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This paper provides detailed guidelines for implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are primarily public donors and not-for-profit foundations and international agencies, although it can also be used by private sector. It is a process that involves the investors, technical experts and numerous other stakeholders, and results in: (i) understanding and defining the context in which investments are performed; (ii) agreeing on expected “returns” on the investments and risk preferences; (iii) defining the main criteria for priority setting; (iv) systematic listing of many competing research investment options; (v) transparent valuation of each research option against each criterion; (vi) adjustment of this valuation according to values of the society; (vii) combining this adjusted valuation with predicted cost, expected “returns” and risk preferences to decide on the optimal investment strategy. “Returns” on the investments can be defined as reduction in existing disease burden (public and not-for-profit sector) or patentable products (private sector). The CHNRI methodology is a flexible process that enables prioritising health research investments at any level: institutional, regional, national, international or global. This paper presents detailed guidelines for application of the CHNRI methodology in different contexts.

Increasingly, there is a need for national governments, public-private partnerships, private sector and other funding agencies to set priorities in health research investments in a fair and transparent way. A process of priority setting is always an activity driven by values of wide range of stakeholders, which are often conflicting. This process always occurs in a highly specific context (eg, agreed policies and targets in terms of disease burden reduction and time limit, defined geographic space, population and specific health problems).

Increasingly, there is a need for national governments, public-private partnerships, private sector and other funding agencies to set priorities in health research investments in a fair and transparent way. A process of priority setting is always an activity driven by values of wide range of stakeholders, which are often conflicting. This process always occurs in a highly specific context (eg, agreed policies and targets in terms of disease burden reduction and time limit, defined geographic space, population and specific health problems).

This paper provides detailed guidelines for implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are primarily public donors and not-for-profit foundations and international agencies, although it can also be used by private sector. It is a process that involves the investors, technical experts and numerous other stakeholders, and results in: (i) understanding and defining the context in which investments are performed; (ii) agreeing on expected “returns” on the investments and risk preferences; (iii) defining the main criteria for priority setting; (iv) systematic listing of many competing research investment options; (v) transparent valuation of each research option against each criterion; (vi) adjustment of this valuation according to values of the society; (vii) combining this adjusted valuation with predicted cost, expected “returns” and risk preferences to decide on the optimal investment strategy. “Returns” on the investments can be defined as reduction in existing disease burden (public and not-for-profit sector) or patentable products (private sector). The CHNRI methodology is a flexible process that enables prioritising health research investments at any level: institutional, regional, national, international or global. This paper presents detailed guidelines for application of the CHNRI methodology in different contexts.

Članak daje pregled teoretskih i praktičnih pristupa postavljanju prioriteta prilikom ulaganja u istraživanje dječjega globalnog zdravlja. Daje i pregled prijašnjih pokušaja razvitka odgovarajućih alata i postupaka u području ulaganja u istraživanja o zdravlju. Napravljen je kratak pregled najvažnijih teoretskih postavki prema kojima bi se trebalo ravnati u postupku određivanja prioriteta. On je pokazao da će se različiti pristupi u postavljanju prioriteta, poput medicinskoga, gospodarskoga, zakonskoga, etičkoga, društvenoga, političkoga, pragmatičnoga, filozofskoga, onoga od poslodavaca i svih drugih nužno sukobiti. Posebno smo raspravili aktualne pravce istraživanja u području globalnoga dječjega zdravlja i njihov odnos prema Milenijskom cilju br. 4 organizacije Ujedinjenih naroda (UN), koji je da se između 1990. i 2015. dječja smrtnost smanji za dvije trećine. Procijenjena su postignuća pristupa koji su bili ranije primjenjivani i prikazane njihove prednosti i mane. Navedeni su razlozi organizacije Inicijativa za dječje zdravlje i prehranu (engl., Child Health and Nutrition Research Initiative) za stvaranje nove metodologije određivanja prioriteta u ulaganju u zdravstvena istraživanja i navedeni su razlozi za njezinu primjenu u području globalnoga dječjega zdravlja. Da bi se mogli obuhvatiti svi kutovi iz kojih je moguće promatrati prioritete ulaganja u istraživanja zdravlja nuždan je interdisciplinarni pristup. Određivanje prioriteta traži da njihovo stvaranje bude javno, jasno i sustavno i da u obzir uzme mnogobrojna gledišta i nastavi se na prednosti prethodnih pristupa., This article reviews theoretical and practical approaches to priority setting in global child health research investments. It also provides an overview of previous attempts to develop appropriate tools and methodologies to define priorities in health research investments. A brief review of the most important theoretical concepts that should govern priority setting processes is undertaken, showing how different perspectives, such as medical, economical, legal, ethical, social, political, rational, philosophical, stakeholder driven, and others will necessarily conflict each other in determining priorities. We specially address present research agenda in glob

Cilj Odrediti glavne zainteresirane strane u procesu postavljanja prioriteta u zdravstvenim istraživanjima i predložiti strategije koje bi uzele u obzir sustave vrijednosti svih zainteresiranih strana. Postupci Između ožujka i lipnja 2006. u tri odvojene vježbe ispitali smo 3 različite skupine zainteresirane za istraživanja zdravlja djece: 1) članove mreže za postavljanje globalnih prioriteta u istraživanju; 2) raznoliku skupinu zainteresiranih sudionika iz Južnoafričke Republike; 3) sudionike na međunarodnoj konferenciji o zdravlju djece u Washingtonu, USA. Svakoj skupini je podijeljena različita verzija upitnika u kojoj su trebali ocijeniti važnost kriterija (i postaviti minimalne pragove gdje je to potrebno) za koje su savjetnici Child Health and Nutrition Research Initiative (Inicijative za istraživanja o dječjem zdravlju i prehrani) ranije odredili da su ključni u postavljanju prioriteta u zdravstevenim istraživanjima. Rezultati Na globalnoj razini ispitanici su pridavali najveću važnost kriteriju maksimalne moguće koristi u smanjivanju tereta bolesti, dok je najstroži prag postavljen za kriterij etičke odgovornosti. Sudionici na međunarodnoj konferenciji odabrali su provodivost, odgovornost i održivost kao najvažnije kriterije. Na nacionalnoj razini Južnoafričke Republike najveća važnost pripisana je kriteriju predviđenog utjecaja na pravednost zdravstvenog istraživanja. Conclusions Kada postavljamo prioritete za ulaganja u zdravstvena istraživanja važno je uključiti što veći broj zainteresiranih strana jer znanstvenici i tehnički stručnjaci ukjučeni u istraživanje ne moraju imati kriterije koji su primjereni određenom kontekstu i koji su u skladu s vrijednostima onih koji ulažu u istraživanja, onih koji imaju korist od istraživanja i društva u cjelini., Aim To identify main groups of stakeholders in the process of health research priority setting and propose strategies for addressing their systems of values. Methods In three separate exercises that took place between March and June 2006 we interviewed three different groups of stakeholders: 1) members of the global research priority setting network; 2) a diverse group of national-level stakeholders from South Africa; and 3) participants at the conference related to international child health held in Washington, DC, USA. Each of the groups was administered different version of the questionnaire in which they were asked to set weights to criteria (and also minimum required thresholds, where applicable) that were a priori defined as relevant to health research priority setting by the consultants of the Child Health and Nutrition Research initiative (CHNRI). Results At the global level, the wide and diverse group of respondents placed the greatest importance (weight) to the criterion of maximum potential for disease burden reduction, while the most stringent threshold was placed on the criterion of answerability in an ethical way. Among the stakeholders’ representatives attending the international conference, the criterion of deliverability, answerability, and sustainability of health research results was proposed as the most important one. At the national level in South Africa, the greatest weight was placed on the criterion addressing the predicted impact on equity of the proposed health research. Conclusions Involving a large group of stakeholders when setting priorities in health research investments is important because the criteria of relevance to scientists and technical experts, whose knowledge and technical expertise is usually central to the process, may not be appropriate to specific contexts and in accordance with the views and values of those who invest in health research, those who benefit from it, or wider society as a whole.

Članak daje pregled teoretskih i praktičnih pristupa postavljanju prioriteta prilikom ulaganja u istraživanje dječjega globalnog zdravlja. Daje i pregled prijašnjih pokušaja razvitka odgovarajućih alata i postupaka u području ulaganja u istraživanja o zdravlju. Napravljen je kratak pregled najvažnijih teoretskih postavki prema kojima bi se trebalo ravnati u postupku određivanja prioriteta. On je pokazao da će se različiti pristupi u postavljanju prioriteta, poput medicinskoga, gospodarskoga, zakonskoga, etičkoga, društvenoga, političkoga, pragmatičnoga, filozofskoga, onoga od poslodavaca i svih drugih nužno sukobiti. Posebno smo raspravili aktualne pravce istraživanja u području globalnoga dječjega zdravlja i njihov odnos prema Milenijskom cilju br. 4 organizacije Ujedinjenih naroda (UN), koji je da se između 1990. i 2015. dječja smrtnost smanji za dvije trećine. Procijenjena su postignuća pristupa koji su bili ranije primjenjivani i prikazane njihove prednosti i mane. Navedeni su razlozi organizacije Inicijativa za dječje zdravlje i prehranu (engl., Child Health and Nutrition Research Initiative) za stvaranje nove metodologije određivanja prioriteta u ulaganju u zdravstvena istraživanja i navedeni su razlozi za njezinu primjenu u području globalnoga dječjega zdravlja. Da bi se mogli obuhvatiti svi kutovi iz kojih je moguće promatrati prioritete ulaganja u istraživanja zdravlja nuždan je interdisciplinarni pristup. Određivanje prioriteta traži da njihovo stvaranje bude javno, jasno i sustavno i da u obzir uzme mnogobrojna gledišta i nastavi se na prednosti prethodnih pristupa., This article reviews theoretical and practical approaches to priority setting in global child health research investments. It also provides an overview of previous attempts to develop appropriate tools and methodologies to define priorities in health research investments. A brief review of the most important theoretical concepts that should govern priority setting processes is undertaken, showing how different perspectives, such as medical, economical, legal, ethical, social, political, rational, philosophical, stakeholder driven, and others will necessarily conflict each other in determining priorities. We specially address present research agenda in glob

Cilj Odrediti glavne zainteresirane strane u procesu postavljanja prioriteta u zdravstvenim istraživanjima i predložiti strategije koje bi uzele u obzir sustave vrijednosti svih zainteresiranih strana. Postupci Između ožujka i lipnja 2006. u tri odvojene vježbe ispitali smo 3 različite skupine zainteresirane za istraživanja zdravlja djece: 1) članove mreže za postavljanje globalnih prioriteta u istraživanju; 2) raznoliku skupinu zainteresiranih sudionika iz Južnoafričke Republike; 3) sudionike na međunarodnoj konferenciji o zdravlju djece u Washingtonu, USA. Svakoj skupini je podijeljena različita verzija upitnika u kojoj su trebali ocijeniti važnost kriterija (i postaviti minimalne pragove gdje je to potrebno) za koje su savjetnici Child Health and Nutrition Research Initiative (Inicijative za istraživanja o dječjem zdravlju i prehrani) ranije odredili da su ključni u postavljanju prioriteta u zdravstevenim istraživanjima. Rezultati Na globalnoj razini ispitanici su pridavali najveću važnost kriteriju maksimalne moguće koristi u smanjivanju tereta bolesti, dok je najstroži prag postavljen za kriterij etičke odgovornosti. Sudionici na međunarodnoj konferenciji odabrali su provodivost, odgovornost i održivost kao najvažnije kriterije. Na nacionalnoj razini Južnoafričke Republike najveća važnost pripisana je kriteriju predviđenog utjecaja na pravednost zdravstvenog istraživanja. Conclusions Kada postavljamo prioritete za ulaganja u zdravstvena istraživanja važno je uključiti što veći broj zainteresiranih strana jer znanstvenici i tehnički stručnjaci ukjučeni u istraživanje ne moraju imati kriterije koji su primjereni određenom kontekstu i koji su u skladu s vrijednostima onih koji ulažu u istraživanja, onih koji imaju korist od istraživanja i društva u cjelini., Aim To identify main groups of stakeholders in the process of health research priority setting and propose strategies for addressing their systems of values. Methods In three separate exercises that took place between March and June 2006 we interviewed three different groups of stakeholders: 1) members of the global research priority setting network; 2) a diverse group of national-level stakeholders from South Africa; and 3) participants at the conference related to international child health held in Washington, DC, USA. Each of the groups was administered different version of the questionnaire in which they were asked to set weights to criteria (and also minimum required thresholds, where applicable) that were a priori defined as relevant to health research priority setting by the consultants of the Child Health and Nutrition Research initiative (CHNRI). Results At the global level, the wide and diverse group of respondents placed the greatest importance (weight) to the criterion of maximum potential for disease burden reduction, while the most stringent threshold was placed on the criterion of answerability in an ethical way. Among the stakeholders’ representatives attending the international conference, the criterion of deliverability, answerability, and sustainability of health research results was proposed as the most important one. At the national level in South Africa, the greatest weight was placed on the criterion addressing the predicted impact on equity of the proposed health research. Conclusions Involving a large group of stakeholders when setting priorities in health research investments is important because the criteria of relevance to scientists and technical experts, whose knowledge and technical expertise is usually central to the process, may not be appropriate to specific contexts and in accordance with the views and values of those who invest in health research, those who benefit from it, or wider society as a whole.