BMJ special issue: Engaging with global health
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British Medical Journal 2000:321 (30 September) runs a special issue
for the International Conference on Health Research for Development
in Bangkok (10 - 13 October) with a series of articles under the
heading "Engaging with global health" that are available on the
internet full text as .html files or as downloadable .pdf files:
http://bmj.com/cgi/content/full/321/7264/0
Globalisation has become a hot topic. Some argue that it has the po-
tential to solve poverty in developing countries. Others regard it as
the very driver of the growing North-South divide. Few dispute the
overwhelmingly strong moral and practical case for tackling the ris-
ing tide of poverty and ill health in developing countries.
At the June World Summit for Social Development, improving the health
of poor and vulnerable people was put at the top of the development
agenda. At the Millennium Assembly earlier this month, 106 world
leaders pledged to halve the number of people living in poverty by
2015.
The scale of the challenge is breathtaking. The stand taken by mas-
sive multinationals and powerful international organizations is cru-
cial. No less so is the direction and governance of global health re-
search. In 10 days' time the International Conference on Health Re-
search for Development in Bangkok, which provides the stimulus for
this special issue of the BMJ, will define this research agenda. Re-
dressing the 10/90 divide - where less than 10% of health research
funds are spent on diseases that account for 90% of the global burden
of disease - has to be a priority. (p 775)
<http://bmj.com/cgi/content/short/321/7264/775>\.
Another priority is to strengthen the capacity of developing coun-
tries to define and conduct their own research. Currently, too much
research is dominated by the interests of (and conditions imposed by)
rich and influential international donors. (p 827)
<http://bmj.com/cgi/content/short/321/7264/827>
Several Education and Debate articles emphasise the need to build
more North-South partnerships. Certain golden rules must be observed,
warn Harris and Tanner (p 817)
<http://bmj.com/cgi/content/short/321/7264/817>\. Success depends on
long term support and mutual exchange.
Equally importantly, the research initiative in Tanzania (p 821)
<http://bmj.com/cgi/content/short/321/7264/821> suggests that strong
national leadership and pooling of existing expertise through South-
South links may be just as, if not more, important than North-South
partnerships.
Lam also reminds us (p 830)
<http://bmj.com/cgi/content/short/321/7264/830>, that developing
countries have much to teach richer countries.
The gap between rhetoric and reality comes through in Bhutta's evi-
dent frustration at Pakistan's failure to improve its devastatingly
high neonatal mortality and childhood malnutrition rates (p 809)
<http://bmj.com/cgi/content/short/321/7264/809>, which is due, he ar-
gues, to a mixture of poor governance, poor planning, poor account-
ability, and failure to conduct research into the underlying determi-
nants of health.
Equally telling is the Personal View in which one Colombian re-
searcher explains why he became part of the "brain drain" (p 841)
<http://bmj.com/cgi/content/short/321/7264/841>\.
Finally, in Information in Practice, Tessa Tan-Torres Edejer dis-
cusses ways to tackle the "digital divide," which she deems to be the
most dramatic of the North-South inequities (p 797)
<http://bmj.com/cgi/content/short/321/7264/797>\.
--
Dieter Neuvians MD
mailto:neuvians@harare.iafrica.com
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