sustainable health programs: any role of universities? bernt lindtjørn
DESCRIPTION
My experience as a ”country physician” Work in rural Ethiopia Visits by”high ranking visitors” Government International organizations Universities Results (long-term) ?TRANSCRIPT
Sustainable Health Programs: Any Role of Universities?
Bernt Lindtjørn
Status in Africa
Population: approaching 1 billion Less than 30,000 African-born PhD-level scientists work in
Africa Independent scientific academies only in ten of 53
countries Health challenges
……… ………
Nature 2004
My experience as a ”country physician”
Work in rural Ethiopia
Visits by”high ranking visitors” Government International organizations Universities
Results (long-term)
?
”Research and Development”
Research at Universities Done in isolation? Do they have the freedom and the means to
participate?
Are the ”large donors” also working in isolation? As viewed from the Universities As seen from the regional/ local authorities As seen from the patients and from the communities
A message from young physicians eager to mix research with medicine:
“We know what we wish to do. So please: do not tell us what you think we ought to do.
Work with us not only to deliver the medicine we need, but also to create the research programme that will support it”
Lancet 2001
Does DOTS work?
Yes! WHO, IUATLD, ……… ”Over 80% of patients are cured”
No April 2004: 50% of patients with AFB+ tuberculosis refused DOTS in
Ujjain (India). The prevalence of tuberculosis is unknown, but higher than expected In Addis Ababa only 10% of patients identified in the community were
on treatment
Alternatives? Should the “No” participate on defining the research research
agenda (and ”tomorrows” development agenda)?
The mission of the EDCTP is to accelerate the development of new clinical interventions to
fight HIV/AIDS, malaria and tuberculosis particularly sub-Saharan Africa
to improve the quality of research in relation to these diseases.
The activities of the EDCTP include: ensuring that research effectively addresses the needs and
priorities of DCs to develop and strengthen capacities in the DCs, including the
promotion of technology transfer ……
? How do you do this?
Emphasis on the developing countries’ own responsibility
Co-ordination of measures … the UN and the World Bank …. greater synergistic effect.
Focus on research on diseases that affect the poor.
……
New white paper on Norwegian development policy
Can we define what is relevant health research in developing countries? Research on inherently global health issues that reduce the
burden of disease, and vice versa
Research that represents concerns or questions defined by developing countries
Research that increases equity in health outcomes between groups within nations
Research that engages civil society
Research that increases equity in knowledge capacities between developed and developing countries
BMJ 2001
the challenge is …..
To modernize Africa's universities To transform Universities and Research institution from
"clubs for old men" to younger, more active and inclusive bodies
To build scientific capacity and address the continent's problems
But, governments must use Universities/ Research institutions
African scientists need to influence their countries' policies on
Public health Agriculture Environment Research priorities ……
Barriers to information exchange between North and South Research Lack of resources
Poor laboratory facilities Limited technical support Little available training Few tutors or mentors No career structure Weak peer networks Diffuse relation between research and academic reward Research biased to Northern interests
Publication Editorial bias Information access
Lancet 2001
Countries need to enable their universities to
Teach Do relevant research Apply their research findings Participate in defining policies Participate as partners in international
collaborations ...
“The politics of knowledge”