Strategic
plan, 2005 - 2010
Research priorities
The MRC's research prioritisation, research portfolio and resource allocation are based on two major inputs:
- The burden of disease and health profile of South Africa as systematised within the Combined Approach of the Ad Hoc Committee on Health Research for Development.
- Strategic priorities in health and development in South Africa as identified by initiatives such as South Africa's Foresight Exercise, the South African Government and the NEPAD Secretariat.
These inputs were used by the NDOH, together with a wide group of stakeholders, in formulating health research priorities for South Africa in 1997. The Foresight Exercise was a South African initiative in which the MRC participated in predicting the strategic areas for research investment in the future.
These health research priorities are rooted in the context of the health transition that South Africa is currently undergoing, which results in a triple burden of disease:
- Communicable diseases.
- Non-communicable or chronic diseases.
- Violence and injuries.
This health transition is largely due to improving socio-economic conditions for many South Africans resulting in an increase in the determinants, behaviours and risk factors for chronic diseases, as well as increased longevity and thus prolonged exposure to these risk factors.
Research prioritisation forms the basis from which to develop and implement research structures and processes to ensure equitable and effective allocation of research Rands and other resources. Such resource allocation enables the MRC to conduct relevant, responsive and excellent health research which, when translated into policy and practice, produces improved health and quality of life for South Africans.
The Millennium Development Goals (MDGs) are also an important determinant of global health research priorities, as health features in half of the ten MDGs. South Africa is one of the few African countries likely to meet the MDGs by 2015 and health research should be deployed to ensure that that target is speedily approached.
Health issues raised at the World Summit on Sustainable Development in Johannesburg in 2000, in which the MRC participated, are also pertinent to the MRC's research agenda.
ENHR approach
The MRC has adopted Essential National Health Research (ENHR) as a philosophy to guide its health research since 1993. ENHR uses burden of disease as the primary measure to evaluate a country's health priorities and thus guide resource allocation in the 'country-specific' mode. ENHR also includes a 'global-specific' mode that takes into account global threats to health requiring health research investment, such as avian flu, multidrug-resistant tuberculosis and climate change.
Burden of disease
Burden of disease includes both morbidity and mortality; the former being particularly difficult to measure on a national basis. The disability adjusted life year (DALY) is a commonly used measure of morbidity plus mortality. However, its accuracy is dependent on the quality of the data fed into it; which even in South Africa, despite the great strides made since 1994, is still sorely lacking. The sources of such data include:
- Cause-specific death certification data from the Department of Home Affairs; the latest available are for 2002.
- National registers of disease incidence and mortality such as the TB register and the National Cancer Registry.
- Technical reports of up-to-date estimates and projections of death and disability.
Strategic priorities and the National Health Research Committee
Strategic priorities will be identified in consultation with the National Health Research Committee (NHRC) which, under the National Health Act, advises the Minister of Health on the national health priorities for South Africa.
For the period 2005 - 2010, these imperatives were used to identify the following research priorities:
- HIV and AIDS.
- Tuberculosis.
- Cardiovascular disease and diabetes.
- Behavioural science and health promotion.
- Cancer research.
- Racial disparities in health.
- Ethics in health research.
- Research translation.
- Post-genomic research.
- Biotechnology.
- Indigenous knowledge systems.
- Environmental and occupational health research.
These research priorities will be further refined during the implementation of the MRC Strategic Plan 2005 - 2010 over the next five years.
New Partnership for Africa's Development (NEPAD)
NEPAD will increasingly become an important determinant of the research agenda of the science councils. Consequently, malaria, which is not a leading cause of death and disability in South Africa, receives large investments of MRC funds because of the importance of the disease in SADC countries and Africa as a whole.
There will be scope to participate more in NEPAD through the NEPAD Health Secretariat, utilising the NEPAD Strategic Plan for Health which MRC employees helped draft in 2000.
Furthermore, G8 funds may soon become available for NEPAD health research programmes once South Africa has been through the NEPAD peer-review process. Likely areas to be funded according to the Africa Commission Report tabled at the 2005 meeting in Gleneagles, Scotland include:
- Health research related to the G8 intent to provide access to HIV and AIDS treatment and care for all in Africa who need it.
- The US government commitment of over US$1 billion to malaria in Africa.
As the national statutory health research council of South Africa, the MRC should be well positioned to access and utilise such funds. |
