NorthSouth research collaboration: perspectives from the Canadian Coalition for Global Health Resear

1
North-South research collaboration perspectives
from the Canadian Coalition for Global Health
Research

• Jacques Girard, Universite Laval
• Vic Neufeld, McMaster University

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Presentation Objectives

• To introduce the Canadian Coalition for Global
  Health Research (CCGHR)
• To provide an update on the work of the CCGHR
  Task Group on Partnership Development
• To offer some reflections from LMIC colleagues
  from a CCGHR workshop linked to the Colloquium

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The Canadian Coalition for Global Health Research

• Introduction

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The Canadian story

• After Bangkok (2000)
• Following the Bangkok conference, it is time for
  all those in Canada concerned with equitable
  health care and health development .to renew our
  commitment to investing resources in
  equity-oriented health research. These resources
  include not only finance, but also--and perhaps
  more importantly, our collective energy and
  talent.
• CMAJ 20011641158-9

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The Canadian story (cont.)

• The emergence of two linked entities
• the Global Health Research Initiative (GHRI)
  
• the Canadian Coalition for Global Health
  Research (CCGHR)
• Note Our working definition of global health
  research (GHR) research on the health problems
  of societies in low and middle income countries
  (LMICs)

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The Canadian story (cont.)

• Federal agencies participating in GHRI
• International Development Research Centre
  (IDRC)
• Canadian Institutes for Health Research
  (CIHR)
• Health Canada (HC)
• Canadian International Development Agency
  (CIDA)
• Memorandum of Understanding (MOU) signed in
  October 2001

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The Canadian story (cont.)

• Goals of GHRI
• 1. Shaping and responding to the GHR agenda
  (including funding)
• 2. Influencing policy and policy coherence
• 3. Facilitating information sharing and
  coordination of effort resources among partner
  agencies

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The Canadian story (cont.)

• Canadian Coalition for Global Health Research
  (CCGHR)
• became a not-for-profit organization (2003)
• elected a board of directors (including 3
  appointed members from LMICs)
• established a secretariat
• recruited 400 members
• created 6 Task Groups

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The Canadian story (cont.)

• Mission of the CCGHR
• To promote better and more equitable health
  worldwide by
• mobilizing greater investment in GHR
• nurturing productive partnerships among
  Canadians and people from LMICs
• translating research into action

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The Canadian story (cont.)

• CCGHR Task Groups
• Mobilizing Support
• Research to Action (Knowledge Translation)
• Building South-Canada Partnerships
  (LMIC-Canada)
• Strengthening National Health Research
  Systems
• Capacity Building
• Global Health Policy Systems Research

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Achievements

• 1. Increased investment in global health
  research
• 2. Increased knowledge production and use
  through South-Canada partnerships
• 3. Stronger advocacy and increasing awareness
• 4. Enhanced capacity development
• 5. Improved coordination and communication

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Achievements (1) - investment

• Increase in funding by GHRI partners
• - from lt CAD 1 million (2001-02) to 8 million
  (2003-04) in jointly funded projects
• Increase health research funding at IDRC from
  3 million (1999-2000) to 12 million (2004-5)
• Other one off funds transferred e.g. 50
  million for HIV/AIDS vaccine development research
  (IAVI) from Canada fund for Africa
• CIDA multi-lateral contributions to TDR, HRP
  and other research initiatives

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Achievements (1) - investment (continued)

• In relation to the 1990 Commission
  recommendation that high income countries should
  contribute 5 of health ODA to health research
• From GFHR Resource Flows study (with data taken
  from OECD database)
• In 2001, Canadas contribution was 3.9 of
  health ODA
• Note Canadas ODA is about 0.3 of GNP

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Achievements (2)- Knowledge Production Use

• 71 South-Canada partnership projects
  supported (development pilot project stages)
• In addition, 6 multi-year N-S collaborative
  research projects funded as part of
  CIDA-supported Canadian International
  Immunization Initiative Total 5 million
• Next round (later in 2005) will involve larger
  3-year partnership proposals

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Achievements (2)- Knowledge Production Use
(cont.)

• Partnership building workshop (Toronto, 2003)
  involving 71 researchers
• Canadians and their research partners from
  Australia, China, Colombia, Cuba, Ecuador, India,
  Jordan, Mali, Mexico, Nigeria, Pakistan, South
  Africa, Tanzania, Uganda, and Zimbabwe.
• Focus strategies for effective South-North
  health research partnerships

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Task Group (TG) on LMIC-Canada Partnership
Building An update

• TG work plan
• Analytic framework for GHR
• Progress on results

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TG work plan list of the TG nucleus group

• From LMIC (7) Bangladesh (BRAC/SPH), The
  Philippines (IHPDS/UP Manila), Bénin (FSS/UNB),
  Jordan (UJ), Guatemala (UG), Mexico (INSP)
• From Canadian Universities (8) Calgary,
  Dalhousie (NS), Laval, McGill, Toronto, SMU
  (Vancouver)
• CPHA CSIH (2)

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TG work plan calendar since october 2004

• CCGHR proposal submitted (October 2004) and
  funded (december 2004) by IDRC for supporting the
  TG
• Recruitment of research assistants
  (february-April 2005)
• Canadian nucleus group meeting in Quebec city
  (2-3 April 2005)
• International nucleus group meeting in Ottawa
  (3-4 June 2005)

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TG work plan outcomes expected in 2005

• A revised working paper with an updated
  bibliography
• A  funding road map  document
• An exploratory dialogue and workshop with
  organizations to foresee joint initiatives
• An expert group team as an on-going resource to
  LMIC-Canada research groups
• A web-based resource on effective LMIC-Canada
  research partnerships

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TG work plan the client perspective

• Researchers as clients tools need to be
  developed within the context of a  broker  type
  of arrangement
• Advocacy on funding agencies we should move
  ahead for influencing the agenda
• Enlarged focus add to the TG a real
  representation from LMIC and put the NGO
  perspectives on the front line

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TG work plan basic orientations in global issues

• Link GHR to Health Policy with  change  as a
  target (ex INDEPTH, TEHIP, etc) potential for
   Observatoires 
• Cross-cutting factors and issues to consider
  within research rights, equity and social
  determinants
• Focus more on participatory research in order to
  involve key actors

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TG work plan some tasks ahead in our lens

• Consensus for a needs assessment survey, a  Tool
  Manual  and a  Funding Road Map 
• Quality of partnerships as a major GHR component
• Output oriented process
• Long term involvement of NGOs as key actors for
  our  niche 
• Champions from LMIC as opportunities to tackle

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TG work plan research project features to foresee

• Capacity component as a contract
• Focus on sustainability in front of
  evidence-based trends as major landmarks
• Objective criteria to forecast a potential and
  effective partnership in GHR

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TG work plan A needs assessment survey

• Start with the funded researchers through GHRI on
  both sides (Canada-LMIC)
• Questionnaires to reflect
• Elements of partnership quality
• Lessons learnt and overcome strategies through
   stories to tell 
• Needs for Web-based resources
• Confidentiality as a requisite

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Analytic framework for GHR A proposal
Ethical position

• APPROACH ON RIGHTS
• Integral observation (between sectors and
  disciplines) and prioritization for action
• Link between research and action agenda
• Evaluation standards
• Advocacy
• EQUITY SOCIAL JUSTICE
• SUSTAINABLE SOCIAL DEVELOPMENT
• Building opportunities (poverty eradication)
• Capacity improvement (exclusion/vulnerable
  groups))
• Intergeneration transfer (vicious circle for
  inequalities inequities

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Analytic framework for GHR how to define the
partnership

• A set of explicit strategies and relationships
  between key actors and organizations/institutions
• Shared responsability as a basic principle for
  ackowledging diversity and inequality of the
  conditions on site
• Systemic perspective for enforcing health
  governance and research
• Synergistic initiatives for autonomy,
  relationship promotion on equal basis and
  capacity improvement for implementing research
  with a focus on health system and social
  determinants.

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Analytic framework for GHR the capacity building
issue

• SYSTEMIC APPROACH distinctive components linked
  to each other on a hierarchic scale
• Structure, system roles
• Human and material resources
• Technical capacity and professional training
• Tool box (methods technics)

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Analytic framework for GHR A tentative
partnership scale
Adapted from Mario Rovere, 1999
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Analytic framework for GHR A capacity monitoring
view

• Result based capacity Building partnership on
  obvious results as assets could mean to question
  actions to be undertaken in the future and
  endeavors to sustain the process.
• Operational capacity Building patnership implies
  that practices and appropriate processes to
  nourish them are implemented in order to
  generate some results in the short, medium and
  long range
• Strategic capacity Building partnerships through
  mechanisms and committment on result based
  management needs to be supported by a strategic
  scope

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Progress on results

• ELECTRONIC INSTRUMENTS
• COMPUTER INTERACTION TOOLS
• WEB INTERACTIVE CONNECTIONS
• TEMPLATES FOR SCIENTIFICS ARTICLES
• SURVEY PROCESS
• QUESTIONNAIRES FOR NEEDS ASSESSMENT
• BIBLIOGRAPHY INDEX
• PARTNERSHIP LITTERATURE

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Reflections from LMIC colleagues

• Overview of concerns linked to the Colloquium

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LMIC colleagues viewpoint what they need to cope
with?

• Lack of funds for conducting research with poor
  government committment
• Lack of dissemination of some key research
  findings
• Lack of a  research culture  in LMIC
• Social development issues a never ending battle
  between politics and scientific evidence

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LMIC colleagues viewpoint what they are telling
us?

• Move from alliances to real partnerships more
  than a time span difference?
• Make interests more explicit, since research is
  not value free, for a better understanding
• Address the  budget shrinking  syndrome from
  the onset for more trust
• Rely on LMIC expertise for transformation
  processes from evidence to policy and action
  through informal network channels

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LMIC colleagues viewpoint Where they would like
to be?

• Within the research agenda in order to reduce
   western type development  in favor of a more
  south to south model
• Within the research process throughout its
  different steps since they are offering more than
  just a field or even a site
• Within the evaluation strategies, because their
  perceptions for leading social change could
  represent the added value we are looking for

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LMIC colleagues viewpoint How they wish to be
involved

• A committment to complement the expertise
  provided by OECD countries depending on the
  capacity level on site
• A participation to joint goals dealing with
  capacity building and  benchmarcks  indicators
• A recognition for their natural allies, namely
  NGO and CBO
• A work endeavor with more mentorship guidance and
  less brain drain

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LMIC colleagues viewpoint Are there issues to
share?

• View research as a transformation process beyond
  knowledge transfer
• Avoid  accidental partnerships  in order to
  build sustainable ones
• Use leverage for funding as basic tools on both
  sides
• Develop management skills, especially for
  research organizations with low critical mass
• Invest in instruments for helping to
   diagnose  research capacity level

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LMIC colleagues viewpoint Could we do better?

• By decentralizing research initiatives out of the
  capital city for more flexibility and
  sustainability ?
• By going beyond traditional academic patterns for
  influence strategies ?
• By a finetuning for Knowledge Transfer to
  different settings ?
• By avoiding ethical gaps when choosing the
  partners to work with the ones likely to benefit
  the most or the strongest ones ?

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LMIC colleagues viewpoint Are there some basic
clues ?

• Rely on a suitable mapping exercise according to
  specific situations before getting into a
  research initiative
• Emphasize the interdisciplinary and the team
  approach within partnerships
• Consider a set of core values when dealing with
  global issues
• Make  empowerment  a must in terms of basic
  orientations

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LMIC colleagues viewpoint What about conflict
zones?

• Need to work with the  oppressor  as well as
  with the  oppressed 
• Research as a bridge for peace on a neutral
  ground
• University-NGO ties even more important as a
  challenge
• Tangible actions and connections in the context
  of a  surge  capacity

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Global Health Research Challenge

• How we could learn together!
• Merci
• Gracias
• Thank you