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The value of health research

[By Stanslous Ngosa]

Research is as important as life itself because it provides the building block upon which societal growth and advancement is hinged.

The understanding of the way things are, how things happen and what is responsible for such occurrences, is due to the help of research. Research also helps to study patterns in the past, feelings, attitudes and opinion, then use it to determine what should happen next.

Like privacy, health research has high value to society. It can provide important information about disease trends and risk factors, outcomes of treatment or public health interventions, functional abilities, patterns of care, and health care costs and use.

The different approaches to research provide complementary insights. Clinical trials can provide important information about the efficacy and adverse effects of medical interventions by controlling the variables that could impact the results of the study, but feedback from real-world clinical experience is also crucial for comparing and improving the use of drugs, vaccines, medical devices, and diagnostics.

For example, Food and Drug Administration (FDA) approval of a drug for a particular indication is based on a series of controlled clinical trials, often with a few hundred to a few thousand patients, but after approval it may be used by millions of people in many different contexts. Therefore, tracking clinical experience with the drug is important for identifying relatively rare adverse effects and for determining the effectiveness in different populations or in various circumstances. It is also vital to record and assess experience in clinical practice in order to develop guidelines for best practices and to ensure high-quality patient care.

Collectively, these forms of health research have led to significant discoveries, the development of new therapies, and a remarkable improvement in health care and public health.

In 2013 government enacted the Health Research Act no. 2 of 2013 which established the National Health Research Authority (NHRA). The NHRA was established to provide a regulatory framework for the development, regulation, financing and coordination of health research and ensure the development of consistent health research standards and guidelines for ethically sound health research.

Following the enactment of the Act, the first National Health Research Authority Council (NHRAC), which is the governing body was appointed in 2015 and this operated with a secretariat which was the research unit under the Ministry of Health.

In October 2017, NHRA management was set up and it then started to fully operate as a statutory body under the Ministry of Health. The functions of the NHRA may be summarised into six thematic areas: research promotion, research regulation, research coordination, research capacity building, research dissemination, research advisory and knowledge translation.

The mission is to promote, regulate and coordinate ethical conduct of quality health research and facilitate translation of all research products into evidence-based policies and programmes that improve the health of the people of Zambia and beyond.

The mission of the NHRA is a healthy research environment where all research is ethically conducted and all research products translate into improving the health status of the people of Zambia.
Further, the institution is there to promote, regulate and coordinate ethical conduct of quality health research and facilitate translation of all research products into evidence-based policies and programmes in order to improve the health of the people of Zambia and beyond.

From the time of inception, the Authority has scored a number of successes worth noting because research in health care is an integral component of attaining universal health coverage. Some of the achievements include development of systems, registration and accreditation of researchers, research institutions, and research ethics committees. Transfer of biological materials, bio-banking and setting up of the Research Trust Fund are some of the other achievements scored since the establishment of the Authority.

NHRA has developed national health research agenda, articulating Zambia’s national health research priorities that are linked to the [Seventh National Development Plan] 7NDP and the MOH NHSP 2017-2021. Guidelines for research in traditional medicine, complementary and alternative medicine to facilitate research in this important area have equally been established.

The research approval process has been digitalised so as to improve efficiencies in terms of time and money in the clearance of research protocols. The approval system is now fully electronic.

Development and dissemination of guidelines for research data management and related issues during public health emergencies and epidemic situations. These guidelines were developed to provide guidance to local and international researchers, epidemiologists and other stakeholders to ensure adherence to ethical standards as well as protect the country from possible abuse and unlawful externalisation of data and biological materials during emergencies.

Provided also is data management support to the Zambia National Public Health Institute (ZNPHI) during the cholera outbreak. NHRA provided an epidemiologist to beef up the data management team at the ZNPHI.

Last we talked about the significance of the Zambia National Public Health Institute. On the international front, NHRA contributed to the assessment of national health research systems (NHRS) in Africa that evaluated progress made in the implementation of the WHO Research for Health Strategy 2016-2025, whose aim is to foster the development of a functional NHRS that generates scientific knowledge for developing technologies, systems and services needed to achieve universal health coverage.

The study assessed the following: research governance, research staffing, research outputs, and research financing. This study revealed that Zambia is one of the few countries that scored high on the NHRS barometer scores in terms of development of NHRS in Africa. NHRA contributed to the Third European and Developing Countries Clinical Trials Partnership (EDCTP3) strategic business plan. NHRA provided direct input into the new EDCTP strategic business plan for 2021 to 2031 to be funded by the European Union.

The Authority has created a research knowledge translation platform to facilitate translation of research results into policies and programmes. A knowledge translation unit has been developed within NHRA, with a specific officer responsible for knowledge translation. Training in data to policy, which involves training in skills for development of research policy briefs, has started.

Development of research policy briefs to support the Ministry of Health policy decision has been done. An example is the development of a Policy Brief and Technical Dossier on Medicinal Cannabis.

NHRA has set up the Zambia Clinical Trials Coordinating Centre (CTCC). A Technical Working Group comprising various health and health research experts has been formed and is operational. The role of the CTCC is to coordinate clinical trials, mobilise resources for clinical trials and build both human and infrastructure for clinical trials in Zambia. The steering committee has started the process of developing a strategic plan.

Four institutions have been designated as centers for research in traditional medicine on an interim basis till they are accredited in 2020. These are: Tropical Diseases Research Centre (TDRC), Zambia Institute for Research in Traditional Remedies, Centre for Infectious Disease Research in Zambia (CIDRZ), and the University of Zambia School of Medicine Centre for Primary Care Research.

The importance of health research cannot be emphasised because it provides important information about disease trends and risk factors, outcomes of treatment or public health interventions, functional abilities, patterns of care, and health care costs and use.

The author is head of media relations at the Ministry of Health.

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