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Setting priorities in global child health research investments: universal challenges and conceptual framework

Aim. It is estimated that more than 130 billion dollars are being invested globally each year into health research, and that figure has been increasing steadily over the past decade. Still, the ideas and proposals for health research funding are growing at much higher rate, far exceeding available resources. Increasingly, there is a need at donor organizations and funding agencies to set priorities in health research investments in a fair and legitimate way, using a sound and transparent methodology. Any process of priority setting, however, is never an abstract scientific endeavour, but rather an activity driven by values of wide range of stakeholders, which are often conflicting. This always occurs in a highly specific context (e.g., time limit, defined space, population of interest and specific health problem) and under existing policies. Methods. Child Health and Nutrition Research Initiative (CHNRI) held a series of expert meetings during which a list of 20 universal challenges inherent to research prioritization were identified. Based on those challenges, several key concepts were proposed. If accepted, they could serve as a basis for a transparent decision-making framework for setting priorities in health research investments. Results. CHNRI firstly proposed that ‘ health research’ funded by public funds should be regarded as an activity undertaken to generate presently non-existing knowledge that will eventually be used to reduce the existing disease burden (or other health-related problem) in the population that provided funding. Three universal and non-overlapping domains of health research were proposed: (i) research to assess the burden of disease and its determinants ; (ii) research to improve performance of existing capacities to reduce disease burden ; and (iii) research to develop new capacities to reduce disease burden (or other problem). An approach to systematic listing of all competing research avenues, options and questions is suggested along with a framework for identifying criteria that can discriminate between values of research questions (e.g. answerability, ethics, effectiveness, deliverability, affordability, sustainability, maximum potential impact on disease burden, equity and others). Conclusions. CHNRI proposes a new approach to undertaking health research priority setting in a fair and transparent way, respecting principles of risk-neutral investing.

priority setting; child health; conceptual framework; CHNRI methodology

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