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Viergever Health Research Policy and Systems 2011, 9:12 http://www.health-policy-systems.com/content/9/1/12 COMMENTARY Open Access

Aid alignment for global health research: the role of HIROs

Roderik F Viergever

Abstract

The lack of a mechanism that aligns financial flows for global health research towards public health priorities limits the impact of health research on health and health equity. Collaborative groups of health research funders appear to be particularly well situated to ameliorate this situation and to initiate discussion on aid alignment for global health research. One such group is the Heads of International Research Organizations (HIROs), which brings together a large number of major government and philanthropic funders of biomedical research. Surprisingly, there is hardly any information publicly available on HIROs’ objectives, or on how it aims to achieve more harmonization in the field of research for health. Greater transparency on HIROs’ objectives and on its current efforts towards addressing the gap between global health research needs and investments would be desirable, given the enormous potential benefits of more coordination by this group.

Introduction

“There is no global coordination of research and development for major diseases, and the global health research and innovation system is highly fragmented” [1]. Such was one of the conclusions of the report of the World Health Organization (WHO) Expert Working Group on Research and Development Financing that was finalized in the past year. This conclusion is not novel; it has been consistently argued for decades that the lack of a harmonized approach for prioritizing, funding, and planning research for health has prevented that research from responding adequately to the world’s health needs [2-4]. To this day, the allocation of health research funding exhibits little tendency to be commensurate with burden of disease [5], and only a small percentage of funding is allocated towards research that addresses the health problems of developing countries, an issue often referred to as the 10/90 gap [2,6]. The harmful consequences of this funding gap for everyday clinical practice in developing countries are extensive.

For instance, in 2006 it was shown that 30 years of pharmaceutical research had resulted in the development of only 21 drugs targeting neglected diseases (including malaria and tuberculosis) out of a total 1556 new chemical entities marketed [7]. Although the emergence of public-private partnerships, increases in total expenditure on global health research and in the number of actors engaged in that research, and a shift in epidemiology of disease in low- and middle-income countries have all substantially changed the landscape of health research for development in recent years, the enduring mismatch between health research needs and investments remains a cause for grave concern [6,8].

Discussion

The Global Ministerial Forum on Research for Health in Bamako in 2008, in line with the Paris Declaration and the Accra Agenda for Action [9], recognized the need for increased coordination in the field of research for health and the important role of research funding institutions therein [10]. It called on funders of research and innovation “to better align, coordinate, and harmonize the global health research architecture and its governance”. There are several collaborative groups of funders of research for health that appear to be well situated to achieve this. One such group is the Heads of International Research Organizations (HIROs). HIROs was established more than ten years ago and brings together government and philanthropic funding institutions for biomedical research, including major funders such as the US National Institutes of Health and the Bill and Melinda Gates Foundation [1]. The enormous collective influence of these organizations is apparent, but is also demonstrated by the impact external © 2011 Viergever; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Correspondence: roderik.viergever@lshtm.ac.uk Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK