Page 1 of 16 REPORT: WHO Informal workshop – monitoring financial flows in support of health research & development 14 th February 2013 at the London offices of the Wellcome Trust Background This workshop brought together people and organizations who are experienced in the area of collecting data on resource flows in support of health R&D and related initiatives that present that data in platforms and online resources. The specific aims of this workshop were: 1. To share details of learning and experience on major initiatives that have been concerned with efforts to map international R & D resource flows with a focus on health (e.g. G Finder and RICYT) and related studies (e.g. OECD and UNESCO R&D surveys and statistics). 2. To explore related issues for example research classification or how the health product pipeline for the health needs of developing countries might be mapped. 3. To discuss current opportunities and challenges in doing R&D resource flow mapping from the perspective of political, economic, social, technical, legal and ethical/environmental aspects. 4. To explore the opportunities to develop a more coordinated approach to R&D resource flow mapping at a global level. The agenda and list of participants are attached at the end of this report.
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REPORT: WHO Informal workshop – monitoring financial flows in support of
health research & development
14th February 2013 at the London offices of the Wellcome Trust
Background
This workshop brought together people and organizations who are experienced in the area of collecting
data on resource flows in support of health R&D and related initiatives that present that data in
platforms and online resources. The specific aims of this workshop were:
1. To share details of learning and experience on major initiatives that have been concerned with
efforts to map international R & D resource flows with a focus on health (e.g. G Finder and
RICYT) and related studies (e.g. OECD and UNESCO R&D surveys and statistics).
2. To explore related issues for example research classification or how the health product pipeline
for the health needs of developing countries might be mapped.
3. To discuss current opportunities and challenges in doing R&D resource flow mapping from the
perspective of political, economic, social, technical, legal and ethical/environmental aspects.
4. To explore the opportunities to develop a more coordinated approach to R&D resource flow
mapping at a global level.
The agenda and list of participants are attached at the end of this report.
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Morning session: Overview of R&D mapping past and present
The morning session consisted of presentations from the participants on initiatives past and present in
the area of mapping R&D and health R&D measures. The presentations are available from the WHO
website at http://www.who.int/phi/workshop14022013/en/index.html
Summary of Presentations
1. Stephen Matlin and Allison Young, ex-Global Forum for Health Research:
Monitoring R&D resource flows. There has been a steady growth of expenditures that has grown from
USD$ 30 billion in 1986 to USD$ 240 billion in 2009 indicating a growth of about USD$ 20 billion yearly.
Typically the larger spender has been the private sector , followed by public (each close to 45%) and
philanthropic contributions make up about 8%. However, for neglected diseases the public sector takes
care of approximately two thirds of the expenditure. There are large gaps on data and lack of uniformity
that makes it difficult to analyse or aggregate data. There is a lack of data transparency especially with
the private sector and a lack of data at the disease level are noticeable particularly in the private sector.
In the public sector there is lack of data beyond OECD countries.
In collecting R&D data it varies between countries which body is tasked, if at all, with the collection of
data. A question is posed as to on whether it is better to have health R&D expenditure in the health
accounts or, as it can be located in other ministries, whether it should be disaggregated from national
accounts. It remains unclear what incentives exist for agencies to invest effort in collecting data within
poorer countries on neglected diseases where this can be a considerable effort for small sums of money.
Incentives will need to be identified that will create a comprehensive and disaggregated data from all
4. Rodolfo Barrere and Analia Porras, RICYT PAHO/WHO
The network provides indicators for Ibero-America and works with national agencies for science &
technologies in more than 28 countries. RICYT works with UNESCO and they are funded by the
IberoAmerican States Organization, and they have collaborations with other organizations such as
PAHO. The scope includes the production and diffusion of information, reaching methodological
agreements, consolidating skills and developing new indicators. The framework for the observatory
nested in the Regional Platform on Access and Innovation for Health Technologies (funded by FDA, MoH
of Brazil ) is presented. Information is taken from different sources and there is a peer review process
for the application of indicators. The funding is not from MoH (just Brazil, US and Canada would have
some significant funding); funding comes from Science & Technology mostly.
In Latin America information for R&D is not disaggregated for health. Argentina, Brazil, Colombia and
Mexico have partnered with PAHO in a pilot to develop a framework to map research, development and
innovation (RDI) capacities in Latin America. The framework included 8 elements that included RDI
inputs and outputs together with IP management, Access, Regulatory capacities.
Categorization remains a big challenge: what to include under health, what to include in budgets and
funds, private funding is hard to measure. Even degrees awarded by the universities have different
categories that do not translate well between countries. Journals and access to information and
networks are also assessed. RICYT pulls together “hard indicators” as well as measures of context
specific data in an attempt to pull all the information together. There is a tonne of data and reducing
those indicators and choosing key indicators for countries, those that are better predictors, remains a
challenge. There are also efforts to assess the efficiency, productivity and economic returns on investing
in R&D. For human resources RICYT works with agencies in countries. They have mapped collaborations
between countries to characterize how collaborations are taking place (See Brazil example above).
One issue is about balancing openness with confidentiality. For example the information about
regulatory agencies includes a confidential assessment by peers which remains closed. Currently many
of the indicators collected are not public and follow a confidentiality agreement. This is particularly true
for data that is collected from the private e.g. pharmaceutical sector.
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5. Javier Guzman, G-FINDER
G-FINDER is part of Policy Cures and funded by the Bill & Melinda Gates Foundation since 2008, five
years initially and now it has been extended 3 more years. G-FINDER measures: 31 neglected diseases;
134 product areas (drugs, vaccines, diagnostics, microbicides and vector control products); Platform
technologies (adjuvants, delivery technologies, diagnostic platforms) and all types of product-related
R&D.
They measure funding on 31 neglected diseases which they designated using a panel of international experts predominantly focusing on those diseases that disproportionally affect low and middle income countries, where there is a R&D gap (i.e. there is no existing product OR improved or additional products are needed) and there is market failure (i.e. there is insufficient commercial market to attract R&D by private industry) . Data is collected from working with funding agencies and product developers, not with countries. They cover research from basic to phase 4 clinical trials. They get data from around240 organizations globally with dominance from public sector. They follow the money and they report on 56 countries, 29 of which are high income, yet 90% of the data is from those high income countries. To obtain data from Brazil, India and South Africa has proven to be expensive and resource intensive and the returns of data were low.
The reports have been extensively used and this is why B&MG has extended their grant. Development
agencies are using their data to prioritize. It has provided the evidence to set up agendas and priorities
by other partners. It has allowed standardizing reporting for example with the industry.
The limitation of this type of survey is that the process is intensive and expensive and has only one
source of funding to support it (B&MG). When asked everyone says they like the resource and value it –
but no one (else) wants to pay for it. There is no data on health systems research as the focus is
products. There are opportunities in the future through linkage with other tracking efforts and an
effort has been made to identify the added value and the use the data is put to. This is slowly changing
attitudes towards the value of providing more data.
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6. Luis Gabriel Cuervo and David Abreu, Health Research Web (HRWeb):
HRWeb provides an online platform to both upload and share information on R&D initiatives, policies
and strategies. It has been constructed as a wiki to allow the uploading information by people in
countries and, after initially seeding the site with available public information, it now relies on people
contributing data. Once a critical amount of information became available to publish analysis and
reports, benchmarking against other – also referred to as “envy and embarrassment”, have played a
role in motivating contributions: people want to showcase their capacities and no one wants to see their
country as having nothing when there are worthy resources.
The aim is to provide practical information and includes publications and analysis of health systems. For
example, there is information on over 1100 ethics review committees in the Americas providing what
perhaps is the most comprehensive mapping of such committees in Latin America.
It is seen as a bottom up approach and has the advantage of being a partnership with the countries that
have ownership over their data. Most of the published data includes links to public sites and documents.
With many different contributors there is a drive towards continuous improvements to the site including
an intention, in the PAHO region, with the International Clinical Trial Database (ICTRP) into HRWeb to
provide a one-stop shop repository with descriptors of national health research systems. Of course this
model provides challenges as well with different approaches to presenting data and changes in country
staff leading to varied quality. Agreeing nomenclature and the classification of what is and is not
research and its subsets is a big challenge. In the future the intention is that the data and the processes
that HRWeb offer can be used by countries for the management of their own research portfolios at
national sub-national and institutional level. The model has allowed developing and publishing in
different media analysis about national health research systems in Latin America, and engaging
delegates from the science & technology and health sectors in the Latin American Conferences on
Research and Innovation for Health (www.paho.org/LACRIH).