Strengthening research capacity

Abstract

In your Oct 27 editorial1The Lancet Strengthening research capacity's weakest link.Lancet. 2001; 358: 1381Summary Full Text Full Text PDF PubMed Scopus (10) Google Scholar you highlight crucial issues about research capacity development in the less-developed world. We agree that, in Africa, greater acceptance of the notion that health research is a prerequisite of development, and not a luxury of affluent societies, is crucial to bridging the gap between research and policy. Existing solid scientific evidence about prevention, diagnosis, and treatment, should be the basis for health policy, and where such evidence is lacking we must invest in research. Less than 10% of the global spending on health research is devoted to less-developed countries, which shoulder 90% of the global disease burden.2Global Forum for Health Research. 10/90 report on health research 2000.www.globalforumhealth.org/pages/index.aspGoogle Scholar With the need to achieve so much with so little, every step must be taken to avoid duplication while maintaining a level of enthusiasm necessary for accomplishing such an enormous task. More research is needed in less-developed countries, but we must also realise that research already done in these parts of the world is under-represented in major databases. The efforts of the Cochrane Collaboration in unearthing previously unknown controlled trials done in these countries by hand searching indexed and non-indexed journals is to be commended.3Pienaar E The African trials register: providing Africa with the best evidence. 9th International Cochrane Colloquium. Lyon, FranceOct 9–13, 2001Google Scholar We believe that an indispensable first step in investing in new research in less-developed countries, as elsewhere, should be a systematic synthesis of relevant existing research. This search should identify areas in which new evidence is needed, and thus chart methods and rational paths for further research. Without such systematic synthesis, the limited resources made available for health research2Global Forum for Health Research. 10/90 report on health research 2000.www.globalforumhealth.org/pages/index.aspGoogle Scholar will continue to be squandered on ill-conceived studies, and avoidable confusion will continue to result from failure to set new studies in the context of other relevant research. Examples abound where failure to systematically review research evidence has resulted in untold and avoidable suffering.4Chalmers I Foreword.in: Egger M Davey Smith G Altman DG Systematic reviews in health care: meta-analysis in context. BMJ Books, London2000Google Scholar Systematic reviews can be done with fewer financial and human resources and faster than other types of research. Such cost-effective research is certainly needed in the less-developed world, whose inhabitants deserve the best possible care that resources permit. Given that evidence-based health care offers the best chance of reaping maximum benefits from limited resources, there is need for funding agencies to provide resources for the preparation and maintenance of systematic reviews of existing research evidence relevant to the less-developed world, as a scientific and ethical requirement, before investing in new research.