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Date : 17/03/2006
Source: Department of Health
Title: Tshabalala-Msimang: National Conference on Health Research Priority Setting


  Speech by Minister of Health, Dr Manto Tshabalala-Msimang, at the National Conference on Health Research Priority Setting

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
   

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