EQUITY IN RESEARCH GOVERNANCE Global HIV/AIDS Initiative Network (GHIN) a network of southern and northern researchers tracking the effects of new global funds for HIV/AIDS on recipient country systems

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EQUITY IN RESEARCH GOVERNANCEGlobal HIV/AIDS
Initiative Network (GHIN)a network of southern
and northern researchers tracking the effects of
new global funds for HIV/AIDS on recipient
country systems

• Ruairí Brugha
• Global Forum for Health Research
• Beijing 1st November 20068

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GHIN coordinators and co-authors

• Dublin (Royal College of Surgeons in Ireland)
• Ruairí Brugha
• Aisling Walsh
• Regien Biesma
• Plus researchers across the 22

• London (London School of Hygiene and Tropical
  Medicine)
• Gill Walt
• Neil Spicer
• GHIN research teams

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Who is in the network?

• 18 southern research groups in 15 countries
• supported by 6 northern research partners
• with funding from 7 donors

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Research Funders Country Studies Research Partners Network (GHIN) Funders
OSI Kyrgyzistan Ukraine Zambia LSHTM (UK)
INCODEV-CO Mozambique Angola South Africa x 2 RCSI (Ireland) Belgium Portugal
Vietnam Tanzania Sweden
Alliance for Health Policy and Systems Research Tanzania Uganda Peru China Georgia Malawi Ethiopia Benin Malawi
Irish Aid DANIDA
Sida?
SWEF Health 20/20
USAID
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Focus and Research Themes

• Three Global HIV/AIDS Funding Initiatives
• Global Fund to Fight AIDS, TB Malaria (GFATM)
• PEPFAR (US Presidents Initiative)
• World Bank AIDS Programs (including MAP)
• Common themes across studies
• Effects on health systems esp human resources
• Equity are poor and marginalized benefiting?
• Harmonization and alignment of donors and govts
• Non-state sector providers involvement
• Effects on non-HIV/AIDS priority services

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Generic Study Timeline

• March 2006
• July-Dec 2006
• October 2006
• Nov 06 (ongoing)
• Jan 07 (ongoing)
• Feb 07 (ongoing)
• November 2007
• Dec 07 Apr 08
• Feb-Aug 2008
• November 2008
• December 2008

• Launch Workshop in London
• Country context mapping
• Regional workshops Malawi and Ukraine
• Research instrument design national data
  collection (1) analysis
• Sub-National (district) baseline studies (1)
• Data analysis and report preparation
• International Workshop 2 (Dublin)
• National data collection analysis (2)
• Sub-National (district) follow-up studies (2)
• International Workshop 3 (Geneva)
• Final country event final report

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Network Aims

• Share resources and expertise
• Share research methods, tools and lessons learned
  where needed build capacity to
  promote high quality outputs
• Maximise comparability
• Promote use of generic tools across country
  studies, mainly at a regional level (generalised
  concentrated epidemics)
• Maximise generalisability
• Facilitate analyses and syntheses across studies
  across
  countries, regions, epidemics and systems
  contexts
• Communication and Dissemination
• Stimulate debate, enhance knowledge around GHIs
  and promote policy uptake of findings at country
  and global level

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Network Principles

• Facilitate Participation
• In decision-making
• In events e.g. Beijing
• Ensure Fairness
• e.g. opportunities for publication
• Accountability
• North-South and South-North
• To study and Network donors
• To country stakeholders
• Transparency
• In what and how decisions are made
• In communications within the Network and with
  external / global stakeholders

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Governance examples of roles responsibilities

• Coordinators
• Communication
• Regular updates to members
• Create website
• Provide information on global evaluations, e.g.
  GFATM 5YE
• Share expertise / resources
• Develop and provide feedback on data collection
  tools
• Facilitate and resource north-south and
  south-south visits
• Participation
• Organise and fund participation in November 07
  Dublin workshop

• Country teams
• Provide country information
• Provide relevant material
• Inform coordinators about country level
  evaluations
• Share tools and lessons learned
• Participate in south-south capacity building
• Participate and present findings at workshop

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Lessons learned (1)

• Raising the funds
• Three yrs negotiations with funding agencies
• Initially northern led but also southern driven
• Built on existing north-north links (European
  US researchers), linked to respective donors
• Southern researcher initiated studies key
  role of Alliance for Health Policy and Systems
  Research (AHPSR)
• Network Coordination
• An intensive activity 3 full-time staff 2
  principle investigators
• Engaging with
• Country teams
• Global stakeholders donors (bilateral UN)
  plus GHIs x 3

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Research Funders Country Studies Research Partners Network (GHIN) Funders
OSI Kyrgyzistan Ukraine Zambia LSHTM (UK)
INCODEV-CO Mozambique Angola South Africa RCSI (Ireland) Belgium Portugal
Vietnam Tanzania Sweden
Alliance for Health Policy and Systems Research Tanzania Uganda Peru China Georgia Malawi Ethiopia Benin Malawi
Irish Aid DANIDA
Sida?
SWEF Health 20/20
USAID
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Lessons learned (2)

• Governance
• Most studies autonomous only 3 of 18 country
  studies funded through the GHIN Network
  Coordinators
• Once Network roles and responsibilities agreed,
  country researchers appear happy for coordinators
  to coordinate
• Does this imply lack of ownership? No take-up
  on early offer to have regional lead-coordinators
• Most country researchers occupied with several
  other studies and have limited capacity /
  interest to take on other roles
• Time-sequence of studies
• Health 20-20 (PHRPlus) Ethiopia, Benin, Malawi
• EU Angola, Mozambique, South Africa, Belgium,
  Portugal, Ireland
• Different time sequences
• May be a problem for cross-country syntheses
• But beneficial for cross-country lesson-learning
  and capacity-building

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(3) Comparability

• A regional approach
• Focused on Generalised (African) and Concentrated
  (FSU) HIV epidemics
• African and Former Soviet Union (FSU) team drove
  regional focus
• Workshops in Malawi and Ukraine in late 2006
• Production of generic tools and guidelines
• Dissemination of lessons between research groups
• from early starters to others
• Also from late-starters (e.g. EU studies,
  focusing on national level studies)
• Longitudinal studies enable lesson learning over
  time an objective of Dublin Nov 2007
  international workshop
• What about other countries Peru and China?

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(4) Capacity-building

• Tool development field work analysis
• Country visits
• Ireland to Zambia and Tanzania
• UK to Ukraine and Kyrgyzstan
• Georgia to Kyrgyzstan, Ukraine to Kyrgyzstan
• Cross-country field-worker training workshops
• How to do national level interviews
• Challenges in identifying support needs and areas
  for capacity strengthening
• Time the main resource constraint

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(5) Dissemination

• 2nd International Workshop, Dublin November 07
• Share and evaluate lessons learned from baseline
  district research
• First opportunity to build on comparability
  efforts and plan for cross-country syntheses
• First opportunity to disseminate to global
  stakeholders
• Plan for 2008 field work
• Other Global dissemination
• Website and GHI database
• Are some countries constrained in terms of lack
  of technological access (for dissemination, but
  also for desk research, lack of access to
  journals etc)?
• Country dissemination
• Responsibility of country researchers
  country-by-country approach
• Advocacy and Dissemination
• GHIN dissemination guidelines
• OSI teams have developed detailed dissemination
  strategies
• Role for specialised groups, e.g. HDNet to work
  with researchers

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(6) Coordination beyond GHIN

• with other similar studies on GHIs difficult!
• GFATM 5 Year Evaluation and CGD
• Role for UN Agencies and Donor Coordination
  (global stakeholder day in Dublin)
• DAC Evaluation Network
• UNAIDS / MERG
• Duplication with other country-level studies?
• In-country communication more difficult
• How to build added value
• Challenges of promoting communication amongst
  members good researchers are in high demand!

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How equitable is GHIN? Conclusions Questions

• North - South equity
• Roles of partners not clearly defined
• Provision of technical support and advice?
• Quality control? accountability to funder
  issues
• Trade-offs between capacity-building and
  interventionism for quality
• Agreed principles can foster trust sharing
  data, authorship
• Activities to build capacity and equity
• Workshop on how to get published (input planned
  for Dublin Nov 07)
• Dissemination opportunities funding for
  Beijing, Dublin, Geneva
• How to promote and incentivise stronger
  governance and leadership roles for Southern
  researchers?
• Need for Southern (GHIN member) perspective in
  evaluating GHIN
• Within-country equity
• Among researchers? Beneficaries and other
  country stakeholders?
• issues for in-country actors (not for
  researchers sitting in Dublin or London or
  Washington to dictate)
• Over to Carlos and Loretta . . . . .