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3 Generate and Share Knowledge to Address Health Problems Endemic to the Global Poor
Pages 79-106

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From page 79...
... The U.S. research commu nity, in collaboration with its global partners, should leverage its scientific and technical capabilities to study health problems endemic to poor countries, more rigorously evaluate programmatic efforts to improve health, and promote global knowledge networks to enable low- and middle-income-country researchers to improve the health of their own populations.
From page 80...
... Today the world faces many enormous challenges in global health, including halting the spread of HIV, eradicating polio, controlling the use of tobacco products and the onset of chronic noncommunicable diseases, and bringing basic BOX 3-1 Smallpox Eradication Made Possible by a Series of Research Discoveries In 1967, when the World Health Organization (WHO) "launched an intensified plan to eradicate smallpox, the ancient scourge threatened 60 percent of the world's population, killed every fourth victim, scarred or blinded most survivors, and eluded any form of treatment" (WHO, 2009a)
From page 81...
... Health research in low- and middle-income countries, especially in the emerging market economies, has increased in recent years. Between 2000 and 2006, the average annual growth rate in the number of patent filings originating from China and India far outstripped that of all reported countries in Europe and North America (WIPO, 2008)
From page 82...
... By tapping more fully into this energy, the United States can further complement the expanded health research efforts of low- and middle-income countries and hasten the discovery and delivery of lifesaving knowledge. Strengthen Knowledge on the Adoption and Dissemination of Existing Interventions Attention is required to address the systemic bottlenecks in health systems and policy making in low- and middle-income countries that keep the full benefits of existing medical and public health knowledge and technologies from being completely realized.
From page 83...
... . Increased support for opera tional and implementation research would help to resolve many of the context
From page 84...
... Operational and implementation research that includes cost-benefit analysis and acceptability studies will also be crucial before the scale-up of new interven tions, such as the human papilloma virus vaccine to prevent infection and ensuing cervical cancer or male circumcision to reduce the likelihood of HIV infection. Policy makers in low- and middle-income countries will need to decide whether and how to add these interventions to their health programs, based on an array of factors including their cost-effectiveness and acceptability, but also larger issues such as disease burden and strain on the health system (Brooks et al., 2009; Saxenian, 2007)
From page 85...
... global health programs. Yet with the exception of the Millennium Challenge Corporation, a U.S.
From page 86...
... and out puts (such as drugs delivered) , Congress and other global health funders should require that efforts to deliver health interventions be accompanied by rigorous country- and program-level evaluations to measure the effect of global health programs on saving lives and improving health.
From page 87...
... . These steps are especially important given that new vaccines against the three major infectious diseases seem unlikely to be deployed for another decade or more.
From page 88...
...  THE U.S. COMMITMENT TO GLOBAL HEALTH BOX 3-2 Identifying Promising Interventions The WHO Commission on Intellectual Property Rights, Innovation and Public Health identified an analytical framework laying out the four interrelated compo nents that together define "the right to health interventions and technologies." According to this framework, interventions should be available, acceptable, a ccessible, and of quality, as detailed below.
From page 89...
... . However it is critical to develop and leverage both cutting-edge research tools and platform technologies because they facilitate innovation and attract the interest of leading research teams seeking breakthrough interventions, especially against the most neglected tropical diseases that have received little investment but place a high burden on low- and middle-income countries.
From page 90...
... A promising drug compound for Chagas was discovered by the UCSF team, with support from the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH) , and developed further by the Drugs for Neglected Diseases Institute (DNDi)
From page 91...
... The committee finds that increased support for basic research, with heightened attention to using cutting-edge research tools and platform technologies, is possible, timely, and indispensable. Investments in basic research, particularly for diseases and condi tions that disproportionately affect poor populations, will generate the knowl edge upon which lifesaving medical interventions can be developed.
From page 92...
... government. Adapt Existing Knowledge for Low- and Middle-Income Countries While many areas require further research to identify novel technologies to address the health conditions of the global poor, additional attention is also required to adapt existing tools and interventions to better serve the global poor.
From page 93...
... . The need to adapt existing technologies for use in low- and middle-income countries goes well beyond the arena of infectious diseases and biomedical tools.
From page 94...
... SHARE KNOWLEDGE THAT ENABLES LOCAL PROBLEM SOLVERS3 Research on global health involves not only generating knowledge relevant to the context of low- and middle-income countries, but also effectively transferring such knowledge and technologies to these settings and ensuring that the intended beneficiaries can apply them on a sustained basis. All of this requires the involvement of researchers on the ground in low- and middle-income countries.
From page 95...
... Access to Scientific Publications One of the challenges to sharing knowledge through scientific publications is that the subscription price of journals is often unaffordable for researchers in lowand middle-income countries. Mailing hard copies of journals to these countries is also prohibitively expensive for research institutes in the advanced economies.
From page 96...
... . The pooling of published research in open access journals or repositories is an alternative method of increasing access in low- and middle-income countries.
From page 97...
... The NIH Public Access Policy requires investigators to submit final, peer-reviewed journal manuscripts arising from NIH funding to PubMed Central upon acceptance for publication. The Wellcome Trust requires submission of scientific publications resulting from its grants into UK PubMed Central within six months of the publication date, and even provides funding for the upfront fees associated with publishing in truly open access journals that make content freely available immediately upon publication (Wellcome Trust, 2007)
From page 98...
... However the patenting of avian flu wild virus samples sent to laboratories in the advanced economies and the likely high costs of any resulting vaccines recently created friction in the Global Influenza Surveillance Network. The refusal of Indonesia to share virus samples with WHO Collaborating Centers without an assurance of sharing in later benefits highlighted the importance of a bidirectional flow of benefits in the sharing of data and materials (Khor and Shashikant, 2008)
From page 99...
... has launched a web portal, TDR Targets, to bring together data and anno tation in a publicly accessible database on tropical disease pathogens. Users can undertake searches ranging from genomic or protein structural data to target drug ability on neglected diseases, or they can find information on diseases such as leprosy, filariasis, and Chagas disease.
From page 100...
... . This voluntary patent pool makes available the patented knowledge it uses to develop medicines for neglected diseases to other drugs companies, governments, and nongovernmental
From page 101...
... (A) Funders of global health research should require that all work sup ported by them will appear in public digital libraries, preferably at the time of publication and without constraints of copyright (through open access publishing)
From page 102...
... Geneva, Switzerland: Global Forum for Health Research. AMC (Advance Market Commitment)
From page 103...
... . GFHR (Global Forum for Health Research)
From page 104...
... 2007. Current priorities in health research funding and lack of impact on the number of child deaths per year.
From page 105...
... 00 U.S. Investment in global health research.
From page 106...
... 801. Expanded clinical trial registry data bank.


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