David Dickson

There’s been much talk in Cape Town at Forum 2012 over the past week of the need for a paradigm change in thinking about health research for development.

Certainly the concept is a useful one to describe the switch from an approach focussed primarily on the allocation of research resources, to one that addresses the need to build systems of innovation in the health field (as elsewhere).

It helps us move beyond a fixation with the famous 90/10 imbalance between research expenditure on developed and developing world health priorities, to embrace a wider perspective.

But at the end of three days of lively discussions, I remained unclear whether talking about “Beyond aid” – the theme of the meeting – represented a radical idea, or a useful way of labelling a set of trends that have been in motion for some time, and identifying the general direction in which they point.

Either way, however, such a discussion is timely.

First, as Carl Ijsselmuiden, executive director of the Council on Health Research for Development (COHRED), the main organiser of the conference, pointed out in his opening remarks, it captures the growing feeling that “foreign aid as hand-outs to the poor” is no longer workable.

The approach may not be one that wins many votes for aid-providing governments. But in the long-term, these realise that “foreign aid as capacity building” is much more likely to produce lasting results.

 Second, talking about what happens next – particularly in an area such as health research and innovation, and at a time when external sources of funding are drying up – provides a spur to developing country governments to address their own responsibilities.

Ending on an up-note: the singer Princess Chaka Chaka, UN Goodwill Ambassador and a champion of Africa's fight against malaria, leads participants of Forum 2012 in a farewell chorus (Gabi Falanga)

This has both funding and policy implications. Health research spending needs to become a higher priority for these governments. And they need to create the incentives that will allow the result of this research to be translated into medical products – such as drugs – and services.

Finally, there is the pragmatic issue that, as aid budgets start falling in many developed countries as a result of their financial difficulties, anything that promises to “do more with less” with what funding remains available becomes increasingly attractive.

Moving from “aid as hand-out” to “aid as capacity building” does just that.

So, three good reasons for embracing the concept of a paradigm change. But it also became clear in the Forum 2012 discussions that there are reasons for not expecting too much, too soon.

There may be consensus on what needs to change. But this consensus does not necessarily extend to agreement on what this change should be.

For example, those seeking a new international convention on health research and development argue that it is needed to make up for the failure of the market system to provide developing countries with access to medicines at affordable prices.

Pharmaceutical companies may agree that this is a challenge. And that they need to work with governments – and aid agencies – to tackle it. But their interests ultimately lie in benefitting from the market, not in seeing alternatives put in place.

Similarly health ministers may be persuaded of the arguments for developing home-grown health industries, better equipped to meet local health needs.

But the people who really need convincing work in finance ministries. And the financial case for operating in a new way, rather than, for example, just importing technologies from abroad, is not always self-evident.

Paradigms get embedded in social – and political – systems. Changing them is not just a question of rational debate (even in science). It also requires challenging the interests that the old paradigm served.  And it can have costs attached.

So, big challenges ahead. The major contribution of Forum 2012 was to help cement the idea that “aid for capacity building” is the new mantra that needs to frame aid and government policies, in developed and developing countries alike.

Also that, as in fields such as agriculture and energy, health needs to move away from the idea that developments are research-driven, to recognising that research is one component of a holistic system of innovation – each part of which needs to be addressed.

The immediate task, as always, is to work out what all this means in practice, identifying needs and opportunities, and assessing the potential contributions of all interested parties (including the media).

Not quite the “Beyond aid” vision that the organisers are aiming for. But a step in that direction.

David Dickson is editor of SciDev.Net

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012.

Lia Labuschagne

What role can scientific journals play in bringing the knowledge divide, not only between North and South, but also between researchers and policymakers?

A lively general discussion at Forum 2012 focussed on the role of journals in knowledge transfer in the field of sexual and reproductive health and rights. But the same issues relating to disseminating scientific information also apply to other disciplines.

Some current topics relating to the international output of scientific journals were introduced by Marge Berer, editor of Reproductive Health Matters, and Ann Strode, senior lecturer at the School of Law, University of KwaZulu Natal, and editorial advisory board member of AIDS Care.

Journal articles can help bridge the gap between research and policymakers (Credit: Reproductive Health Matters)

Berer commented that “there has never been so much information before, nor so many means of disseminating and using it”.

Participants in the general discussion nevertheless pointed out that, especially in developing countries, there is often a big time lag between research being completed and finding its way into text books.

Factually outdated information is often still being taught. And although new health and other policies may be adopted, there may be no change in teaching material.

Scientific journals provide a useful link across this divide, partly because their up-to-date research findings and information is increasingly becoming available in accessible, electronic format to a global readership of academics and practitioners within various disciplines.

Advocates and lobbyists also use the information in journals as the basis of advancing well-founded arguments for change of policies and practices.

Strode said journals such as AIDS Care are therefore used by both researchers and policymakers as a high-quality source of knowledge that they can provide from a multi-disciplinary perspective.

Some additional ideas to emerge from the discussion of ways to use the contents of scientific journals to aid development included translations of articles into local languages, and selecting key pieces of writing on specific topics to be made them available as thematic packages.

In terms of the North/South divide, Berer pointed out that “more authors from developed countries than from developing countries have access to the resources to publish in international journals”.

To help to redress this imbalance, she said that RHM gives preference to papers about developing countries by authors from those countries, or written with authors from those countries.

Broader issues discussed at the session included the continued debates around open and closed peer review processes, formal recognition for reviewers, and questions of ownership and funding.

Lia Labuschagne is a freelance journalist based in Cape Town

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

David Dickson

It’s not often that a department of transport gets applauded for solving a major health problem. But this happened in Uganda, where health officials had been struggling to reduce infant mortality rates in an area outside the capital Kampala.

Success came not with a new medical strategy, but with the opening of a road built to speed bananas to Kampala’s markets. An unplanned consequence was that the road gave mothers quicker access to better medical facilities – and mortality rates dropped sharply.

Banana transport in Uganda: an unlikely aid to reducing infant mortality (Credit: IITA)

The story was picked up at the closing session of Forum 2012 by the chair of the meeting’s steering committee, Francisco Sogane, former minister of health in Mozambique, as epitomising one of its main conclusions.

“We need to cut across sectors in addressing the multiple challenges still faced by billions of people across the world,” Sogane said.

“We in the health sector need to open the doors of our community and work with other sectors in meeting our common challenges. The way forward is to bring together expertise from different sectors, and develop novel and sustainable solutions to the problems that we face”.

The same theme was echoed by Gwen Malegwale Ramokgopa, South Africa’s deputy minister of health, who urged that “we must make health research everyone’s business”.

Ramokgopa stressed that governments in developing countries needed to invest more in health research, particularly at a time when funding from donor agencies in the developed world – the traditional source – was falling due to the financial difficulties of their governments.

“We can see this situation as a threat, or we can see it as an opportunity to look at better and more sustainable ways of dealing with research and innovation in our countries and regions,” she said.

Indeed, there’s been a general feeling at the three-day meeting that the idea of moving “beyond aid” – the title under which it is being held – is a robust one whose time has come, and that the challenge is now to move from talk to action.

Sogane: "We need to open the doors of our community" (Gabi Falanga)

Sogane pointed out that developing country governments needed to address three tasks: setting their own priorities for health research (rather than letting these be determine by donors); training more people to carry out the necessary research; and providing incentives for turning research results into pharmaceutical products and medical treatments.

Ramokgopa picked up the same theme, pointing out that South Africa had already held its own national research summit of stakeholders to agree on joint objectives – and ensure that the country’s research goals are aligned with its health priorities.

“Those in the knowledge-based sector have been focussed on their own priorities, those in government on theirs, and civil society organisations on theirs,” she said. “Our summit helped us to develop a common research agenda for improving the health of our people.”

There was also a general feeling that, despite the lack of any major new developments, Forum 2012 has strengthened the case for focussing on the links between health research and health innovation, and broadening the debate to include new actors, including the private sector – and even the media.

The next forum is provisionally planned to take place in two years’ time. Before then, discussions are taking place about holding regional fora on the same theme, perhaps in Africa and Asia.

As for the content of such discussions, the road ahead already seems well mapped out. And this time, meeting health needs – not those of Ugandan bananas – will be the top priority.

David Dickson is editor of SciDev.Net

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012.

Kathryn Strachan

African countries are at a turning point, where they have an opportunity to invest in research capacity and ‘leapfrog’ over research institutions in other parts of the world.

This was the optimistic message from Val Snewin, international activities manager for Britain’s Wellcome Trust, who was addressing a session of Forum 2012 on the topic of developing research capacity.

Snewin said that, in light of the recession in Europe and the United States, and set against positive economic growth in Africa, a new opportunity presented itself for African research capability.

Getting fitter: new opportunities are opening up for health research in Africa (Credit: Flickr/Oxfam)

“The world is shifting on its axis here,” she said. “But very few national governments are stepping up and engaging with it. We need political will, and for governments to invest in research capacity, where they can afford it.”

Two examples were Ghana and Tanzania, both of which were showing commitment to creating research and innovation.

Rene Loewensen, of EQUINET in Zimbabwe, said that a changing landscape, in which countries were being encouraged to take charge of their own health research agendas, also brought an opportunity to shift the paradigm of how research is carried out.

Previously the focus had been on building capacity in research institutions in universities, she said. Now there was a need to extend this research to a broader context.

Placing research capacity in the community and in health services would enable it to be more responsive to the needs of both the community and the country.

“It allows us to look at the real world, rather than at theoretical issues,” said Loewensen.

But this new focus on community and multidisciplinary research had also brought new challenges, such as how to keep track of quality in a rapidly changing field.

Yogan Pillay, deputy director general of the South African health department, said that policymakers were increasingly recognising the importance of research, but were now seeking an answer to “how to make it happen”.

The questions they faced were around the implementation of research results, and scaling them up to make a wide impact.

Kathryn Strachan is a freelance health and development journalist working in Johannesburg.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne

Health researchers should consider the creative use of social media – and in particular of new communication tools such as “edutainment” – as part of a comprehensive communication strategy because, like anything else, research findings need to be effectively marketed.

In the words of Kirsten Patrick, clinical reviews editor of the British Medical Journal, addressing a session of Forum 2012 devoted to the topic of science and social media, “it is our job not only to do the research, but to get it out there.”

Soul City: Showing how "edutainment" can communicate health messages (Credit: Soul City)

One example of how edutainment can be done successfully is demonstrated by Soul City in South Africa – or to give it its full title, the Soul City Institute for Health and Development Communication.

This uses an entertaining storyline in television drama to influence behaviour and practices relating to health, nutrition and sexuality.  Recent themes have included medical male circumcision and the prevention of mother-to-child transmission of HIV.

Bongiwe Ndondo, monitoring and evaluation manager of Soul City, told the session that edutainment as a technique for transmitting social messages through entertainment had been practiced in traditional societies for centuries.

Soul City has brought the idea up-to-date by translating this concept into national television series, supported by 23 radio talk shows on seven community radio stations, printed material, internet-based social media such as Twitter, Facebook and YouTube, and mobile applications, in particular Young Africa Live.

She explained that research is the cornerstone of the roadmap leading to the production of a new television series, which is always “based on an extensive and rigorous research process that ensures quality, relevance and effectiveness.”

Denis Jjuuko, a media and communication consultant from Uganda, argued that social media could stimulate discussions and fill gaps left by reports in traditional, mainstream media. This was especially important in countries with limited press freedom, or where mainstream media shy away from sensitive topics.

Jjuuko said that the rapid growth of mobile technology in Africa provided an important new distribution medium. “Social media has become mainstream, and can sometimes do what other media cannot do, especially in some parts of Africa, where mainstream media may, for example, be virtually closed when you deal with certain issues of sexuality.

“In such cases you can use mobile technology and social media such as blogs and video on YouTube to get your message across.”

ResearchAfrica managing editor Linda Nordling argued that social media “give you quite a lot of control, because you can respond and you do not rely on an intermediary such as a journalist as in the traditional media.”

She also said that social media were also “important in terms of ‘narrow casting’:  talking not only to many people, but the right people”.

In the discussion that followed the presentations, participants pointed to some of the difficulties that researchers have encountered with social media, and indeed with attempting to engage in the public communication of their research results.

These includes the dangers of being misquoted, ethics issues – particularly when sensitive clinical trials were involved –  fears around the improper use and interpretation of data, and the adverse effects of an indiscriminate dissemination process, especially when researchers were working on sensitive topics.

Speakers on the panel also included contributions by SciDev.Net editor David Dickson and Brenda Zulu, founder of Africa Interactive Media in Zambia.

Lia Labuschagne is a freelance journalist based in Cape Town

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Kathryn Strachan

Forum 2012 has heard several examples of ways in which entrepreneurs in developing countries are beating a new path for bringing health innovation to poor communities.

In Bangladesh, where there are not enough doctors and nurses to provide care for a population of 160 million, almost 70 per cent of care comes from the ‘barefoot doctors’ – 400,000 informal healthcare providers.

An enterprise based on providing these informal health workers with medical information –  particularly in prescribing medicine to diabetic and chronic patients – through mobile and smart phones has gone a long way to providing better care for these patients.

Sikder Zakir, managing director of the Telemedicine Reference Centre, said the enterprise had so far reached 1.5 million people with diabetes. But with a total of seven million people with diabetes in Bangladesh, they still had a long way to go.

Another of its projects was aimed at the 11 million Bangladeshi migrants who are working in eight countries in the region. The scheme provides a hotline number for them – and their family members back home – which refers them to the local health services.

The enterprise has been operating for seven years, and in the past two years it had extended to India and Pakistan.

The advantage of the service has been that it could be provided at a far lower cost than by government – and it made business sense too.

The element that worked in favour of his enterprise was that the technology had become significantly cheaper over time. And the potential market of 160 million people made it a powerful platform for attracting investors.

Another example came from South Africa, where the enterprise Care Cross is offering high quality medical care for half the cost of a normal doctors’ visit to members under its medical scheme.

And in Rwanda, a public-private partnership One Family Health was setting up primary healthcare clinics on a franchise system, a business-model which was bringing health care to the village level.

An issue discussed over several of the forum’s sessions was how to stimulate private sector interest in African countries. In India part of the success was the support from its government in attracting private investment, and this government-level support needed to be encouraged on the African continent.

Ralph Schneideman of PATH, the non-profit organisation based in Seattle which aims to transform global health through innovation, said companies in the United States and Europe had lost out on the opportunity to form public-private partnerships with India in the 1990s.

However they now had a window of opportunity in Sub-Saharan Africa. Similar initiatives were starting up in Africa, and these companies did not want to lose out again, he said.

Kathryn Strachan is a freelance health and development journalist working in Johannesburg.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne
Freelance journalist working in Cape Town

Research on humanitarian responses to emergencies faces practical challenges relating to data collection and feasibility. In addition, there are often sensitive ethical implications relating to carrying out research in such conditions.

A case study presented at Forum 2012 by Jun Yan, director of the mental health division of China’s Ministry of Health, and Sun Xueli  of Sichuan University, looked at some of the experiences relating to mental health services after the deadly 7.9 magnitude earthquake near Wenchuan, in the Sichuan province, in May 2008.

The Wenchuan earthquake in May 2008 caused 69,000 deaths (Flickr/Wen Chuan)

More than 69,000 people had died, a further 370,000 were injured, with about 4.8 million people left homeless: in total 40 million people were affected by the disaster.

A guideline for psychological crisis intervention in emergency situations was published by the Chinese ministry of health, five days after the disaster.

Among the responses was a post-disaster mental health aid project aimed at adolescents and children. This was prompted by the fact that many thousands of school children had died, and at least 7,000 school buildings in the province had collapsed.

There were very few counsellors to provide mental health support services to children, said Jun, and teachers were ill-prepared to take on the task.

The challenge was to find quick, effective ways to treat mental problems among the affected children, and to help them get through the traumatic period following the disaster.

The response programme included setting up an education-healthcare mental health platform, based on local educational administrative departments.

A major resource was the West China Hospital of the Sichuan University, which has one of the best mental health centres in China and which formed the core of an expert group providing professional guidance. Support also came from the numerous motivated volunteers.

A pilot study was aimed at collecting evidence through a baseline survey, creating service teams, developing training material and guidelines, equipping facilities, training the trainers, and organising working teams.

The subsequent programme actions included, among others, group therapy for high-risk students, family support and therapy, prevention interventions focusing on single-parent and divorced, training teaching staff to integrate mental health issues into regular teaching, and building school counselling centres.

As an extension of the programme, a mental health outpatient service was set up in villages and towns by training part-time and full-time primary mental health staff.

Lessons learnt included the importance of multi-sector coordination and participation with government leading; the need for a provincial level expert group (consisting of psychiatrists, as well as educational and public health experts) to provide professional guidance; and support from private bodies, both locally and internationally.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Kathryn Strachan

Freelance health and development journalist working in Johannesburg

 Research for health has traditionally received little attention in the Arab world. And the extent to which the situation that has followed last year’s ‘Arab spring’ is influencing the region’s agenda for health research was discussed in a session at the Forum 2012 meeting.

In particular, several speakers pointed out that people in the Arab world now have a voice – and that this presents an opportunity to change the way decisions about both health research and development are made.

According to Hassen Ghannem, professor of medicine at the university hospital Farhat Hached in Sousse, Tunisia, people in his country were now asking about issues that had been accepted without questions in the past.

“The main message from Tunisia is to listen to the population,” he said. People were now demanding answers from policymakers. This created an opportunity to change that way decisions were made, and to place research at the centre of those decisions.

Fouad M Fouad, co-ordinator of the Syrian Centre for Tobacco Studies, said that in an emergency situation, where there was no food or proper sanitation, the place of research was not always clear.

Virtually no research had been carried out in Syria in peaceful times, he said. But the current conflict in the country had brought a renewed need for research on questions such as why vaccination rates had fallen over the past year.

“This should keep us motivated to work harder for research. We should keep going, even when we are in such a shaky position, and work together for change,” he said.

Francisco Becerra, the head of projects at the Council on Health Research for Development (COHRED), said change in Egypt had to be about more than replacing one group of leaders with another.

Political leaders had to listen to the voice of the people. Otherwise the previous neglect of the needs of the population would be repeated, and the opportunity for changing society would be lost.

Other speakers pointed out that the changes sweeping across the Arab world had brought opportunities at every level. But there was a danger that previous hard-won gains – such as progress in women‘s rights – could be lost if they were not adequately protected.

“We have achieved a lot in the past in the areas such as reproductive health, informed choice, and family law, but now the old language is reappearing again,” Hoda Rashad, director of the Social Research Centre at the American University of Cairo, Egypt told the meeting.

“In people’s excitement with the new revolution, they want to cut all ties to the past, and this includes throwing out all the achievements that have been made over the past few years.”

It was essential for researchers to remain aware of the complexities of the issues that they faced, and to have informed debates about them. Otherwise there was a risk that progress made in women’s rights and in health equity would be lost.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

David Dickson
Editor, SciDev.Net

Can the governments of both developed and developing countries be persuaded to back a paradigm shift in the way that research into novel treatments for the diseases of the developing world is funded?

Eye on the future: keeping vaccines affordable is the challenge ahead (Credit: Gates Foundation)

This is the challenge being thrown down by supporters of a proposed international convention on the funding and co-ordination of health research that is being proposed to the World Health Assembly next month (see my recent editorial).

As described to a session of Forum 2012 devoted to the proposal, the case for change is clear. Carlos Corea, a member of the WHO’s Consultative Expert Working Group on Research and Development (CEWG) which draw up the proposal, outlined three reasons that change was needed.

Firstly, he said, although investment by pharmaceutical companies has increased significantly in recent years, product innovation – measured by the number of new drugs emerging – has gone down.

Secondly, despite increased investment in research and development for diseases in developing countries, a lack of incentives means that this remains insufficient. And thirdly, “there is little co-ordination [in drug research]. Global efficiency is not very high.”

Michelle Childs, of Medecins sans Frontieres, put it more pragmatically. “We are interested in the proposed convention because of the frustration of our medical teams that many of the tools that they need are unavailable, un-affordable, or ill-adapted to the situations they face on the ground.”

The reason, she suggested, was that drug industry relies on recouping the costs of research and development through high prices on the resulting products, which it is able to charge through the exercise of patent rights.

At the core of the proposed treaty would lie a fundamental break with this principle. Namely, the costs of R&D on new drugs would be de-linked from the costs of providing the drugs to patients.

James Love of Knowledge Ecology International, one of the original architects of this novel approach, described the challenge. “How do you change the paradigm and come up with something new that reconciles the needs for innovation and access.”

Why was this controversial? “Because it challenges current thinking about how R&D is financed”. Furthermore, the principles on which it is based “are seen as a threat to existing business models”.

But Love argued that the treaty model “should not be considered that controversial, since it focusses on areas where the market is not working, and where the access issues are particularly acute”.

The fate of the proposal at next month’s meeting of the WHA is uncertain. “Some people may try to delay the decision for a year,” says Love.  “But you don’t want this report to sit on the shelf.

“What is needed is for the WHO to create an intergovernmental body to move this thing forward. We need to open the door that allows people to start discussing this proposal.”

Francisco Songane, the chair of the Forum 2012 steering committee, warned that for even this to happen, it was important that delegates to the WHA should be fully informed about the proposals.

Otherwise there might be last-minute attempts to block progress not out of disagreement, but out of a lack of knowledge.

Others added that it was not just health ministries that needed to be involved, but other ministries with a stake in the outcome. In particular this included finance ministries, since the treaty has potentially significant financial implications.

Despite the challenges in generating the necessary paradigm change, there was an air of optimism in the discussion in the Forum 2012 session.

“The world we live in today is different from the world in which we will live in 20 years’ time,” said Love. “You have to find a path to change things. The R&D treaty is an attempt to build a different future.”

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012.

Lia Labuschagne
Freelance journalist working in Cape Town

Can lower and middle income countries (LMICs) engage in producing the drugs needed to combat neglected tropical diseases? And to what extent do their governments hold the key that will allow them to do so?

Where next? Drug production is the next step after research for low and medium countries (Source: ANDDI)

These questions led to a lively round-table discussion at Forum 2012 chaired by Elizabeth Ponder, associate director for scientific affairs at BVGH in the United States.

Ponder pointed out that neglected diseases affect more than 1 billion people around the world.

Millions of people in resource-poor countries die from these diseases, she said, because life-saving drugs, vaccines, and diagnostics are inaccessible, outdated, unsafe, ineffective – or not yet created.

The challenge was put to a panel representing a wide range of interested government bodies, NGOs, funders, and research laboratories, as well as the private biopharmaceutical sector .

Most panelists agreed that capacity was not the problem; many lower and middle income countries had the scientists and technologies needed to develop the relevant products.

The main problem lay in raising the funding needed to get the drugs into production, and to ensure that they were distributed to where they were required. And this frequently required a political – as well as a financial – commitment.

Jean-Pierre Paccaud, director of business development at Drugs for Neglected Diseases initiative in Switzerland, said that it was important to understand the specific needs of the areas in which diseases occurred, and then to focus on leveraging local capacities.

Konji Sebati, director of the department of traditional knowledge and global challenges at the World Intellectual Property Organization in Switzerland, said that lobbying governments was important since “without political will nothing will change”.

According to David Walwyn, chief commercialisation officer with the company iThemba Pharmaceuticals in South Africa, “it is important to articulate clearly to governments what we want, and to set clear targets.”  Universally-accepted goals were needed so that progress could be monitored.

And Alex Ochem, of the African Network for Drugs and Diagnostics Innovation, agreed that the research capacity exists in Africa. But he stressed the sobering truth that “no matter how much research we carry out and articles we publish, if we do not get the product – the medicines – to the market, then we have failed.”

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Kathryn Strachan

While many country representatives described to the Forum 2012 meeting their battles to create a flow of financing for health research, an unusual problem has come up in Colombia: how to make it stop.

Mery Barragan Avila, head of the research division at Columbia’s Department of Science, Technology and Innovation’s research division, told a session at the meeting that being selected as a recipient for the funds derived from a tax on gambling had created its own share of problems.

Health research funding should not be left to chance (Credit: Flickr/sincerelyhiten)

“It was like winning the lottery,” she said of the unexpected windfall. But problems followed, as the department lacked the capacity to manage the funding.

In addition, the stipulation that royalties remained in the regions in which gambling took place had also created conflicts – and the potential for unequal treatment – between the regions.

Her example reflected the need for health research to retain government support at its core. Other forms of funding were often erratic, and based on a shorter timescale than that required for effective in-depth health research.

An example from Panama, on the other hand, showed the importance of advocacy, as the research community had made a strong case to government, to donors and to the pharmaceutical industry, emphasising the value of research.

Partnerships with pharmaceutical companies are widely quoted as one way forward, for example by the UK Medical Research Council (MRC), but this route has to be navigated with care.

“We have to ensure that we all understand each other, because we all have different aims,” said Catherine Elliot, the MRC’s head of clinical research support. It could take 40 years of research to develop a major breakthrough. But pharmaceutical companies needed research to be translated into results in three to four years, she said.

Kathryn Strachan is a freelance health and development journalist working in Johannesburg.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne
Freelance journalist working in Cape Town

Turning research into innovation is a complex issue. It requires considerable human, financial and other resources. And these must be drawn together by strategies that work within specific local contexts.

At a session at Forum 2012 examining investments that have been made in Africa to address outstanding issues of research and innovation for health and development, Hannah Akuffo, deputy head of the Research Cooperation Unit at the Swedish International Development Cooperation Agency, proposed the creation of a global facility to fund and monitor innovation on the continent.

Anti-malaria bednets in Tanzania: an example of successful African innovation (Credit: Flickr/Prashant Panjiar)

“Governments need to invest innovation, not only in their own countries but also into the continent,” said Akuffo, who believes such a facility could combine practice with training, and both conduct studies on and monitor the evolution of innovation systems.

It would also formulate medium-term strategies and tactics for supporting innovation, and attract partners for collaborative efforts to increase both quantity and quality of innovations, focussing on the need for inclusive development.

Akuffo suggested an international host for such an initiative – ideally an intergovernmental organisation such as UNESO or UNDO – but that there should be a gradual shift of responsibility for specific programmes to the national level.

Partners for regional organisations could come from high-income countries and NGOs. Funding might be drawn from a combination of multinational donors, development banks, donors and international aid organisations involved in science and technology. Partner countries would provide funding out of their regular budgets.

The session was chaired by Peter Ndumbe, responsible for research, publication and library services at the WHO Regional Office for Africa, and included a review of South Africa’s Strategic Management Framework, created to stimulate local health innovation, by Glaudina Loots, director of health innovation at the Department of Science and Technology.

Case studies of successful programmes supporting innovation were presented by Budzanani Tacheba, of the Botswana Innovation Hub, and Hassan Mshinda of the Tanzanian Commission for Science and Technology.

Tacheba, quoting Steve Jobs’ comment that “innovation distinguishes between a leader and a follower,”  described how the Botswana initiative is aimed at helping the country to compete in global markets, providing a home for knowledge-intensive, technology-driven businesses.

In Tanzania, Mshinda said that research into the way that insecticide-treated nets contribute to the fight against malaria had led to the creation of a successful manufacturing industry that was currently producing 50% of the global output of bednets.

Research had earlier shown that the nets reduce malaria parasitaemia and anaemia by 60%, and improve child survival rates by 27%. A well-planned programme had led to Tanzania’s doubling the value of its export of nets, from US$50 million in 2008 to US$100 million in 2010, and to an industry that now employs employing 7,000 people.

 Innovation is far from dead on the African continent.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne is a freelance journalist based in Cape Town

Lia Labuschagne
Freelance journalist working in Cape Town

Women researchers have long explored the frontiers of knowledge, and have in the process made major contributions towards meeting health and development challenges, according to the moderator of a panel discussion at Forum 2012 on the role of women in science in the developing world.

Yet Jill Farrant, professor of molecular and cell biology at the University of Cape Town, and an expert on resurrection plants – plants that can ‘come back to life’ from a desiccated state when rehydrated – pointed out that women have not necessarily received recognition for their achievements.

Jill Farrant: women scientists are often not acknowledged (Credit: UNESCO/L'Oreal Foundation)

For example, said Farrant, one of the 2012 winners of the L’Oréal-UNESCO Awards for Women in Science, only 16 Nobel Prizes have been awarded to women, compared to more than 500 men.

Nashima  Badsha, an advisor to the South African Minister of Science and Technology, said that gender equality was protected by the country’s constitution, and that, especially in higher education, the statistics were encouraging. Women made up most enrolments and graduates in universities, and at PhD level, the number of women was fast approaching that of men.

But these figures masked less encouraging details. For example, women still only accounted for a third of publishing scientists in South Africa, while black women were under-represented in science, and the overall employment of women in higher education was under 18% – below that in other BRICS countries.

In Brazil, according to Claude Pirmez, vice president for research at the Oswaldo Cruz Foundation in Rio de Janeiro, the number of women holding PhDs was growing strongly. But the highest positions in science were still dominated by men – the Brazilian Academy of Science, for example, remained 90% male.

Javie Ssozi, a digital media consultant from Uganda, described how information and communication technologies were giving women access to opportunities and information sharing. For example, rural women farmers could be given information about new agricultural skills or ways to deal with climate change.

But he added that policies were often not gender sensitive, and that projects could be influenced by cultural issues. For example, men often tried to decide when and how women used their mobile phones.

Finally, for Devaki Nambiar, a postdoctoral research fellow in the Public Health Foundation of India, a key issue was the personal safety of women in society. “If you can’t leave your home in safety, how can you make progress in science and technology?” she asked.

But noticeably, all but one member of the discussion panel were females, and they spoke in front of an audience consisting mainly of women.  Perhaps a case of preaching to the converted?

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

Lia Labuschagne

Kathryn Strachan
Freelance health and development journalist working in Johannesburg

The widespread adoption of mobile phones in developing countries is opening up a world of possibilities for the health sector, a session of Forum 2012 devoted to “mobile health” was told.

Expectant mothers in South Africa, Bangladesh and India, for example, are being reached through a mobile phone campaign that sends them health information and continues through to the first year after the birth of a child.

The programme, the Mobile Alliance for Maternal Action (MAMA), is run by the USAid-supported mHealth and the pharmaceutical company Johnson and Johnson, and has in its first two years has already reached half of pregnant women in South Africa.

The project already has several sources of revenue, and the intention is that its initial donors will withdraw after two years, leaving it to stand on its own feet.

The session was also told that telecommunications has not only made it possible to reach people in remote areas, but has allowed people to make informed decisions on their health.

“It has allowed us to target low-income women in hard to reach areas, and has also helped in our goal of promoting gender equity,” said USAid advisor Lauren Marks.

Telecommunications has also come to the aid of health in fighting the US$75-billion market in counterfeit medicine.

A system run by mPedigree, a non-profit organsition based in Ghana, allows customers to scratch a panel on a medicine package and text the code to a central authority, which can then verify in seconds whether the medicine is safe.

mPedigree president Bright Simons told the session that this not only saved lives, but had a wider health impact, as counterfeit medicines had contributed to the growing problem of drug resistance.

The real power, he said, was not in the technology, but in the wide range of partners that had come together to create this system. “It’s about sharing accountability,” he added.

Another example, of “mobile health” came from South Africa, which has 75% mobile phone penetration, and where Vodacom had agreed to support 70,000 volunteer community health care workers through its Nompilo project.

By helping them keep track of patient details, the community workers are able to improve the care that they provide. And based on the success of the project, Vodacom is planning to extend it to Kenya and Tanzania.

These were just some of the ways in which the mobile telephone is revolutionising health-care in the developing world. And the future promises to be even brighter.

Kathryn Strachan is a freelance health and development journalist working in Johannesburg.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012. 

David Dickson
Editor, SciDev.Net

Most international conferences start with a solemn series of speeches welcoming delegates, describing the importance of the theme, and looking forward to a successful outcome.

But this is South Africa.

The opening session of Forum 2012, which is taking place in Cape Town over the next three days, started with a colourful group of musicians entering the auditorium blowing on instruments made out of animal horns.

Health reseach and gumboots dancing -- a heady mixture (Photo: Gabi Falanga)

It ended with an energetic dance display by the Gumboot Dancers, who gave an exuberant performance derived from musical traditions established within South Africa’s mining communities.

Between these two performances, the country’s Minister for Science and Technology, Naledi Pandor, gave an equally impassioned performance.

Pandor’s theme, echoing that of the meeting, was that African countries should be thinking seriously about the implications of moving “beyond aid”, towards a situation where they not only produce the research required to meet their needs (in health as elsewhere), but also generate the capacity to put science into practice through innovation.

This should be done in partnership with the private sector, Naledi said. But not in a way that remains controlled by foreign-owned corporations — in the pharmaceutical sector as elsewhere — as is the case too often at present.

Earlier, Carel Ijsselmuiden, executive director of the Council on Health Research for Development — the main organiser of Forum 2012 — outlined progress already made in this direction.

But he also referred back to a meeting in Lagos in 1989, at which African countries pledged to spend 1 per cent of their gross national product on research and development — a goal that many are still far from reaching.

“Just think what Africa would look like today if that target had been met,” Ijsselmuiden said.

Pandor reminded the audience of a line from Shakespeare’s Julius Caesar in which Mark Anthony describes Caesar’s ambition as a “grievous fault”, in a speech at his funeral.

“We have a great deal of ambition, as Caesar did,” said Pandor. The only way to prevent this ambition from becoming a grievous fault was through practical activity, she said.

Her suggestion? That the next forum identifies 10 to 15 countries in which concrete actions, particularly through developing the capacity to apply science and technology, could move from being aid recipients to self-sustaining economies.

Ten years later, “we would know whether we have been able to lift these countries beyond aid,” said Pandor.

Hopefully the dancing at that point would not be on the grave of unachieved ambitions, but in celebration of “all’s well that ends well”.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012.

David Dickson
Editor, SciDev.Net

Is it too soon to start planning for a world in which “foreign aid” is a concept of the past? And in which countries across the developing world – even in Africa – are able to stand on their own feet, meeting their own needs and solving their own problems?

Not according to the organisers of Forum 2012, which opens in Cape Town tomorrow, and from which we will be blogging regularly for the next three days.

The subtitle of the meeting says it all: “Beyond Aid: research and innovation as key drivers for health, equity and development”.

In other words, the goal of the forum is to sketch out how enabling developing countries to build their own capacity for research-based innovation holds the key to weaning them away from dependency on external aid.

An ambitious enough goal. But one worth aiming for. And certainly closely aligned with a goal that has been at central to SciDev.Net since we started just over ten years ago, summed up in our own slogan “putting science at the heart of development”.

The main focus of the meeting will be to look at how all this could work for health technology and the treatment of disease, particularly in Southern Africa.

This reflects the fact that the forum has been organised by the Council on Health Research for Development (COHRED), which merged two years ago with the Global Forum for Health Research (after the latter had imploded in difficult circumstances).

But the message also reflects the desire of COHRED’s ambitious executive director, Carel Ijsselmuiden, to go further and establish home-grown innovation as the model for growth across the whole development spectrum.

Three days of discussion lie ahead, with contributions from a wide range of stakeholders, in particular those who COHRED identifies as “change-makers” – individuals who can make things happen. Young scientists and health workers, representing the voice of the future, will also be given a prominent place on the programme.

The first day — after an introductory session that will include welcomes from both South Africa’s Minister of Science and Technology, Naledi Pandor, and the Gumboot dancers, something to look forward to — will focus on introducing the major themes, with a particular emphasis on the situation in South Africa.

The second will look at “making it work” for research and innovation. And the third on “the way forward”.

Each topic has lots of meat on it. Plenary and interactive sessions will range from discussion of recommendations to the World Health Organization (WHO) on the possible contents of an international treaty on R&D — which I described in last week’s editorial — to a session that I’m taking part in on Thursday about the role of the media (and particularly social media) in helping change to happen.

So, lots of lively debate to look forward to.

And with Cape Town’s weather looking at its best — even though the locals as complaining that there’s already an autumnal chill in the air — hopes are high that the meeting will be able to take an important step “into the beyond”.

This blog post is part of our Forum 2012 coverage — which takes place 24–26 April 2012.

Luisa Massarani
Latin America regional coordinator, SciDev.Net

Well, the conference is finished, and my luggage ready for the 6am morning flight. Before leaving, I asked Massimiano Bucchi, co-chair of PCST 2012, to give me his comments on this year’s conference.

“It was an intense programme. The sessions and discussions were of very good quality,” he said.

Bucchi said the meeting had strengthened “the interaction between research and practice” in science communication, and said for him one of the highlights this year was a meeting of PhD students, which attracted some 60 people from around the world who are engaged in science communication research.

“It was a good opportunity for networking and to make more visible what Italian institutions are doing in terms of public engagement,” Bucchi said.

There was also an announcement in the final session from Toss Gascoigne, about an important change to the PCST network, of which he is the president.

“The network has been working in an informal way for more than two decades, headed by a scientific committee,” he said.

“Now, we [have] decided to make a structural change toward a formal network, with legal status,” he said, adding that the constitution of the network and a membership scheme will be discussed in the coming months.

After the final session, the scientific committee — of which I am a member — met to take some decisions.  We approved two workshops to be held in 2013; one in New Zealand and other in Indonesia.

Then we had to decide where to hold the PCST 2016. We received two bids from two very exciting cities: Nairobi, in Kenya, and Istanbul, in Turkey. Very exciting, isn’t it? And the decision was… Istanbul!

But before the Istanbul conference there is, obviously, PCST 2014 which will be in another part of the globe: Brazil! I will be one of the chairs of that meeting, sharing the responsibility with Germana Barata.

Two strong institutions will host the conference: the Museum of Life/House of Oswaldo Cruz/Fiocruz, and Labjor/State University of Campinas.

It is very exciting, since it will be the first PCST conference to be held in the Americas. We want to show that Latin America is the stage of an increasingly vibrant science communication community, strong in both practical and academic approaches.

After having had beauty, honesty and quality as the theme of this year’s conference — so apt in such a wonderful city as Florence — we want to add social and political concern ingredients to the discussion on science communication.

So the 2014 meeting will have as its theme, “Science communication for social inclusion and political engagement”. It will be held in Salvador, another fantastic city, with an extremely diverse culture.

See you there!

This blog post is part of our Public Communication of Science & Technology (PCST2012) conference coverage.

Luisa Massarani
Latin America regional coordinator, SciDev.Net

Marzia Mazzonetto, Ecsite Project Coordinator and my good friend after years of working together in science communication, heard that I was writing a blog on PCST 2012 and got “jealous” — in the good sense, of course. She has attended several sessions on science centres and museums during the conference and has written a post for us. Cool, isn’t it? Here it is:

Science centres and museums all over the world are one of the places where public communication of science and technology is put into practice. They were also the focus of some of the several presentations that have been given during the two intense days of the PCST conference.

Different issues have been raised by the experts from the field, showing that science centres and museums face similar challenges and innovation needs as the rest of the wide science communication community.

One of the questions that was asked and discussed during these sessions was how science centres are and should be forums for communicating controversial scientific issues.

Underwear in a 2010 exhibition at the State History Museum in Moscow, Russia

Catherine Franche, director of Ecsite, the European Network of Science Centres and Museums, mentioned a controversial list recently published in the US about objects that should never be shown in museums, which even included such items as underwear or images of naked human bodies.

How can be science explained in museums without being able to show some of the basic elements of biology and the world around us?

Sharon Ament, director of public engagement at the Natural History Museum in London, United Kingdom, presented some interesting examples of how her museum managed recently to use objects from its own collections to present an exhibition and associated activities on controversial topics such as slavery, evolution and sex.

Homo Habilis skull from a 2009 exhibition at London's Natural History Museum

The environment was a key theme of several presentations.  It’s not just journalists who face the pressure of reporting on environmental issues; museum experts and researchers also fear a lack of real connection between what is being shown and told and the critical issues with which to engage the public.

A interesting presentation on the topic was given by Joëlle Le Marec, from the Université Paris Diderot in France, during a highly multicultural session entitled “On the meaning of participation and democracy in different cultural and social contexts”.

Joëlle talked about how the theme of the environment “entered” science museums in France. She said that while in the 1970s and 80s environmental issues were presented as elements of reflection between inhabitants and their own territories, nowadays the environment is presented as a scientific object, more closely related to progress and international development and events rather than something connected to local issues.

Butterfly from Foz do Iguaçu, Brazil

Is this new narrative of environment in science centres contributing to making people feel like environmental issues are something very far away from them?

Several other sessions at PCST 2012 have offered interesting experiences and studies coming from activities in science museums on topics such as evolution, genetically modified organisms and climate change. One more session worth mentioning was “Science and governance in a knowledge society: Research and best practices on the role of science centres and museums”.

Organising activities and exhibitions in a museum means a lot of work but it’s also fun, interesting and sometimes very difficult and challenging. Paola Rodari, project manager at Sissa Medialab in Trieste, Italy — and an expert in museum studies — said something that museums should never stop doing is evaluation; reflecting and possibly researching the effectiveness of the exhibitions and activities that they offer.

Museums are places where people can get together to discuss, dialogue and share opinions on science issues, but also contribute directly to the museum’s growth by sharing their hopes and expectations. They are also places where, in some instances, visitors can interact directly with scientists who have labs and run research directly inside the museum complex (as is the case with the Nature Live Labs at the Natural History Museum in London).

A young visitor to the Houston Museum of Natural Science in the United States

How to evaluate and learn more about how these activities and issues are pushing science centres and museums to evolve, and how they are directly influencing science research and science policy is food for thought for future PCST conferences for sure!

This blog post is part of our Public Communication of Science & Technology (PCST2012) conference coverage.

Luisa Massarani
Latin America regional coordinator, SciDev.Net

Communicating science in Mexico, as in any developing world country, can be a big challenge. Most of Mexico’s estimated 100 million inhabitants have only received eight years of basic education. For every 100 inhabitants over the age of 15 years, eleven females and seven males are illiterate.

On the other hand, comics are enormously popular in Mexico. Having this situation in mind, Aquiles Negrete, a researcher at the Autonomous National University of Mexico, has been describing his exploration of the use of comics to communicate science issues at PCST.

An image from the comic, "Sustainable Love"

His Sustento de amor (sustainable love) comic is a love story that uses visuals and a skilled narrative to disseminate information about sustainable development and natural resources  in Mexico and Central America.

Negrete has also developed what he calls the ‘RIRC’ method to evaluate the project, which uses four memory tasks, and  explores different levels of understanding.

“Our results show that comics can be an interesting tool for communicating science,” he says.

Also from Mexico, Rolando Riley from the Autonomous University of Chiapas, is using visual information to get science news and ideas to Chiapas, a state in which access to scientific information is poor.

“About 35 per cent of the population do not speak Spanish, the official language,” he explains.

One of the pilot projects is on nutrition, with a view to targeting women, because they “actually decide what the family will eat”.  Two other pilot projects will start soon, focusing on technology applied to agriculture, and the use of natural resources.

This blog post is part of our Public Communication of Science & Technology (PCST2012) conference coverage.

Luisa Massarani
Latin America regional coordinator, SciDev.Net

Two ‘classics’ of science communication — Baudouin Jurdant from the University of Paris 7 (pictured on the left) and Steve Miller of University College London, taking part in an exploration of science theatre at PCST 2012.

The pair participated in a play reading that aimed to encourage reflections on the challenges for communicating science to the public using drama.

The reading was also participated in by Jöelle Le Marec of the Université Paris Diderot and Yves Jeanneret of Paris Sorbonne Université — both in France —  and Ana Godinho from the Instituto de Filosofia da Linguagem in Portugal.

The play was written by Jourdant, who has no immediate plans to stage the play in a regular theatre.

This blog post is part of our Public Communication of Science & Technology (PCST2012) conference coverage.