Bamako 2008

02 Feb 2009

The unresolved challenge

Posted by: Paul Chinnock - Editorial Team

A notable aspect of the Bamako Ministerial Forum was that, while it attracted a lot of comment before it took place (and also during the event itself) internet searches suggest that very little has been said about it since. It is, however, important to keep the momentum going and to ensure that the Call to Action is not ignored.

Writing a few days after the end of the meeting, Martin McKee - Professor of European Public Health, London School of Hygiene and Tropical Medicine - asked ‘What happens next?’. In an Read the rest of this entry »

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02 Feb 2009

A modest proposal: should six become one?

Posted by: Paul Chinnock - Editorial Team

The Bamako Ministerial Forum called for funders and development agencies “to better align, coordinate, and harmonize the global health research architecture and its governance through the rationalization of existing organizations, to improve coherence and impact, and to increase efficiencies and equity”. What might this rationalization actually involve?

An article in the Lancet has proposed that six research-related organizations are merged. (The article was summarized on TropIKA.net).

Is this a reasonable suggestion or would it be taking rationalization too far? Would there be opposition from the bodies that the writers of the article want to see merged? Would such a big new organization be too powerful or be bogged down by its own bureaucracy?

The proposal certainly needs to be discussed and nothing should be done until there has been a proper debate. TropIKA.net offers an excellent forum for such debate. Let us know what you think.

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02 Dec 2008

Developing countries should have a greater say in local research agendas

Posted by: Paul Chinnock - Editorial Team

Comment on the Bamako meeting continues to come in. Robert Walgate, writing in the BMJ, says that ‘Developing countries should have a greater say in local research agendas’.

The article includes positive comment from participants in the meeting. However, Robert Walgate notes that there was disappointment that the important issue of intellectual property was barely mentioned.

The article is not open access but those with a subscription to the BMJ may see it here.

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02 Dec 2008

‘Concern and commitment and creativity’

Posted by: Paul Chinnock - Editorial Team

A Lancet editorial (1) has commented on the Bamako meeting and the Call for Action. The journal was a partner in the meeting and has now published a number of articles refering to it.

The editorial takes a very positive view of the meeting saying that delegates dealt with the issues with concern, comiitment and creativity. It takes the view that substantial advances have been made on the previous meeting in Mexico and concludes that Bamako was, ‘an example of what can be achieved through patient and persistent engagement. 2009 must be the year when the promises of Bamako are acted upon.’

1. Editorial. The Bamako call to action: research for health. The Lancet, Volume 372, Issue 9653, Page 1855, 29 November 2008. doi:10.1016/S0140-6736(08)61789-4

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01 Dec 2008

BMJ Editor’s view on Bamako

Posted by: Paul Chinnock - Editorial Team

The BMJ blog is often worth a look. The journal’s Editor-in-Chief, Fiona Godlee, has used it to give a personal view of the Bamako meeting, which she attended. It may be accessed here.

Fiona Godlee seems sceptical about aspects of the meeting. She describes the Call to Action as being ‘better than some had feared’. However, her own fear is that at the next meeting, in four years time, delagates will be having the same conversations.

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27 Nov 2008

‘A victory for equity over efficiency’

Posted by: Paul Chinnock - Editorial Team

A contribution to the blog of The Global Economic Governance Programme (based at the University of Oxford, UK) discuses the Bamako meeting, speaking of its outcome as ‘a victory for equity over efficiency’. The blogger, Rajaie Batniji, also comments on the surprising absence of the Gates Foundation.

Read the blog here.

Please draw our attention to other comments on the meeting which come to your attention, so that we may link to them from TropIKA.net.

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24 Nov 2008

Bamako wrap-up

Posted by: Greer van Zyl - Editorial Team

Andrew Kennedy (COHRED), Stephen Matlin (Global Forum for Health Research) and Carel Ijsselmuiden (COHRED)
Andrew Kennedy (COHRED), Stephen Matlin (Global Forum for Health Research) and Carel Ijsselmuiden (COHRED)

Lindiwe Makhubalo and Pakiso Netshidzivhani from South Africa
Lindiwe Makhubalo and Pakiso Netshidzivhani from South Africa

Representing the South East Asian region were Pornpit Silkavute of the Health systems research Institute in Thailand, and Vibha Varshney of the Centre for Science and Environment in India
Representing the South East Asian region were Pornpit Silkavute of the Health systems research Institute in Thailand, and Vibha Varshney of the Centre for Science and Environment in India

L-R: Gill Samuels, chair of the Global Forum for Health Research, Sue Kinn of the UK Department for International Development, and Robert Ridley, director of TDR
L-R: Gill Samuels, chair of the Global Forum for Health Research, Sue Kinn of the UK Department for International Development, and Robert Ridley,director of TDR.

Delegates give their views of the Global Ministerial Forum on Health Research as the meeting winds up in Bamako today:

“I found some of the cut and thrust of the questions helped me focus on what was missing which is about translating research into policy and delivery of healthcare. Lots of fine words have come out. But, as a wild thought, how would it be if each of the 42 ministers were to tell the conference what they intended to do in the next year in terms of applying research to service delivery and filling the gaps where the needs are? That to me would give the conference real bite.” Chris Bateman, News Editor – South African Medical Journal, South Africa

“We had a session on non-communicable diseases on the first day, and the conference was successful in that there were ministers of both health, and science and technology coming together to have ownership of a common cause. This is a unique feature of this meeting. One hopes this type of inter-ministerial dialogue will be widened.” Dr Shanti Mendis, WHO (Geneva)

“What was powerful was that the meeting seemed to pick up on gaps of previous declarations and calls to action and tried to identify where there had been no movement, and try to correct that. I thought that was important because we have been talking about these things for a number of years now, it’s really time to look at where the blockages are and try to move them. Some of the discussions did pick up on those issues, like the greater involvement of communities, civil society and certain aspects of industry.” Dr Lindiwe Makubalo, Ministry of Health, South Africa

“The conference was a special event, but there was too much separation between the ministers and the delegates. I think politicians should be accountable to people. The process of a declaration should be interactive. For the future, the challenge is how to get ministers to listen to audiences that becomes an iterative process in a meeting like this. Otherwise, I think the meeting was great for networking and motivating and infusing energy in the world of research and development.” Carel Ijsselmuiden, Director, COHRED (Geneva)

“The conference was a great success, achieving most of the objectives it set out to do, by looking at the critical areas of health research and trying to organize health research in such a way to benefit society. The meeting has come up with a communiqué which addresses the importance of involving civil society and co-ordinating and prioritizing health research issues and dissemination of information – so, the full participation of civil society. The other highlight is the issue of funding for health research and the importance of allowing countries to set their own priorities, with health research funders coming in to complement rather than to impose.” Edwin Muguti, Ministry of Health, Zimbabwe

“The atmosphere has been great, better than in previous conferences. It’s unfortunate that the ministerial process has been devolved from the body of the conference because some of the sessions which went on would have benefited from the ministerial input, and have the ministers hear the input from the delegates.” Andrew Kennedy, COHRED (Geneva)

“I’m pleased that this conference managed to deal with all the issues on the programme in the time allotted. I am very impressed and surprised at the research taking place in Mali. They have done so much, also with the help of a country like the USA and organizations. There were many panels covering the good results of their research. I’m happy that many African countries were able to participate fully at this meeting, unlike in Mexico where we couldn’t speak because it was in Portuguese and Spanish. Here there were lots of French-speaking countries participating; it was very good!” Dr Moussa Yarou, Ministry of Health, Benin

Some off-the-record comments were also offered by participants:

“The representation appears to be broad and seems to include people from almost all parts of the world. This is a good thing. I only wish that the other Presidents (apart from the Malian President) were also available at this conference. I would have wished that the people gathered here included key decision-makers of health policy in their respective countries.”

“The aspect of the conference that I am concerned about is the ownership of research. I wish those donating for health research would allow the recipient countries to have more power in the decision-making.”

“I have always been concerned about who owns the knowledge that is generated, if there is anything like knowledge ownership. What I mean is that even though we are always meeting to discuss issues like setting the health agenda by developing countries themselves, even these meetings are to a large extent being funded by donors.”

“There have been many declarations from meetings from the last decade or so. It would be interesting to know what proportion of those declarations have been adopted or implemented.”

“Could there have been more representation from the groups we (researchers + communicators about health research) claim to represent? It would have been good to know the views of such groups as well.”

“I think it is a good idea that so many people of diverse backgrounds are gathered in one place to share ideas about how to improve health through research. This in itself is a good start, apart from the fact that the forum offers incredible opportunities for people to network. Even interactions at such informal levels have tremendous capacity – in my opinion – to bring about change in the way people do things in their own countries.”

Some comments were also offered about TropIKA.net:

« Avant ce forum je ne connaissais pas TropIKA. Quand j’ai vu le badge TropIKA porté par des collègues du Mali, ma curiosité a été piquée. Du coup je suis allé leur poser des questions. Ils m’ont donne amples informations et ensuite je suis allé visiter le stand, et puis le site de TropIKA. J’avoue que c’est une bonne chose cette initiative, d’autant plus que lors des meetings on n’a pas la possibilité d’être présent partout à la fois. Mais si, en fin de journée, tu as déjà accès à un résumé complet des sessions, c’est très bien. Je pense que c’est à encourager beaucoup. » Dr Maiga (immunologiste, SEREFO, Bamako, Mali)

“I knew TropIKA.net a while ago. It’s very important for meeting participants but also for people who for some reason were not able to attend. I like their daily report and I can tell that the reports are accurate since I have got to read report on session I attended. Big thanks to the TropIKA. net team. Keep the good job. Thanks.” Dr Francis (Kenya)

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19 Nov 2008

Celebrating the history, cultural diversity, and spirit of Mali

Posted by: Mzamose Gondwe - Editorial Team

During the conference I have heard murmurings of displeasure with the organization, complaints of incompetence, poor administration, and resignations that the above is to be expected in Africa. In the face of all this adversity, Mali should be applauded for its capacity to host such a large, important, international conference. As an African myself, I know what we lack in both technical and human capacity, we make up for in our ability to thrive in adversity. The road to success is turbulent but our determination to reach our final destination is strong and unyielding.

I think all the conference delegates can agree with me when I say the reception in Mali has been very warm and welcoming. We have been treated as royalty, from the VIP welcome on arrival at the airport to police escorts when we move around the various conference venues. The demeanor of the people is extremely open and friendly. My pathetic attempts to speak French has certainly kept our hosts and hostesses, conference organizers, taxi drivers, catering staff and security personnel amused. These courageous efforts of mine, I am sure are a great disappointment to my high school French teacher. But given the difficulties with language, we still manage to get around but maybe I owe this to the French speakers in the TropIKA team.

My family and friends have been calling and emailing me, asking me what is Mali like? I still have not comfortably come up with an accurate description of Mali, Mali is all things at once, a melting point of old traditions and modern technology. There is a strong Muslim element to Mali that can be seen in the mosques that dot the city, the attire of people in the streets, and least I not forget the early morning call prayers that remind me, I only have a few more hours sleep. I work in veil of air conditioned comfort and only experience the soaring temperatures when I make a quick dash to a meeting room. The heat and aridity does not support much in terms of vegetation but the wide highways are lined with palm trees giving Bamako a tropical ambience. The landscape is mainly flat which is dissected by the extensive Niger River and low lying hills can be seen in the background. When crossing the street, one has to be careful to check the left side of the road and keep a look out for the motorbikes wheezing around at great speed. It appears there are more motorbikes on the road than cars and they daringly move in between the traffic at break necking speed.

Bamako is a bright city not only because of the blaring sun but the beautifully colored attire that people wear. The female dress is majestic while the men’s is stately and imposing. The anniversary dinner at the National Museum last night, was a lavish display of culinary treats from across Mali. It was a wild adventure for my taste buds and a fascinating gastronomic experience far removed from the Western cuisine being served during the conference lunch.  We have been treated to various musical displays during the opening ceremony and the anniversary dinner. Malian music is performed with both traditional and modern instruments. It is pleasing to the ear, rhythmic, melodic and hypnotic

All of this I have only been able to view from the window of my hotel room, taxis and buses, and experience within the confines of the conference centre. I look forward to my day off on Thursday when I will be able to trade my skirt and jacket for shorts and sneakers, grab my English-French book and explore the streets of Bamako. The guide book highlights the botanical gardens, prehistoric grottos with cave paintings, traditional “Pinasse” boat excursions, and Ali Baba style markets. Tomorrow, I will thoroughly immerse myself in the spirit of Mali, sample the food, dance to the music, fashion myself in local attire, and engage with the people.

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17 Nov 2008

The road to Bamako and beyond

Posted by: Greer van Zyl - Editorial Team

Ania Grobicki

A unique meeting is taking place in Africa today. The Global Ministerial Forum on Research for Health, hosted by the Republic of Mali, is being held in Bamako, and is the first of its kind to be held in Africa. It is the first time, too, that a unique assembly of partners has come together with a common vision to promote the importance of research for health. The World Bank, World Health Organisation, and the United Nations Education Scientific and Cultural Organisation are joining together with two civil society non-governmental organizations – the Council on Health Research for Development (COHRED) and the Global Forum for Health Research – in what the conference organizers hope will be the birth of a multi-stakeholder governance mechanism.
“One of the achievements for Bamako 2008 is to get the partner organizations working together to try to develop a multi-stakeholder governance mechanism for research for health, because no one organization can do it alone This is being discussed as a platform to take Bamako beyond 2008. It has to be inter-sectoral, involving lots of stakeholders including civil society,” says head of the conference secretariat, Ania Grobicki.
“It would not necessarily a new organization because in this day and age, we’ve got virtual networks and they’re the way to go - but they need to work. There is now a real opportunity for these organisations to work together, through networking and inter-sectoral action,” she said.
“Research for health is broad, across the spectrum, so there’s lots of networking needed. Technology is now available to do this, to help improve implementation of research results and policies to improve people’s lives on the ground. We need research to provide long-term vision for the way in which things can be done.  It allows us to prioritize and structure how future health can be safeguarded. People are beginning to appreciate the long-term vision is more important; short-term action can be valuable but can cause a lot of waste, duplication and unintended consequences such as the weakening of health systems because of vertical programmes. A long-term vision can forestall that.”
She said it had been a long road since Mexico in 2004 when the first ministerial summit was held. That conference provided the push for WHO to develop a strategy on research for health which is going to be discussed here at Bamako and which will go to the World Health Assembly next year. Health systems research has been strengthened, and a number of preparatory meetings have been held in regions building up to Bamako.
“I really hope that people will see that the process has generated a momentum that would not otherwise have been there. By 2012 perhaps once the multi-stakeholder governance mechanism is working, it will be possible for the international community to use that mechanism to start to look at some of the urgent crisis issues such as environmental health, climate change,” said Ms Grobicki. The conference will focus on the process and the systems that are needed.

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17 Nov 2008

Civil society vision for Bamako 2008

Posted by: Greer van Zyl - Editorial Team

Michael Devlin, COHRED
Michael Devlin, COHRED

Susan Jupp (Global Forum for Health Research) and Jamie Guth (WHO)
Susan Jupp (Global Forum for Health Research) and
Jamie Guth (WHO)

Civil society needs to be involved in the research process in a practical way, urging governments and decision-makers to apply the results of evidence-based research for the benefit of health.
This call has been made by the Council on Health Research for Development (COHRED) and the Global Forum for Health Research, two non-governmental organizations who jointly organized the Global Ministerial Forum on Research for Health along with WHO, UNESCO, the World Bank and the Republic of Mali.
COHRED’s Michael Devlin said he hoped the final declaration of the conference would strongly recognise the value civil society organisations could add to research efforts of big funders, organisations and governments.
“Everyone wants to know what impact they’re having. Well, the NGOs have put a declaration on the table to say that we can add value to what’s being done in these areas. Our view is that the big players need to think about focusing their work on country priorities and be better organized to play a role in improving health research. There should be a clear statement on harmonisation – it shouldn’t be lip service.”
He stressed that there should also be a strong emphasis on the alignment of health research on country priorities and how that should be done. Big vertical programmes should require themselves to build capacity to have a huge lasting effect on the millions being poured into countries. “It’s about leaving a legacy behind,” he said.
Echoing the sentiments of moving beyond lip service, Susan Jupp of the Global Forum on Health Research hopes that instead of a meeting of which there is lots of discussion, some of the lessons can be taken forward.
“We can understand what some of the questions are and put some pressure on governments based on the evidence which will be demonstrated here to apply some of the very good lessons of the work going on in Mali and take them out to other countries,” she said.
Mali has a government policy that makes equitable access to health care a national ambition, supported by a strong grassroots demand for quality care, close to homes. The World Health Report 2008 singles out Mali’s progress towards universal coverage as an example of what can be achieved when policy engages community participation, and uses health as an entry-point for broader community development. Health policy in Mali has been strongly guided by evidence generated during numerous internal and external evaluations, plot studies and research projects.

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