Investing in health R&D: where we are, what limits us, and how to make progress in Africa
Investing in health R&D: where we are, what limits us, and how to make progress in Africa
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DOI：
10.1136/bmjgh-2018-001047
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发表时间：
2019-03-01
影响因子：
8.1
通讯作者：
Mossialos, Elias
中科院分区：
文献类型：
--
作者：
Simpkin, Victoria;Namubiru-Mwaura, Evelyn;Mossialos, Elias
针对对非洲国家影响尤为严重的疾病，全球研发 (R&D) 渠道似乎不足，各国政府努力优先考虑研发投资。本文深入介绍了非洲健康科学研究的投资来源、现有研究能力和研究产出水平。非洲地区人口占世界15%，但2016年研发投入仅占全球的1.1%。非洲大陆内部差异巨大，埃及、尼日利亚和南非占研发支出总额的65.7%。在经济合作与发展组织的大多数国家，研发资金的最大来源是私营部门。非洲的研发主要由公共部门资助，许多国家的很大一部分资金来自国际资金。限制私营部门投资的挑战包括不稳定的政治环境、治理不善和腐败。有证据表明，考虑到全球背景，非洲的研究成果和研究能力存在各种局限性。反映这一点的指标包括大学排名、研究人员数量、出版物数量、临床试验网络和药品制造能力。非洲大陆内部存在巨大的地区差异。激励投资对于培养当前和未来的研究成果和研究能力至关重要。本文概述了正在进行的许多值得称赞的举措中的一些。创新和协作的融资机制可以刺激进一步的投资。鉴于非洲各地在研发方面存在巨大的不平等，战略需要反映各国解决这一差距的不同能力。
Global research and development (R&D) pipelines for diseases that disproportionately affect African countries appear to be inadequate, with governments struggling to prioritise investment in R&D. This article provides insights into the sources of investment in health science research, available research capacity and level of research output in Africa. The African region comprises 15% of the world's population, yet only accounted for 1.1% of global investments in R&D in 2016. There were substantial disparities within the continent, with Egypt, Nigeria and South Africa contributing 65.7% of the total R&D spending. In most countries of the Organisation for Economic Co-operation and Development, the largest source of R&D funding is the private sector. R&D in Africa is mainly funded by the public sector, with significant proportions of financing in many countries coming from international funding. Challenges that limit private sector investment include unstable political environments, poor governance and corruption. Evidence suggests various research output and research capacity limitations in Africa when considering a global context. Metrics that reflect this include university rankings, number of researchers, number of publications, clinical trials networks and pharmaceutical manufacturing capacity. Within the continent there are substantial regional disparities. Incentivising investment is crucial to foster current and future research output and research capacity. This paper outlines some of the many commendable initiatives under way. Innovative and collaborative financing mechanisms can stimulate further investment. Given the vast inequalities across Africa in R&D, strategies need to reflect the different capacities of countries to address this disparity.