Wednesday, October 13, 2010

Placing health research in Nigeria’s healthcare sector

Taking a cursory look at healthcare delivery across the globe, there is no gain saying that health research plays a pivotal role in the development of any nation. This is in view of its contribution to the provision of solutions to health problems, providing evidence for addressing communicable and non-communicable diseases, reducing health disparities, strengthening national health systems as well as deliver healthcare services. Little wonder the World Health Organisation (WHO) revealed that improvement in healthcare delivery has closely been associated with advances in medical research.

Sadly, with Nigeria not in the driving seat of health research in sub Saharan Africa let alone the entire globe, medical experts have called for the Government to provide the necessary leadership in the development and sustainability of health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in- country and at global levels.

Speaking recently at a program organised by the Nigeria Institute of Medical Research, (NIMR), Yaba, Lagos on the theme “Nigeria at 50; Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja said that till date, medical research has provided the strongest support for preventive and curative medicine.
Lecky revealed that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few were held but regretted that certain policy directives to champion health research in the country is still yet to be implemented thus stalling the advancement of medical research in Nigeria.

According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He added that factors responsible for the inadequacies in health research in nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, dearth of research infrastructures, sub-optimal capacity building strategies, ineffectual documentation.

For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (such as Nigerian Institute of Medical Research and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively contributed in the relegation of medical research in the country
Nwanyanwu noted that currently, health research is not a priority of governments and most funding agencies, weak linkages with the academia, governance and industry even as health research is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.

He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partner to include research into all interventions and encourage the use of research findings in services”

It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS, statins and increasingly successful treatments for cancer and other emerging diseases.
Furthermore, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.

In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research.

Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.

With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its vision of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.

For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”

More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP- which is a heath component of Vision 20;2020) which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP. In addition, at the national level, it is eminent to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.

ALEXANDER CHIEJINA

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