ESSENCE on Health Research

Enhancing Support for Strengthening

the Effectiveness of National Capacity Efforts

Conclusions (1)• ESSENCE is an initiative of research funders

committed to finding efficient methods of strengthening research capacity for health in low income countries in Africa in a concerted way in the spirit of the Paris Agenda

• Research in and by low income countries requires the presence of robust in-country research capacity

• Sustainable research capacity strengthening for health is more than research project support involving individual training; it requires support to the basis for performing research as defined by funded institutions

Conclusions (2)• For alignment of efforts of funders to happen, there

need to be strategies and implementation plans defined by institutions performing research for health

• Harmonisation does not necessarily mean funders funding exactly the same thing, but agreeing to “simplify” where possible, for instance agreeing to joint reporting systems

• Coherence in research capacity funding suggests working in concert to reduce fragmentation and above all “to do no harm”

ESSENCE for health research

• Is a collaborative framework between funding agencies (development agencies, philanthropists, charities and multilateral initiatives) providing synergism to address research capacity needs.

• It aims to improve the impact of investment in institutions and enabling mechanisms that address the identified needs and priorities within national strategies on research for health.

ESSENCE

Focus

• Funders of research for health

• Research (and innovation) capacity strengthening

• Low income countries in Africa

The Universal Declaration of Human Rights

December 10th 1948, General Assembly of the United Nations

Article 271) Everyone has the right freely to

participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits.

2) Everyone has the right to the protection of the moral and material interests resulting from any scientific, literary or artistic production of which he is the author.

But does this translate to every low income country having the

right to have capacity to produce and utilise scientific information

Or is it enough for others to produce and give to them to use?

“Not all countries should have national airlines, some must use the expertise of those with resources. So why should all low-income

countries have institutions of health research?”A provocative statement made by one of the Northern

proponents of research for health

• Perhaps not all need an airline, but low-income countries definitely need a cadre of people who can ask their own questions and have the tools to address getting the answers

• Otherwise, who will ask the pertinent questions deemed relevant and of importance to the low income countries?– Unreasonable to think it will be those with other agendas,

however well meaning

The tensions of research for health approaches in low-income African countries

Different approaches justified by:• By and for

– Defining the important problem of the countries and providing the know-how to be copied by the low-income countries through ”technology transfer”

– If there is not the adequate capacity, who or what system can receive the transferred technology and sustain it?

• Doing for– Basing the argument on urgent need to address the burning

issues of today– Sustainability in question

• In and by– It is only by having the research know-how in the countries where

the problems exist, to do and utilise research done that sustainable research capacity can be achieved

– This is a long term endeavour

Research capacity is more than human resources

What then are the other elements?

National Research capacity entails

Asking nationally relevant questions

Culture of inquiry

Innovation systems

Agents of Change: Using evidence to question

Capacity to be part of international research community

Skills for carrying out research

Nationalresearch capacity

National research and ethics CapacityResearch

University as a hub

Capacity to utilise external research/knowledge

Capacity for evaluation

Capacity for analysis

National commitment to research

Budget line for National research

National research policy & strategy

Capacity to generate own knowledge

University Research capacity entails

Skills for research management

University policies and strategies

Mechanisms to encourage & reward research

Research Leadership skills

Access to Information Communication Technology

Capacity for local PhD examination

Well trained Researchers

ResearchUniversity

An EnablingEnvironment for research

Improved teaching- less didactic

Dedicated university budget for research

Culture of inquiry

University mechanisms for innovation

Mechanisms of research communication

Access to scientific literature

SMÖRGÅSBORD for UNIVERSITY/INSTITUTIONAL and NATIONAL RESEARCH DEVELOPMENT

NATIONAL Research Support

RESEARCH Management Support

RESEARCH Support

PROJECT Support

REFORMS

Library

Faculty Funds

University

Funds

Registration

fees

Stipends

Research collaboratn.

ICT

Central

Lab.

Project 1

Project 2

Project 3

Project 4

STRATEGY

Project Y in cooperation with other Institutions

Project X in cooperation with other Institutions

CO-ORDINATION

INSTITUTIONAL POLICY

MIN. SCI. TECH

STRATEGY

NATIONAL RESEARCH COUNCIL

Africa is huge and capacity to do research diverse

Diversity in capacity for research for health in low income countries

• Continued research capacity strengthening is an ongoing endeavour in all countries

• Research capacity issues are under control in some countries but in others the challenges remain acute

• It is important to distinguish the needs of countries (even those on the same continent) who have attained their targets for research capacity with those who are struggling to attain such targets

• Emphasis of ESSENCE is on low income countries in Africa with weak research capacity for research for health

Reiterating the Paris Agenda

In the context of research capacity strengthening

Paris Agenda

For research it is relevant to note:

• The Paris Declaration highlights the need for research in relation to development for providing the knowledge foundation and the expertise that make it possible for partner countries to analyse, formulate, negotiate, implement and evaluate their own development agenda.– Today these functions are often performed by external

consultants and technical assistance, provided by the donors

Paris Agenda

To change the situation the Paris Declaration states that partner countries should undertake to:

• “Integrate specific capacity strengthening objectives in national development strategies and pursue their implementation through country-led capacity development strategies where needed.”

Paris Agenda - Alignment“Donors base their overall support on

partner countries’ national development strategies, institutions and procedures”

Currently support to research (for health) is mainly focused on:– research on issues of relevance to low-income

countries (theme-based research), organised as projects, with a short- to medium-term perspective and closely connected to the agenda of the funding organisation

Less funding goes to– The long-term commitment aimed at all levels of

production and utilisation of research in a national or regional setting

Paris Agenda - Ownership

– “Partner countries exercise effective leadership over their development policies and strategies and coordinate development actions”

• Development of partner countries’ capacity to negotiate collaborative research activities and to apply for research grants in line with their strategic orientation should be advocated

• Donors involved in research cooperation with a country or regional/ international organisation ought to respect the rules and regulations for research, including research permits, research ethics, staff remuneration and institutional contracts

Paris Agenda - Alignment

Paris Agenda - Harmonisation

• “Donors’ actions are more harmonised, transparent and collectively effective”

This requires support for– establishment of efficient mechanisms for

management of external research funds; making it possible to channel funds through partner countries’ systems

– production of uniform reporting formats at the supported institutions to be used by all donors.

Paris Agenda - Mutual Accountability

• “Donors and partners are accountable for development results”– partner countries and regional organisations

should be encouraged to invite all research donors/funders to joint review meetings

Coherence

Funders should endeavour to adhere to the Paris agenda;

We should• Be mindful that in an attempt to assist, we

should not undermine and fragment the efforts of fragile institutions

• At the least our actions should “do no harm” to partner country institutions

Basis for research for health• The basis for capacity for research for

health also requires capacity in areas/disciplines of research of a broad nature. – These include fundamental science (Biology,

Statistics, Bio-Physics, molecular biology etc.) as well clinical research and health systems research

ESSENCE is a response by funders to contribute to this

• ESSENCE was established after a meeting of funders in April 2008 in Stockholm entitled “Stockholm Meeting on Capacity Building for Research for Health”

The Establishment of ESSENCE

• The initial executive group includes development cooperation agencies – the United Kingdom Department for International Development (DFID ), International Development Research Centre (IDRC), the Ministry of Foreign Affairs of the Netherlands, Norwegian, Agency for Development Cooperation (Norad), the Swedish International Development Cooperation Agency (Sida) – plus the Bill & Melinda Gates Foundation and the Wellcome Trust. NEPAD Science, Technology & Innovation have accepted an invitation to be part of the executive group

• The ESSENCE secretariat is hosted in TDR (Special Programme for Research and Training in Tropical Diseases).

ESSENCE

The organisations taking part in the Stockholm meeting

• Bilateral funding agencies• Canada: IDRC + Global Health Research Initiative• The Netherlands: NWO/WOTRO (Research Council, Science for

Global Development), + Ministry of Foreign Affairs, Netherlands Platform for Global Health Policy and Health Systems Research,

• Norway: NORAD• Denmark: DANIDA/MFA + The Danish Research Network for

International Health Department of International Health, Immunology & Microbiology University of Copenhagen,

• Sweden: Sida + Ministry of Foreign Affairs• UK: DFID• Multilateral organisations• The World Bank + WHO, TDR + The Bamako Secretariat • Other funders (foundations, research funding bodies)• Bill & Melinda Gates Foundation + Howard Hughes Medical Institute

+ The Wellcome Trust + EDCTP • African representatives• ISHReCA + WHO/AFRO + WHO Region for Africa Sub-Regional

Office in Harare, Zimbabwe,

• ESSENCE for health Research has started a process between the funders/development partners/donors (collectively referred to as “funders”) in the spirit of the Paris Agenda

• ESSENCE is focused on how the funders can best align and harmonise and be coherent and learn from each other in the quest for supporting research capacity in Africa

• ESSENCE will of course engage partner countries and institutions

ESSENCE

• Is open for all funders, bilateral development agencies, philanthropists, charities etc. who support or are interested in supporting research capacity in low income countries in Africa

ESSENCE

ESSENCE

Sec.

Executive Committee

ESSENCE Secretariat

ESSENCE membersDFID

SidaBMGF

Dutch

Wellcome

IDRC

NEPAD

Norad

World BankEDCTP

INDEPTH

NWO

DANIDA

ISHReCA

WHO/AFRO

Global Health Research Initiative

RCS initiative A

African Dev. bank

RCS initiative B

RCS initiative C

RCS initiative A

African countries

African countries

Afri

can

coun

tries

African advisors

Working in the spirit of the Paris Agenda

Strategies forHarmonising, alignment and

coherence in support for research capacity strengthening in low income

countries in Africa

What ESSENCE is Not• It is not a research (R&D) project but it must be driven by

research activities

• Not a new initiative for disbursing research project funds but a mechanism of funders funding low-income African country strategies of research capacity in a concerted fashion

• Not a ”budget support” arrangement but could involve basket funding when possible

• It is not trying to coordinate and define the research for health research performed, but seeking to find appropriate research capacity strengthening modalities in low income countries which if leveraged could have significant impact

ESSENCE

The Objectives

  Results Performance Indicators

Overall objective Research capacity strengthening is strengthened in Africa in line with the Paris Agenda for Aid Effectiveness

Extent to which research capacity support programmes of funders are aligned, coordinated and harmonised, extent to which systems of partner countries are being used (financial, monitoring, etc

Long-term objectives: to be achieved by 2015

1) A system of support for research capacity strengthening by funding agencies is established that is aligned with the strategies of African Institutions

1) no of funding agencies with support aligned with African partners strategies, implementation of strategies aligned with Afr institutions priorities, interviews (qualitative indicator)

  2) Increased number of consolidated meetings organised by supported African Institutions for presenting and reporting on results on research capacity strengthening to all funding agencies/ funders

2) Routines for joint reporting, quality of joint reporting, frequency of joint reporting

  3) An increase in the number of development partners in African countries that support research capacity strengthening as an integral part of the development assistance

3) No. of development partners/funders, type of partners/categories, level of funding for RCS

  4) Funding agencies accept one reporting format from the African Institutions

4) No of funding agencies using reporting format of Afr institutions

  5) Funding agencies accept channelling funding through the African Institutions' own financial system

5) Share of funding going through Afr institutions financial systems, no of funding agencies

  6) An increased use of analytical capacity among African researchers to benefit the country’s development

6) The extent to which research produced within African countries is used

  Results Performance Indicators

Overall objective Research capacity strengthening is strengthened in Africa in line with the Paris Agenda for Aid Effectiveness

Extent to which research capacity support programmes of funders are aligned, coordinated and harmonised, extent to which systems of partner countries are being used (financial, monitoring, etc

Initiative objectives 2008-2010. To be achieved by 2010

1) Increased understanding of the modalities, logic, role and impact of external research capacity strengthening support in African institutions by ESSENCE members

1a) procedures/Channels for information exchange and collaboration, frequency of coordination meetings

  2) Electronic platform for sharing of information on research capacity strengthening established

2) One stop shop for resources in capacity development for science & technology in research for health used by ESSENCE members

  3) Procedures for ESSENCE members working together in a concerted fashion in Pilot country collaborations established in Tanzania, Zambia, Uganda, Malawi and Mali.

3) Pilot country collaboration tested in Tanzania and continued to be refined in other test countries that follow namely Zambia, Uganda, Malawi, Mali

  4) Administrative systems in African Institutions capable of channelling funding from various sources

4) strengthened/developed institutions/routines/practices of financial/adm systems

  5) Increased consideration by funding agencies of research strategies and implementation plans of African countries and African Institutions prior to providing support for research capacity strengthening, long-term = alignment

5) strategies and plans in line with those of African countries/institutions

  6) Increased number of African Institutions that have comprehensive reporting formats that can be used by several funding agencies/funders (= long-term)

6) No of African institutions with reporting formats used by several funding agencies, usefulness of joint reporting formats (based on interviews)

How can ESSENCE work practically?

UndergraduateTraining

PostgraduateTraining

Innovation

Research Training

ResearchFunding

Outreach

InstitutionalNeeds

One Funder may address some institutional needs

UndergraduateTraining

PostgraduateTraining

Innovation

Research Training

ResearchFunding

Outreach

InstitutionalNeeds Funder X contribution

UndergraduateTraining

PostgraduateTraining

Innovation

Research Training

ResearchFunding

Outreach

InstitutionalNeeds Funder X contribution

Funder Z contribution

Funder F contribution

Funder Y contribution

Funder Y contribution

Several Funders can better impact on overall institutional needs

Research capacity needs

• Endeavouring to limit the fragmentation in the little research capacity strengthening that is supported

A concerted approach to research funding

• Support for the conditions/foundation for research

• Support for individual researchers• Support for research projects

– Finding opportunities to work with other donors and funders in the spirit of the Paris Declaration for Aid effectiveness

Foundationand

Basis

Individualresearchers

How far have we come?

Objectives Key activities/methods Status

•Global collaboration/dialogue

Multilateral meetings involving donors and recipients to discuss cooperation strategies and harmonization

Ongoing

•Advocacy Secretariat to promote Essence through multiple contacts and major funders. ESC to develop a common advocacy package to use in country visits and high level contacts.

Ongoing

•Mapping Identify strategic focus and modalities of funding of agencies/funders including geographic coverage in Africa, gaps and overlaps of institutions and countries funded. Strategic and implementation plans of African Institutions

Initiated and soon to be presented to group

•Country-based pilot models Review, analyse and harmonize multiple input and approaches to selected recipient countries. Common plans to be drafted in discussion with developing countries institutions and investigators.

Planning for Pilot-1 in Tanzania

•Document successes• and failures

Collate reports, information, interviews and results from country visits and questionnaires on most successful practices and support modalities and of unsuccessful ones, identifying reasons for both.

To be initiated

•M&E indicators Working group to review literature, share experiences, develop an indicator matrix and field test indicators

To be initiated

•Electronic platform Working through TropIKA or SciDev to develop an interactive community of practice space for learning experience. Consolidation of information on calls, reports, guidelines, scientific documents, etc

Ongoing negotiations with TropIKA

The response is the establishment of ESSENCE

A strategy of funders to work together to support research

capacity strengthening for health in low-income African Countries

Conclusion 3 ESSENCE aims address a number of points raised in the Global

strategy and plan of action on public health, innovation and intellectual property

• (2.3) improving cooperation, participation and coordination of health and biomedical research and development

• (a) stimulate and improve global cooperation and coordination in research and

• development, in order to optimize resources• (b) enhance existing fora and examine the need for new

mechanisms, in order to improve the coordination and sharing of information on research and development activities

• (c) encourage further exploratory discussions on the utility of possible instruments or

• mechanisms for essential health and biomedical R&D, including inter alia, an essential health and biomedical R&D treaty

• (d) support active participation of developing countries in building technological capacity

• (e) promote the active participation of developing countries in the innovation process

• (3.2) Framing, developing and supporting effective policies that promote the development of capacities for health innovation

• (a) establish and strengthen regulatory capacity in developing countries• (b) strengthen human resources in research and

development in developing countries through long-term national capacity building plans

• (c) encourage international cooperation to develop effective policies for retention of health professionals including researchers in developing countries

• (d) urge Member States to establish mechanisms to mitigate the adverse impact of the loss of health personnel in developing countries, particularly researchers, through migration, including by ways for both receiving and originating countries to support the strengthening of national health and research systems, in particular human resource development in the countries of origin, taking into account the work of WHO and other relevant organizations.

Conclusion 4 ESSENCE aims to support in a concerted way