Assessment of Assessment of recommendations of the 5 recommendations of the 5

past ACHR sessionspast ACHR sessions 26 26thth – 30 – 30thth

Dulitha N. Fernando.Dulitha N. Fernando.

ToR of the APWToR of the APW To develop tools to assess To develop tools to assess

• the quality of the ACHR the quality of the ACHR recommendationsrecommendations

• implementation of the recommendationsimplementation of the recommendations Conduct an assessment of the 5 past Conduct an assessment of the 5 past

ACHR recommendations using the ACHR recommendations using the aboveabove

Prepare a report based on the Prepare a report based on the findingsfindings

ToR of the ACHRToR of the ACHR Advice the Regional Director on :Advice the Regional Director on :

• Formulation and implementation of health Formulation and implementation of health research policies and health research (HR) research policies and health research (HR) agendaagenda

• Coordination and harmonization of HR Coordination and harmonization of HR activities of national bodies with those of WHOactivities of national bodies with those of WHO

• Development, management and improvement Development, management and improvement of HR information systemof HR information system

• Collection , analysis and dissemination pof Collection , analysis and dissemination pof existing HR findingsexisting HR findings

MethodMethod Review of available documentsReview of available documents Using the tools developed, assessment of the Using the tools developed, assessment of the

recommendationsrecommendations : : • numbers, technical areas, clarity, relevance to numbers, technical areas, clarity, relevance to

countries of the region, follow up required etc.countries of the region, follow up required etc.• obtain information from relevant technical units obtain information from relevant technical units • assessment at the country level ( not carried out due to assessment at the country level ( not carried out due to

issues related to feasibility)issues related to feasibility)

Summarize the observations re. the assessment of Summarize the observations re. the assessment of the recommendations the recommendations

Obtain views from ACHR members using a tool Obtain views from ACHR members using a tool developed for the purpose developed for the purpose

Prepare the reportPrepare the report

Findings - summaryFindings - summary Number of recommendations per Number of recommendations per

session – ranged from 8 -14.session – ranged from 8 -14. Total number of recommendations - Total number of recommendations -

5 sessions :555 sessions :55 Of them, Of them,

• 27( 49%) - on topics related to health 27( 49%) - on topics related to health research development research development

• Others - : on selected technical areasOthers - : on selected technical areas

Of the recommendations, Of the recommendations, • 35 : to be followed up at SEARO35 : to be followed up at SEARO• 15 : follow up at country level15 : follow up at country level• 05 : SEARO with HQ / countries05 : SEARO with HQ / countries

Recommendations related to Recommendations related to research developmentresearch development

General observationsGeneral observations• A wide range of focus areasA wide range of focus areas• Some degree of overlapSome degree of overlap• Some recommendations include several Some recommendations include several

follow up actionsfollow up actions• Some are stated in general terms, Some are stated in general terms,

making follow up less clear.making follow up less clear.

Recommendations related to health Recommendations related to health research - Broad areas research - Broad areas

Activities supporting national health systems Activities supporting national health systems ( updating profiles of national health ( updating profiles of national health research systems, identifying strengths and research systems, identifying strengths and weaknesses, knowledge dissemination etc.)weaknesses, knowledge dissemination etc.)

Strengthening country capacity for health Strengthening country capacity for health researchresearch

Strengthening research management Strengthening research management capacitiescapacities

Resources for researchResources for research Links with HQ research programmesLinks with HQ research programmes Research ethicsResearch ethics Collaborating centresCollaborating centres

Review of recommendations on Review of recommendations on research , focusing on : research , focusing on :

Relevance to countries of the regionRelevance to countries of the region• All recommendations are relevant to all countries, to All recommendations are relevant to all countries, to

varying extents.varying extents. Clarity and ease of interpretationClarity and ease of interpretation

• Varied with each recommendationVaried with each recommendation• Writing style varied between different reportsWriting style varied between different reports• Some are clearly stated ‘focused’ statements with Some are clearly stated ‘focused’ statements with

others stated in more general termsothers stated in more general terms Follow up requiredFollow up required

• Some require several follow up actions, spread over a Some require several follow up actions, spread over a period while others are “targeted “ period while others are “targeted “

• Most of them clearly indicate the follow up required , Most of them clearly indicate the follow up required , SEARO, Country or SEARO in collaboration with the SEARO, Country or SEARO in collaboration with the country or with HQ units. country or with HQ units.

Recommendations in technical Recommendations in technical areasareas

2626thth Session Session Human Genetics(5Human Genetics(5)) 2727thth Arsenic poisoning (2)Arsenic poisoning (2) Health Impact Assessment (2)Health Impact Assessment (2)

CVD (2)CVD (2) 2828thth TB (1)TB (1) Thalassaemia ( 5)Thalassaemia ( 5) 2929thth EID (5)EID (5) 3030thth Avian Influenza (1)Avian Influenza (1)

Vaccine development (1)Vaccine development (1)

2626thth ACHR -Recommendations on ACHR -Recommendations on human genetics ( 5)human genetics ( 5)

RelevanceRelevance – Contributes to a vast – Contributes to a vast area of research. Relevant to all area of research. Relevant to all countries, Resource availability varies.countries, Resource availability varies.

ClarityClarity : All 5 recommendations are : All 5 recommendations are clearly stated , no overlapclearly stated , no overlap

Follow upFollow up : with SEARO. Required F.U. : with SEARO. Required F.U. is feasible.is feasible.

2727thth ACHR ACHR Arsenic poisoning ( 2)Arsenic poisoning ( 2) RelevantRelevant to several countries of the to several countries of the

region. Cause debilitating disease, high region. Cause debilitating disease, high burden of disease, preventableburden of disease, preventable

Clarity and follow up :Clarity and follow up : Two Two recommendations to be implemented at recommendations to be implemented at the country level. Areas of research the country level. Areas of research grouped as : immediate, medium term and grouped as : immediate, medium term and long term.long term.

2727thth ACHR – continued.. ACHR – continued.. Health impact assessment (2) : Relevant Health impact assessment (2) : Relevant

to all countries of the region. Two to all countries of the region. Two recommendations – clearly stated, recommendations – clearly stated, identified SEARO to take f.u. actionidentified SEARO to take f.u. action

CVD (2) : relevant to all countries. Need CVD (2) : relevant to all countries. Need for research on prevention and for research on prevention and management. Clearly stated. WHO to work management. Clearly stated. WHO to work in partnership with relevant institutions to in partnership with relevant institutions to promote research promote research

2828thth ACHR ACHR Tuberculosis – one recommendation which Tuberculosis – one recommendation which

includes two components, one -which includes two components, one -which includes technical inputs and another , includes technical inputs and another , requiring financial inputs.requiring financial inputs.

Thalassaemia – 5 recommendations made. Thalassaemia – 5 recommendations made. Relevant to several countries of the Relevant to several countries of the region. 3 of the recommendations were to region. 3 of the recommendations were to be f.u. at SEARO, one of them to be linked be f.u. at SEARO, one of them to be linked with collaborating centres.with collaborating centres.

2929thth ACHR ACHR EID – 5 recommendations. Relevant to EID – 5 recommendations. Relevant to

all countries of the region. all countries of the region. Recommendations clearly stated . Recommendations clearly stated . Identifies several inputs to be carried Identifies several inputs to be carried out by the countries and /or by the out by the countries and /or by the WHO.WHO.

Two recommendations focus on Two recommendations focus on SEARO support for countries in public SEARO support for countries in public policy analysis, others for SEARO to policy analysis, others for SEARO to take follow up action.take follow up action.

3030thth ACHR ACHR One on Avian influenza and another on One on Avian influenza and another on

vaccine development.vaccine development. Relevant to all countries to varying Relevant to all countries to varying

extentsextents

Less clarity .Less clarity . Each recommendation has several Each recommendation has several

components which are inter related and components which are inter related and covers a wide scope.covers a wide scope.

Implementation of Implementation of recommendationsrecommendations

Sources of informationSources of information Report of the ACHR session that follows the session in Report of the ACHR session that follows the session in

which the recommendation is madewhich the recommendation is made

From relevant technical units at SEAROFrom relevant technical units at SEARO

From countries – ( not feasible during this review, even From countries – ( not feasible during this review, even though a tool was developed for the purpose) though a tool was developed for the purpose)

From 29From 29thth ACHR : an Agenda item titled “Follow up of ACHR : an Agenda item titled “Follow up of recommendations of the previous ACHR” was included.recommendations of the previous ACHR” was included.

Status of implementationStatus of implementation Total of 12 recommendations made Total of 12 recommendations made

at the at the 2626thth ACHR ACHR Report of the 27Report of the 27thth ACHR – 4 have ACHR – 4 have

been implemented.been implemented. Information from RPC and other Information from RPC and other

technical units - follow up action has technical units - follow up action has been taken in respect of all been taken in respect of all recommendations.recommendations.

Status of implementationStatus of implementation 2727thth ACHR ACHR Of the 12 recommendations, no information Of the 12 recommendations, no information

on follow up of 5 , including those on on follow up of 5 , including those on Arsenic poisoning.Arsenic poisoning.

Of the other 7, two recommendations on Of the other 7, two recommendations on CVDs have been implemented and on 5 CVDs have been implemented and on 5 others, the available information is others, the available information is inadequate to assess the status of inadequate to assess the status of implementation.implementation.

2828thth session session 14 recommendations made14 recommendations made Report presented at the 29Report presented at the 29thth ACHR session indicated ACHR session indicated

that only 2 recommendations were implemented.that only 2 recommendations were implemented. Additional information shows that, for three others , Additional information shows that, for three others ,

follow up action has commenced and are on going.follow up action has commenced and are on going. The recommendation on vaccine policy has been The recommendation on vaccine policy has been

followed up in 2009 with the establishment of sub followed up in 2009 with the establishment of sub committee of SEA-ACHR on vaccines and drug committee of SEA-ACHR on vaccines and drug development development

Available information on the recommendations on Available information on the recommendations on Thalassaemia and TB are not adequate to make an Thalassaemia and TB are not adequate to make an assessment of the status of implementation.assessment of the status of implementation.

2929thth ACHR ACHR 8 recommendations made.8 recommendations made. 5 of them were related to EIDs, 5 of them were related to EIDs,

detailed information on their detailed information on their implementation is available.implementation is available.

Information from RPC indicate the Information from RPC indicate the implementation of the other three implementation of the other three recommendations.recommendations.

3030thth ACHR ACHR 9 recommendations9 recommendations Follow up action taken in respect of 6. Follow up action taken in respect of 6.

Of them, follow up of 4 Of them, follow up of 4 recommendations are on going.recommendations are on going.

Two others focus on broad based Two others focus on broad based activities aimed at promoting health activities aimed at promoting health research in the region. There is no research in the region. There is no information to assess the information to assess the implementation of these implementation of these recommendations.recommendations.

3131stst ACHR – an overview ACHR – an overview A total of 12 recommendations were madeA total of 12 recommendations were made ( some of them , with several components)( some of them , with several components)

Follow up meetings held: at the 1Follow up meetings held: at the 1stst follow up follow up meeting 8 recommendations were meeting 8 recommendations were identified for early action.identified for early action.

Recommendations revised and included in Recommendations revised and included in the report of the 31the report of the 31stst ACHR ( published) ACHR ( published)

22ndnd F.U. Meeting held - Presentations on F.U. Meeting held - Presentations on Regional strategy and guidelines for Regional strategy and guidelines for developing a national health research developing a national health research strategy were presented.strategy were presented.

Sub committee on drugs and vaccine Sub committee on drugs and vaccine development establisheddevelopment established

Regional consultation on ‘strategy for Regional consultation on ‘strategy for health’ held in July 2011. Final draft ready.health’ held in July 2011. Final draft ready.

Review of the regional policy on Review of the regional policy on immunization – being undertaken.immunization – being undertaken.

Action to strengthen research capacity in Action to strengthen research capacity in three countries – commenced. three countries – commenced.

SummarySummary Nearly half the recommendations are related to aspects relevant Nearly half the recommendations are related to aspects relevant

to health research.to health research. Many recommendations include several follow up actions by Many recommendations include several follow up actions by

different implementing agencies within and outside SEARO.different implementing agencies within and outside SEARO. Some recommendations are very specific and clear.Some recommendations are very specific and clear. Of the 55 recommendations, 35 were to be followed up at Of the 55 recommendations, 35 were to be followed up at

SEARO, 5 at SEARO in collaboration with relevant units at HQ SEARO, 5 at SEARO in collaboration with relevant units at HQ and 15 at country level.and 15 at country level.

Follow up action varied – some of them requiring “one time “ Follow up action varied – some of them requiring “one time “ action while others - “ implementation over a period of time”.action while others - “ implementation over a period of time”.

Information on follow up action taken was not readily accessibleInformation on follow up action taken was not readily accessible Of the 55 recommendations, 35 have been implemented and Of the 55 recommendations, 35 have been implemented and

some are ongoing. 4 – not implemented and4 – no information.some are ongoing. 4 – not implemented and4 – no information. On 12 recommendations – information inadequate to make an On 12 recommendations – information inadequate to make an

assessment of the status of implementation.assessment of the status of implementation.

Considerations for the futureConsiderations for the future Introduction of an agenda item titled ‘follow up of Introduction of an agenda item titled ‘follow up of

recommendations of the previous ACHR” has to be continued recommendations of the previous ACHR” has to be continued and monitored to ensure that the information provided is and monitored to ensure that the information provided is “comprehensive”.“comprehensive”.

Mechanism to disseminate the recommendations at SEARO and Mechanism to disseminate the recommendations at SEARO and at country level – to be streamlined.at country level – to be streamlined.

Develop a mechanism to follow up at SEARO, through sharing of Develop a mechanism to follow up at SEARO, through sharing of information with all relevant technical units and obtaining their information with all relevant technical units and obtaining their views on the priority areas, within those recommendations. views on the priority areas, within those recommendations.

Feasibility of implementing the recommendation at SEARO and Feasibility of implementing the recommendation at SEARO and at country level needs to be assessed.at country level needs to be assessed.

A “forum” to be established to follow up at SEARO level. RPD A “forum” to be established to follow up at SEARO level. RPD unit to take the role of the Coordinator unit to take the role of the Coordinator

Financial requirements needed for Financial requirements needed for implementation to be considered in biannual implementation to be considered in biannual financial planning. financial planning.

Develop a mechanism to follow up at country Develop a mechanism to follow up at country level. Suggested that ‘ the focal point for level. Suggested that ‘ the focal point for research’ at country level be strengthened research’ at country level be strengthened and be provided with a clear set of and be provided with a clear set of responsibilities so that he/she could establish responsibilities so that he/she could establish links with the country focal point, all other links with the country focal point, all other relevant research institutions and with RPC at relevant research institutions and with RPC at SEARO.SEARO.

3131stst ACHR session – an overview ACHR session – an overview A number of recommendations were made A number of recommendations were made

during the session.during the session. WHO Representatives to play a key roleWHO Representatives to play a key role Follow up meetings held.Follow up meetings held. Action taken to : established ACHR Sub Action taken to : established ACHR Sub

Committee on vaccine and drugs Committee on vaccine and drugs developmentdevelopment

Review the regional policy on vaccine Review the regional policy on vaccine developmentdevelopment

Regionla strategy for researcj for health - Regionla strategy for researcj for health - initiated. initiated.

Thank youThank you