investment for health research remains
focused on diseases affecting communities in highly industrialised regions.
There have also been a meeting of African health Ministers in Abuja to
discuss issues of research in Africa. The Ministers recognised the importance
of research in improving health systems, the quality of healthcare and healthy
living as well as in providing evidence based health policy formulation and
implementation.
Ethics in health research have been of major concern over the past decades,
particularly regarding the vulnerability of research participants. There is a
long history of human rights abuse with poor communities who have low levels of
literacy and populations with unquestioning acceptance of authority being the
main targets.
Programme Director, South Africa provides a unique environment for research.
The former advantaged areas of our country have good infrastructure, skilled
researchers and well equipped research institutions comparable to many
developed countries while the rest of the population is affected the burden of
diseases common to many developing countries particularly in sub-Saharan
Africa.
All these have attracted many international institutions to develop and test
their drugs in our country. As you know, increasing research activity,
competition and attractive research environment may sometimes result in
dishonest and fraudulent practice.
As we utilise the opportunities presented by this environment, we need to
ensure that we protect human rights particularly of research participants as
entrenched in our Constitution and the National Health Act.
The National Health Act also provides for the establishment of the National
Health Research Ethics Council (NHREC). The Ethics Council must:
* Register and audit health research ethics committees
* Set norms and standards for conducting research on humans and animals,
including norms and standards for conducting clinical trials
* And adjudicate complaints and institute disciplinary action if ethics have
been contravened.
The establishment of the NHREC and committee is one of the most important
steps we have taken to ensure maintain ethical conduct in research and protect
the rights of research participants.
We have led the way in establishing government stewardship role in setting
priorities for research. The National Health Act has dedicated a whole chapter
on health research which, among others, provides for the Minister to establish
the National Health Research Committee (NHRC).
The NHRC will advise the Minister on research priorities. In identifying
these priorities, the committee will take into consideration the burden of
disease, the cost effectiveness and availability of human and institutional
capacity for implementation of interventions to address these diseases. The
priority setting should also take into consideration the health needs of
vulnerable groups including women and children, people with disabilities and
the elderly.
I am sure you will agree that this is indeed cutting edge legislation. We
will not only be focusing on the burden of disease, but also addressing the
needs of vulnerable groups and the needs of communities.
Emergent diseases such as avian flu and Severe Acute Respiratory Syndrome
(SARS) have brought to the fore the reality that there are no boundaries in the
spread of diseases. At the same time, we are faced with the challenge of other
health conditions that are neglected in terms of research such as tuberculosis,
asthma, hypertension and nutritional deficiencies, (including obesity and
malnutrition). All these call for renewed efforts on health research focusing
on these areas.
We also have deficiencies in the health systems which receive little or no
attention from donor organisation; international organisation and local
research institutions.
These areas include infection control in our health facilities, integration
of health information systems and improving efficiency in the utilisation of
resources available in the public and private health sector. We therefore need
to focus on research that improves the functioning of the health system as a
whole.
Programme Director, the rising cost of new drugs pose a major public health
burden and continue to limit the capacity of Governments and people of Africa
to access innovative and appropriate drugs and other disease control tools.
Aside from the limitations of costs of medicines, challenges encountered by
many African countries also include limited institutional capacity for
forecasting need, procurement and distribution and this is also applicable to
South Africa.
Understanding that we are Africans with a particularly history dating back
several centuries, we need to also pay attention to those things that sustained
the health of Africans throughout our history of denied access to health and
other basic services.
We need to invest resources and efforts into the research and development of
African traditional medicine in particular which have been suppressed through
several years of colonialism and apartheid.
No one will do this work for us. No one can reclaim our dignity on our
behalf. There is a great deal of literature on Indian or Chinese traditional
medicine. We need to establish those things within African traditional medicine
that add value to management of diseases and improvement of health.
There are many health challenges before us. We need to be broadminded in our
approach and diversify our interventions. Our success in the research and
development of African traditional medicine will probably be the best
contribution the health sector can make to the African renaissance.
In line with our endeavour to prioritise prevention of diseases, we also
have to focus on the area of behavioural science. We need to establish the best
measures we have to take to modify our own behaviour or lifestyle that puts us
at risk of contracting communicable diseases like tuberculosis (TB) and AIDS
and developing non-communicable illnesses such as diabetes and
hypertension.
Programme Director, I am pleased to note that we have international
organisations and various collaborating partners here with us. The substantive
participation of donor agencies and international institutions is critical in
establishing a mutual understanding of national priorities which should guide
resource allocation.
I can also not stress enough the importance of developing capacity within
communities to be true partners in setting the research agenda. Setting
priorities without community participation would be meaningless. I am therefore
glad that members of the civil society accepted our invitation and are part of
this important process. Also amongst us here are members from various Community
Advisory Boards on Research.
Priority setting should be a broad based, interactive, continuous process
that ensures equitable health development. Priority setting should also have
direct impact on funding decisions.
There are many competing social needs and resources available to address
these enormous challenges are limited. We therefore have to find the best way
to make maximum impact in improving the lives of our people using the limited
resources available. This requires that we agree on our priorities as a country
and focus our energies and resources on those agreed upon areas.
I am looking forward to receiving the outcomes of this important
conference.
Thank you.
Issued by: Department of Health
17 March 2006
