Health research for development: making health research work ... for everyone.

The Commission on Health Research for Development tabled its findings in 1990 following three years of intensive data gathering on global health research [1]. The report documented for the first time the major mismatch between global expenditure on health research and the nature and extent of global mortality: only 5% of the world’s health research budget was spent on conditions responsible for 93% of global mortality. This discrepancy was later restated as the ‘‘10/90 Gap’’ – a more ‘‘communication-friendly’’ term that became the slogan for global disparities in health research funding [2]. The work of the Commission was built on the belief that health research can play a key role in the overall development of resource-poor countries, both through focusing national research efforts on national health priorities rather than on sponsordriven interests, and through the identification and documentation of health inequities and consequent action taken to reduce or eliminate these. Essential National Health Research (ENHR) was promoted as the strategy through which to operationalize ‘‘health research for development’’ (HRfD) [1]. Several modifications have been made to this early conceptualization of HRfD in response to a rapidly changing global environment, and as a consequence of experience gained since 1990. A major expansion in understanding how to optimize the impact of health research in the South was generated in the process leading up to the International Conference on Health Research for Development in Bangkok in 2000. At this landmark meeting, which focused on review of progress with HRfD over a decade, the concept of ‘‘national health research systems’’ [3] was widely discussed and endorsed.