Global Forum highlights deficits in disease and gender research



Fiona Fleck




Public health officials, scientists, nongovernmental organizations (NGOs) and private sector representatives from over 100 countries gathered on 2–5 December 2003 at the annual conference of the Global Forum for Health Research, a Geneva-based NGO which lobbies to raise awareness about the fact that less than 10% of health research funds are spent on 90% of the world's health problems. The Forum looked at the contribution of health research to economic investment, poverty, gender, globalization, violence and injuries and noncommunicable diseases.

Only a tenth of the US$ 73 billion spent on health research last year went towards developing vaccines, medicines or new treatment for "diseases of the poor" — like malaria and tuberculosis, said conference organizers. Participants in the conference heard that although health research was a major factor in poverty reduction it was often overlooked by governments and other donors.

Nancy Birdsall, President of the Washington-based Center for Global Development, said that most of the 13 million deaths from infectious diseases each year can be prevented with known, relatively inexpensive treatments. "What is striking ... is that the full benefits of existing technologies are far from being fully realized," Birdsall told the conference.

Carlos Morel, Director of the joint WHO Special Programme for Research and Training in Tropical Diseases (TDR), used historical examples to illustrate the importance of continued investment in health research. Polio control was transformed by the discovery of an effective vaccine which relegated the "iron lung" machine to little more than a museum piece, he said. He also stated that the health sector often fails to invest in further research once a promising tool is discovered. Malaria research was neglected once insecticide appeared to be an effective tool for disease control — so when resistant mosquitoes appeared, no one was prepared, he said. Morel pointed out that it was a very different story in the defence sector: even though it possesses highly sophisticated and effective weapons, massive investment in research continues.

Louis Currat, the former World Bank economist and outgoing Executive Secretary of the Global Forum described the imbalance in health research funding as understandable since the private sector — which accounts for 42% of global spending on health research — responds to market forces while public health officials tend to focus on national health.

Currat said, however, that health problems like AIDS, malaria and tuberculosis contributed towards poverty, instability and violence which in turn triggered migration and a need for humanitarian aid — both of which could be costly for rich, developed countries.

"AIDS in Africa not only means instability, and a tremendous loss of income and people in the labour force but it also means that the economic partners of Africa suffer," said Currat. "Africa would be a better economic partner if its economy were growing and it were buying more products," he added.

However, governments are beginning to pay attention to the 10/90 health research gap, stated Currat who said this was indicated by the fact that a tool devised by the Global Forum called the Combined Approach Matrix to help countries calculate their health priorities was catching on.

Lesley Doyal of the University of Bristol in England, one of the world's leading experts on gender, and Vikram Patel of the London School of Hygiene and Tropical Medicine described how globalization affects the health of men and women differently. Global restructuring is leading to increasing economic difficulties in developing countries and the burden of poverty is disproportionately borne by women, they said. Patel cited several examples from the field of mental health: de-creasing fertility in South Asia is making the sex of a new born child a risk factor for post-natal depression; Fiji, whose culture did not traditionally favour a slim figure, has witnessed an increase in eating disorders; several Eastern European cultures have experienced a rapid rise in alcohol use disorders.

The Global Forum conference also heard that although women's health is more vulnerable than that of men, mainly due to their childbearing role, there is a lack of research into maternal mortality, pregnancy-related disorders and other women's health problems in the developing world.

Dr Stephen Matlin succeeded Louis Currat as Executive Secretary of the Global Forum on 1 January 2004. Louis Currat, who has led the Secretariat from its establishment in 1997, retired at the end of 2003. Matlin said that he plans to engage the media much more in the activities of the Global Forum.

World Health Organization Genebra - Genebra - Switzerland