National expenditure on health research in South Africa: How has the landscape changed in the past decade?
National expenditure on health research in South Africa: How has the landscape changed in the past decade?
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DOI：
10.7196/samj.2020.v110i4.14349
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发表时间：
2020-04-01
影响因子：
2.2
通讯作者：
Blackburn, J. M.
中科院分区：
文献类型：
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作者：
Barnabe, M. A.;Gordon, R.;Blackburn, J. M.
背景在过去的18年里，南非卫生部承诺将国家卫生预算的2%用于研究，而国家卫生研究政策（2001年）提出卫生研究预算应占公共部门卫生总支出的2%。2014年，国家卫生研究委员会利用截至2009/10年度的现有数据进行了一次审查，以确定这些目标是否已经实现。它显示，公共部门的卫生研究资金仍然低于国家卫生预算的2%，支持减少公共部门的卫生研究资金的看法。提供上次审查的最新情况，以调查自2009/10年以来健康研究领域的变化以及是否达到了目标。各种公开可用的信息来源，在SA的公共和私人的卫生研究支出被用来调查卫生研究的资金和支出。此外，问卷调查被发送到35个主要的国家和国际卫生研究的资助者在SA获得的资金水平和资助的研究领域的数据。2016/17年度，南非的卫生研究总支出为69亿兰特，占研发总支出的19.2%，国家财政部386亿兰特的国家卫生部预算中有1.7%通过南非医学研究理事会用于卫生研究（6.58亿南非兰特），相当于政府卫生综合支出的0.4%。然而，尽管2016/17年度政府加上科学理事会在卫生研究方面的总支出为14.5亿南非兰特，但这仅占国内生产总值（GDP）的0.033%，因此仍远低于国家人权委员会在2014年设定的占GDP 0.15%的目标。根据资助者的反馈，2016/17年度估计的基线健康研究资金超过41亿兰特，这比许多研究人员可能意识到的要高得多。四分之三的资金来自国外，这表明了南非卫生研究的优势和机会，但也突出了对外国资金的依赖。值得注意的是，大多数的资助者接触不能够容易地打破支出根据疾病领域。自我们上次审查以来，卫生研究资金已经发生了重大变化，尽管政府自己的承诺仍然没有实现。迫切需要改进跟踪卫生研究支出的机制，以更好地调整资金优先事项，并加强科学委员会在卫生研究资金方面的协调。
Background. Over the past 18 years, the South African (SA) Ministry of Health has committed to allocate 2% of the national health budget to research, while the National Health Research Policy (2001) proposed that the health research budget should be 2% of total public sector health expenditure. A review was conducted by the National Health Research Committee (NHRC) in 2014 to determine whether these goals had been met, using available data up to 2009/10. It revealed that public sector health research funding remained below 2% of the national health budget, supporting the perception of reduced public sector health research funding.Objectives. To provide an update on the previous review to investigate changes in the health research landscape since 2009/10 and whether goals have been met.Methods. Various publicly available sources of information on public and private expenditure on health research in SA were used to investigate health research funding and expenditure. In addition, questionnaires were sent to 35 major national and international funders of health research in SA to obtain data on the level of funding provided and the fields of research funded.Results. Total health research expenditure in SA was ZAR6.9 billion in 2016/17, or 19.2% of gross expenditure on research and development, with 1.7% of the ZAR38.6 billion National Department of Health budget from National Treasury being spent on health research through the South African Medical Research Council (ZAR658 million), corresponding to 0.4% of the consolidated government expenditure on health. However, although the total government plus science council spend on health research in 2016/17 was ZAR1.45 billion, this represents just 0.033% of the gross domestic product (GDP), thus remaining well below the aspirational target of 0.15% of the GDP set by the NHRC in 2014. Based on feedback from the funders, the estimated baseline health research funding in 2016/17 was in excess of ZAR4.1 billion, which is considerably higher than many researchers may realise. Three-quarters of this funding originated from foreign sources, suggesting both strengths and opportunities for health research in SA, but also highlighting increasing dependence on foreign funding. Notably, the majority of funders approached were not able to readily break down expenditure according to disease area.Conclusions. Health research funding has changed significantly since our previous review, although the government's own commitments to it remain unmet. Improved mechanisms to track health research expenditure are urgently required for better alignment of funding priorities and increased co-ordination between science councils in health research funding.