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Essential national health research (ENHR) ensures that health research will be undertaken in priority areas defined by the people and will be used in decision making. Needs-based technology assessment (NBTA) is anchored on the ENHR philosophy. Two case studies are presented, one illustrating a successful application of NBTA and the other a failed approach. Reasons for the difference in success are examined.

Although developing countries can ill afford to make the wrong choice of technology, they usually find it difficult if not impossible to support an adequate technology assessment programme. Much of the available information on the efficacy of various products is valid for other countries, but factors such as epidemiology, cost-effectiveness and acceptability also have to be taken into account, and these vary considerably from one setting to another. There is therefore a strong case for developing national programmes as quickly as possible.