Global Forum for Health Research forum 9

The following are extracts from "World needs fresh research priorities and new policies to tackle changing patterns of chronic disease" (BMJ 2005; 331: 596) in the 17 September 2005 issue of BMJ about the Global Forum for Health Research forum 9 conference. Much of the conference focused on the need for research relevant to chronic disease in developing countries.

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New Delhi Ganapati Mudur
The priorities of health research and government policies will need to change so that changing patterns of disease in poor countries can be tackled, said delegates at a meeting in Mumbai this week. In a plenary session on worldwide disease challenges at the global forum for health research meeting, health policy analysts said that studies predict a convergence of disease burdens around the world and dispelled the notion that the health needs of people in developing countries differ from those of people in rich countries. Chronic illnesses such as cardiovascular diseases, cancer, and diabetes are now important contributors to the burden of disease in developing countries, except in some parts of sub-Saharan Africa, where infectious diseases continue to dominate, speakers said. "China and India are fast advancing into the cardiovascular risk zone," said Kolli Srinath Reddy, head of cardiology at the All India Institute of Medical Sciences, New Delhi. Cardiovascular causes now account for 40% of all deaths in China and 30% of deaths in India.

"The convergence of health problems needs to be recognised for future priority setting," said Catherine Michaud, from the Harvard School of Public Health. Although new infections such as severe acute respiratory syndrome and avian influenza pose threats to all nations, and reproductive and child health persists as a major unfinished task in some countries, greater emphasis on research to reduce the burden of chronic diseases is also needed, she said. Dr Michaud said the focus of research should shift to health problems shared by rich countries and developing countries. Such a movement is "not strong enough yet, because the changing disease patterns have not been widely acknowledged," she said.

Health policy researchers also said that making health care available to large populations will demand extra funding as well as strengthening of local capacities...."As epidemics of non-communicable diseases advance in developing countries, the poor among countries and within countries will emerge as the most vulnerable victims," Dr Reddy said. Studies from India, Brazil, and China indicate that low income and low educational level are associated with a higher risk of cardiovascular diseases, high blood pressure, greater use of tobacco, and a higher proportion of undetected disease and inadequate access to health care, he said. Tobacco consumption has been shown to be inversely related to educational level among men in north India and among women in China. One Indian survey showed that 22% of people with a postgraduate qualification, 40% of people with a first degree, and 60% of school dropouts consumed tobacco. Studies in Brazil and Tanzania have shown an inverse relationship between economic status and body mass index: the higher the income, the lower the body mass index. Socioeconomically disadvantaged groups also fare worse in access to clinical care. A survey of patients with hypertension in India showed that 45% of patients in one urban centre but only 9% of people in rural areas had been offered treatment. "Governments will need to recognise the power of policy to influence human behaviour," Dr Reddy said. He argued for special policy interventions, such as taxes and price regulations, to change people s patterns of consumption. Finland, Poland, and Mauritius provide examples of how policies can make a difference in consumption and minimise risk factors for cardiovascular disease, he said.

Innovative developing countries inject hope for future of health research
Press release: Mumbai, 16 September 2005 - Innovative Developing Countries

(IDCs) with growing resources and networks hold dramatic promise for solving their own health problems, participants at Forum 9 were told today in final plenary session. In opening the session, Charles Gardner, Associate Director, Health Equity at the Rockefeller Foundation, cited the fact that 67% of India s drugs are exported to other developing countries while 63% of Uganda s come from others. These South-South networks are critical. Top health research leaders from Brazil, India and South Africa painted a bright picture today of their joint innovative capability to develop and produce new drugs, vaccines and technologies. The three are known as Innovative Developing Countries (IDCs) and have a trilateral agreement to work closely together....What are needed are a "well developed and sustainable national infrastructure and human resources combined with powerful international collaborations that provide not only finance but also technical support and training....[According to Professor Anthony MBewu, President of the Medical Research Council of South Africa, "Such programmes should engender mutual partnerships based on an equal footing, in ground-breaking novel enterprises, focused on problems of both local and global significance. These partnerships should be both South-South as well as North-South, such as the emerging IBSA partnership of India, Brazil and South Africa."

Date Posted: 17 September 2005