Priorities for health research in the Philippines
Jaime C. Montoya, MD, MSc, is Executive Director of the Philippine Council for Health Research and Development.
Jamie Montoya outlines the challenges for health research in the Philippines. He explains why cooperation and partnership are the best ways for a country to raise ‘new funds’ in a climate of decreasing resources, and describes the country’s approach to making health research effective and focused on the population’s needs.
Your background combines public health, teaching and research and work in the private sector. How has this experience shaped your view of the health research needs of the Philippines?
My background is different from that of most researchers and research managers. It includes 12 years as faculty member of the University of Philippines College of Medicine, doing basic and applied research on infectious diseases and as an internist and infectious disease specialist, followed by six years in the corporate sector. Experience in business and research bring complimentary perspectives to my role as head of the Philippine Council for Health Research and Development (PCHRD). My public health and research background tells me that the decisions we make for national health research – and the policies that are defined and developed – need to be based on credible evidence. From a corporate perspective, our work needs to be well designed and planned, and its performance measured. Defining priorities is particularly relevant to good performance, as we need to get the most out of the limited resources that are available for health research in the country.
What is your vision of the Philippine Council for Health Research and Development and what it can achieve for the country?
The vision and mission of the Council reflect and addresses the current state of health research in the country. They also voice the need we have to improve and do more.
The Vision is: to build a nation of healthy and world-class Filipinos by nurturing our resources to generate new knowledge and innovations on products and services that will improve health care delivery. The Mission calls for us to: provide and strengthen the scientific and technological base for health care delivery. To my mind, this captures the essence of what research in the Philippines should be: dynamic, realistic, responsive and relevant.
In practical terms, how will you and your colleagues make this work and bring these goals to life over the coming years?
I have decided that the Co uncil will focus on five priority areas: research priority setting; capability building; development of ethical standards; resource generation and utilization; and information dissemination. Work in these areas is done in a spirit of multidisciplinary, multi-sectoral networking, with cooperation and coalition building between all stakeholders and programme managers.
Research Priority Setting
To address the dual problem that the Philippines faces – of significant health problems and decreasing resources available for health – we set clear research priorities for health.
The Council spends significant time and resources on priority setting in managing the national health research agenda. We now need to revisit these priorities in the light of emerging external factors such as globalization, migration and advances in information technology.
A clear and agreed set of priorities needs to address the issues that most affect the majority of the Filipino population, especially the poor members of the society. The relevance of our health service can then be measured by our ability to address these needs.
Having a set of clear, realistic and agreed priorities guides our research agenda. They need to be well communicated, to encourage researchers to address the country’s leading causes of morbidity and mortality – such as heart disease and infectious diseases. Priorities also need to be realistic and credible. We hope to achieve this by developing priorities in consultation with local government and NGOs that are actively involved in communities.
My past experience in academia, tells me that the Philippines needs to create more Centers of Excellence for research. A group of centers will improve the quality and depth of our basic science research, and has the potential to generate new income and investment through the development of new products. Government support and resource generation are needed for us to move forward.
To deliver on this the Philippines needs to improve its research infrastructure, which lacks highly-skilled researchers – for example familiar with Good Clinical Practices and Standards of Registration of Pharmaceuticals for Human use. Our researchers also lack the training and laboratory facilities needed to produce leading research work, particularly in the different teaching hospitals and medical centers.
We also need to expand our pool of researchers and offer more training – in the Philippines and abroad – so that our health research system keeps abreast with the advances in science and technology.
Ethical Standards Development and Dissemination
What higher purpose should research serve but the best interests of our patients? If our research is to be truly responsive to the times it must follow internationally accepted ethical standards. This means ensuring that every patient is guaranteed care in line with principles of autonomy, beneficence, non-malfeasance and justice.
To do this we are training our Institutional and Ethical Review Committees to give them the skills to review research proposals from an ethics perspective, and ensure patient protection. I am aware that the Ethics working group is among the most active in the Philippine National Health Research System. We are building on the good ethics work already done in the Philippines and will prioritize the dissemination of ethical standards throughout the country.
Resource Generation and Utilization
A shortage of resources will always be an issue (here and I believe in most countries!). So rather than wait for large amounts of new government funding, that we would like to have, to magically appear, the current difficult funding situation gives us the opportunity to be resourceful in how we use our existing funds and work with others. A practical approach I see is to increase cooperation between the national programmes and health initiatives so that they address common problems – ideally aligned with our research priorities. This kind of cooperation creates ‘new funding’ by focusing the attention of existing activities on common goals. Today, different groups have resources for their own goals and objectives. But we can achieve higher investment and higher impact by working together toward on a common agenda. In addition to unlocking new funds, this approach fosters participative democracy and a spirit of community responsibility to contribute to the overall good.
Putting in plac e an improved information strategy – and skills for individual researchers and our institutes – will improve the relevance and use research produced in the Philippines. Major improvements in information and communication activities will directly support health research. The majority of health research produced in the Philippines remains unpublished, which hampers our ability to share the knowledge created by our national health research system. The information strategy includes expanding medical informatics services, and using information technology to offer boarder access to the good work done by Filipino researchers. Targets for improving information are to make research more relevant to the different groups in society, from individuals to communities to those who shape policy. Health research communication and information are more than publishing and dissemination – it directly supports better delivery to all Filipinos.