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Introduction More than two decades ago it was shown that only 5% of the world's resources for health research and development (R&D) were spent on the health problems of developing [...], Objective To explore what can be learnt about the current composition of the 'global landscape' of health research and development (R&D) from data on the World Health Organization's International Clinical Trials Registry Platform (ICTRP). Methods A random 5% sample of the records of clinical trials that were registered as interventional and actively recruiting was taken from the ICTRP database. Findings Overall, 2381 records of trials were investigated. Analysis of these records indicated that, for every million disability-adjusted life years (DALYs) caused by communicable, maternal, perinatal and nutritional conditions, by noncommunicable diseases, or by injuries, the ICTRP database contained an estimated 7.4, 52.4 and 6.0 trials in which these causes of burden of disease were being investigated, respectively. For every million DALYs in high-income, upper-middle-income, lower-middle-income and low-income countries, an estimated 292.7, 13.4, 3.0 and 0.8 registered trials, respectively, were recruiting in such countries. Conclusion The ICTRP constitutes a valuable resource for assessing the global distribution of clinical trials and for informing policy development for health R&D. Populations in lower-income countries receive much less attention, in terms of clinical trial research, than populations in higher-income countries. Objectif Etudier et, dans la mesure du possible, connaitre la composition actuelle du <> en termes de recherche et de developpement (R&D) dans le domaine de la sante a partir de donnees provenant d u systeme d'enregistrement international des essais cliniques de l'Organisation mondiale de la Sante (ICTRP). Methodes Un echantillon aleatoire de 5% des enregistrements des essais cliniques qui ont ete references comme etant interventionnels et recrutant activement des patients a ete obtenu de la base de donnees de l'ICTRP. Resultats Dans l'ensemble, 2381 enregistrements d'essais ont ete etudies. Leur analyse a montre que pour chaque million d'annees de vie corrigees du facteur incapacite (AVCI) causees par des pathologies transmissibles, maternelles, perinatales et des deficiences nutrition nelles, par des maladies non transmissibles ou par des blessures, la base de donnees de l'ICTRP contenait respectivement environ 7,4, 52,4 et 6,0 essais dont les causes contributives a la charge de morbidite etaient en cours d'etude. Pour chaque million d'AVCI dans les pays a revenu eleve, a revenu intermediaire de la tranche superieure, a revenu intermediaire de la tranche inferieure et a faible revenu, il a ete estime qu'environ 292,7, 13,4, 3,0 et 0,8 essais enregistres, respectivement, recrutaient des patients dans ces pays. Conclusion L'ICTRP constitue une ressource precieuse afin d'evaluer la distribution mondiale des essais cliniques, et une excellente source d'informations sur l'evolution des politiques de recherche et de developpement dans le domaine medical. Les populations des pays a revenu faible beneficient d'une attention bien moindre en matiere de recherche axee sur les essais cliniques que les populations des pays a revenu eleve. Objetivo Analizar que se puede aprender acerca de la composicion actual del, <> de la investigacion y desarrollo sanitarios (I+D) a partir de datos de la plataforma de registros internacionales de ensayos clinicos (ICTRP, por sus siglas en ingles) de la Organizacion Mundial de la Salud. Metodos Por medio de un alistamiento activo se tomo una muestra aleatoria del 5% de los expedientes de los ensayos clinicos registrados como intervencionistas de la base de datos de la ICTRP. Resultados En total, se investigaron 2381 expedientes. El analisis de dichos expedientes indico que, por cada millon de anos de vida potencialmente perdidos (AVPP) causados por enfermedades transmisibles, maternas, perinatales y nutricionales, por enfermedades no transmisibles o por lesiones, la base de datos de la ICTRP contenia aproximadamente 7,4, 52,4 y 6,0 ensayos, respectivamente, en los que se investigaban las causas de esas cargas de morbilidad. Por cada millon de AVPP en paises con ingresos altos, medios-altos, medios-bajos y bajos, se alistaron aproximadamente 292,7, 13,4, 3,0 y 0,8 ensayos registrados en dichos paises. Conclusion La ICTRP constituye un recurso valioso para evaluar la distribucion global de los ensayos clinicos y para informar sobre el desarrollo de politicas para el I+D sanitarios. Las poblaciones en paises con ingresos bajos reciben mucha menos atencion, en terminos de investigacion de ensayos clinicos, que las poblaciones en paises con ingresos mas altos.

Abstract Today we have an incomplete picture of how much the world is spending on health and disease-related research and development (R&D). As such it is difficult to align, or even begin to coordinate, health R&D investments with international public health priorities. Current efforts to track and map global health research investments are complex, resource-intensive, and caveat-laden. An ideal situation would be for all research funding to be classified using a set of common standards and definitions. However, the adoption of such a standard by everyone is not a realistic, pragmatic or even necessary goal. It is time for new thinking informed by the innovations in automated online translation - e.g. Yahoo's Babel Fish. We propose a feasibility study to develop a system that can translate and map the diverse research classification systems into a common standard, allowing the targeting of scarce research investments to where they are needed most.

Abstract Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.

Abstract Background This paper presents the first comprehensive effort to provide an overview of the research associated with the World Health Organization (WHO) headquarters in 2006/07. Methods Information was obtained by questionnaire and interviews with senior staff operating at WHO headquarters in Geneva. Research type, purpose and resources (both financial and staff) were defined and compared for each of the 37 departments identified and a comparative analysis was made with the global burden of disease as expressed by Disability Adjusted Life Years (DALY). Results Research expenditure in 2006/07 was estimated at US$215 million. WHO is involved in more than 60 research networks/partnerships and often WHO itself is the network host. Using the DALY model, 84% of the funding WHO allocates to research goes to DALY Type I diseases (communicable, maternal, perinatal and nutritional diseases) which represents 40% of DALY. 4% is allocated to Daly Type II (non-communicable diseases) which contributes to 48% of DALY. 45% of WHO permanent staff are involved with health research and the WHO's approach to research is predominantly focused on policy, advocacy, health systems and population based research. The Organization principally undertakes secondary research using published data and commissions others to conduct this work through contracts or research grants. This approach is broadly in line with the stated strategy of the Organization. Conclusions The difficulty in undertaking this survey highlights the complexity of obtaining an Organization-wide assessment of research activity in the absence of common standards for research classification, methods for priority setting and a mechanism across WHO, or within the governance of global health research more generally, for managing a research portfolio. This paper presents a strategic birds-eye view of the WHO research portfolio using methodologies that, with further development, may provide the strategic information required if there is to be balancing of research efforts between communicable disease, non-communicable disease and other pressing public health needs. As the rollout of the WHO strategy on research for health proceeds we would hope to see similar exercises undertaken at the WHO Regional Offices and in support of capacity building of national health research systems within Member States.

It seems astonishing that in the 21st century decisions on health care can still be made without a solid grounding in research evidence. This is true even in clinical research, [...]

Objective. To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002-2012. Methods. This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002-February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG). Results. Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. Conclusions. Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG. [ABSTRACT FROM AUTHOR]

Objective: To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012., Methods: This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG)., Results: Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions., Conclusions: Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.