Tracey Koehlmoos: From the first global symposium on health systems research

Tracey KoehlmoosI must confess that I am at a meeting…again. This time I am at the long awaited First Global Symposium on Health Systems Research. I am in Montreux with more than a thousand people from around the globe who do what I do, which is try to figure out how societies can best organise themselves to produce health in the population.  Milling about the convention centre set on beautiful Lake Geneva are researchers from more than 100 countries, policy makers, development partners, consumers, health providers, and leaders of academic institutions as well as from the World Health Organization (who planned the meeting.)  With more than 150 sessions and almost 600 posters, this event is heaven for the health systems scientist. There is so much to learn. However, most amazing to me is the common sense of purpose and urgency among the participants towards the methodology of health systems research but also for the topic of universal coverage, which is the theme of the meeting.

The symposium, which is more erudite-sounding than “conference,” opened with a welcome from the new assistant director general from WHO and from the director general of the Swiss Agency for Development and Cooperation. There was a speech by the Minister of Health from Laos, which was immediately followed by the most riveting keynote address by Judith Rodin, who is the President of the Rockefeller Foundation.  Her use of health outcomes data was fantastic but her delivery style was truly inspirational.  As someone who still works hard to overcome public speaking anxiety, I can tell you that I really appreciate a great public speaker.

On the afternoon of the first day of the symposium, 16 November, the Alliance for Health Policy and Systems Research hosted another session on the working group document on “Do we need an international collaboration for synthesizing health system evidence?” It was hosted by John-Arne Røttingen, who in addition to being chair of the Alliance’s Board, is also the Chief Executive of the Norwegian Knowledge Centre. Speakers included Professor Till Barnighausen from Harvard, Dr. Chris Henshall from Brunel University, and the Honorable Fatimata Moussa from the Ministry for Health of Niger. I spoke briefly if not a bit nervously on the types of synthesized evidence that policy makers need and the methods of synthesis that might deliver that information. The people in attendance became active participants in the discussion around this issue and for the first time, people were not looking at the health systems synthesis issue as being divisive.  People generally seemed ready to work on how we can fulfill this need collaboratively.

The symposium has 13 consecutive sessions so that I often hear people saying, “There are too many good things happening at the same time.” It is indeed very hard to choose. I’ve been fortunate to attend fantastic sessions so far on the health systems impact of measles eradication, scaling up towards equitable health systems, and the scale and scope of private contributions to health systems.

Tomorrow I have to present in two sessions at the same time. One session is for the Good Health at Low Cost work on how Bangladesh has made such tremendous strides in improving health outcomes since the end of the Liberation War. The other session is by the network of Centres for Systematic Review on how systematic reviews can provide comprehensive research findings for universal health coverage. I will talk about how systematic reviews conducted by network centres in the areas of financing, human resourcing, and engaging the non-state sector are helping to bridge the gap between research and policy in low and middle income countries. For example, I will emphasise the secret life of my social franchising review, which has spawned other reviews, research reports, policy briefs, general discussion on the research agenda and funding of non-state sector research initiatives. It has been used extensively to call for more research funding in an area of great health investment in which there is no rigorous evaluation.

In addition to the plethora of great plenary speakers and interesting sessions, is the real benefit of coming together with so many of my global colleagues. For many of us, we fight the war on poverty and disease from the frontlines in developing countries. Some groups work in relative isolation or grouped on the occasional multi-country study. We often only hear of one another or read one another’s research findings through publications.   After exercising early, I sat alone at breakfast the other morning, and within twenty minutes I was surrounded by a large group of South Asian colleagues most of whom had not met previously but we had all heard of one another and some of us had corresponded with one another via e-mail.  It was transformational to sit face to face and talk about our common challenges in the region.  I left the table feeling empowered —and pretty sure that we will figure out a way to work together in near future.

I am thankful to Dr. Tim Evans, who lately has joined our team in Bangladesh and is now actually my dean at the James P. Grant School of Public Health, for coming up with such an excellent idea.  Organising such a big event took a lot of people and influence so that the list of core organisers includes the WHO, the Alliance for Health Policy and Systems Research, the Global Forum for Health Research, and the two special programmes on human reproduction and tropical disease research, which are known generally by their acronyms: HRP and TDR. I cannot imagine how much money they had to raise to bring so many people together for this purpose. The programme booklet contains the names of more than 20 major sponsors. From the UK they include DfID and the Wellcome Trust but there are also private foundations like Rockefeller and Doris Duke. Like everyone else here on scholarship, I am thankful to them for making it possible for us to learn from one another with the common hope of building stronger health systems in our homes in developing countries.

Tracey Koehlmoos is programme head for health and family planning systems at ICDDR,B and adjunct professor at the James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh.