Expenditures on health research in sub-Saharan African countries: results of a questionnaire-based survey.

OBJECTIVE To estimate the sources of funds for health research (revenue) and the uses of these funds (expenditure). DESIGN A structured questionnaire was used to solicit financial information from health research institutions. SETTING Forty-two sub-Saharan African countries. PARTICIPANTS Key informants in 847 health research institutions in the 42 sub-Saharan African countries. MAIN OUTCOME MEASURES Expenditure on health research by institutions, funders and subject areas. RESULTS An estimated total of US$ 302 million was spent on health research by institutions that responded to the survey in the World Health Organization (WHO) African Region for the biennium 2005-2006. The most notable funders for health research activities were external funding, ministries of health, other government ministries, own funds and non-profit institutions. Most types of health research performers spent significant portions of their resources on in-house research, with medical schools spending 82% and government agencies 62%. Hospitals spent 38% of their resources on management, and other institutions (universities, firms, etc.) spent 87% of their resources on capital investment. Research on human immunodeficiency virus/tuberculosis and malaria accounted for 30% of funds, followed by research on other communicable diseases and maternal, perinatal and nutritional conditions (23%). CONCLUSIONS Research on major health problems of the Region, such as communicable diseases, accounts for most of the research expenditures. However, the total expenditure is very low compared with other WHO regions.