00-08 Contents GF6:GF5 23/10/09 16:07 Page 1 00-08 Contents GF6:GF5 26/10/09 14:42 Page 3 Contents Editorial Advisory Board: Jose Luis Di Fabio, Technology and Health Services Delivery, PAHO Thomas Egwang, African Academy of Sciences Pamela Hartigan, Skoll Centre for Social Entrepreneurship Mohamed Hassan, African Academy of Sciences Calestous Juma, Harvard Mary-Louis Kerney, UNESCO Elil Renganathan, World Health Organization Padmanashree Sampath, IQSensato and African Technology Policy Studies Network Judith Sutz, Universidad de la República, Uruguay Editorial Team: Charles A Gardner, Global Forum for Health Research Susan Jupp, Global Forum for Health Research Stephen A Matlin, Global Forum for Health Research Christine Mauroux, Global Forum for Health Research Pro-Brook Publishing Team: Trevor Brooker, Pro-Brook Publishing Tim Probart, Pro-Brook Publishing Stephen Kemp-King, Pro-Brook Publishing Simon Marriott, Art Direction Jude Ledger, Copy Editor Pr Photo credits: WHO/PAHO/Carlos Gaggero WHO/TDR/Andy CraggsWyndeham Grang The Global Forum Update on Research for Health Volume 6 is published for the Global Forum for Health Research by Pro-Brook Publishing Limited Pro-Brook Publishing, 13 Church Street, Woodbridge, IP12 1DS, United Kingdom Copyright Text © the Global Forum for Health Research 2009 Volume © Pro-Brook Publishing Limited 2009 All rights are reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photo-copying, recording or otherwise without the permission of the Publisher. The information contained in this publication is believed to be accurate at the time of manufacture. Whilst every care has been taken to ensure that the information is accurate, the Publisher and Global Forum for Health Research can accept no responsibility, legal or otherwise, for any errors or omissions or for changes to details given to the text or sponsored material. The views expressed in this publication are not necessarily those of the Publisher or of the Global Forum for Health Research. Application for reproduction should be made in writing to the Publisher. ISBN 978-2-940401-24-6 First published 2009 Acknowledgements: The Publishers hereby acknowledge the assistance of all the contributors who have helped in the production of the publication and the advertisers who have made the publication possible. e, Southwick, UK Global Forum Update on Research for Health Volume 6 3 00-08 Contents GF6:GF5 23/10/09 16:07 Page 5 Contents Contents 009 Foreword Gill Samuels 011 Introduction Charles A Gardner Research and innovation in Cuba 014 Scientific research in the field of health in Cuba, based and oriented towards primary health care Dr José Ramón Balaguer Cabrera 020 Research in health from the Cuban international medical cooperation perspective Nestor Marimón Torres and Evelyn Martínez Cruz 024 Connecting immunology research to public health: Cuban biotechnology Agustin Lage 029 Development of Cuban biomedical technology and its impact in “Health for All” Ismael Clark Arxer Social entrepreneurship 034 mothers2mothers: social entrepreneurship and public health – scaling innovation Gene Falk with Julia Coyner Robinson and Cynthia Schweer 039 African giant rats for tuberculosis detection: a novel diagnostic technology Bart J Weetjens with Georgies Mgode, B Witkind Davis, Christophe L Cox and Negussie W Beyene moting healt 043 Social innovation “pull” incentives Liza Kimbo 048 Promoting prevention-oriented approaches for chronic noncommunicable diseases Chorh Chuan Tan Social innovation incentives: from “push” to people 054 Building global momentum for social innovation: accelerating systemic solutions through leadership networks François Bonnici and Mirjam Schöning 060 Innovative financing mechanisms – can they help to improve aid effectiveness for health systems development? Amrita Palriwala and Aarthi Rao 066 Healthful academic translations: cultivating Collaborative Doers as Innovation Managers for societal well-being Usha R Balakrishnan 072 The challenges of cardiovascular medicine in sub-Saharan Africa: opportunities for engagement between academia, industry and civil society Tembeka Mpako-Ntusi and Ntobeko BA Ntusi 080 Civil society engagement – a key strategy in research for health Sylvia de Haan with Samuel Anya, Ayo Palmer and Paul Bloch 083 Last mile delivery in health care and patient empowerment through technology: the case of “Telecommunication for Health” Roberto Tapia-Conyer and Rodrigo Saucedo 087 Community-directed intervention: replicating Japan’s health successes in Africa? Satoshi Omura and Andy Crump 091 Dragon Net: secret society or a network of health policy researchers? Toshihiko Hasegawa Global Forum Update on Research for Health Volume 6 5 00-08 Contents GF6:GF5 26/10/09 15:00 Page 7 Contents 094 New approaches to health worker training, deployment and retention Mubashar Sheikh and Sigrun Møgedal 100 Brazil’s conception of South-South “structural cooperation in health” Celia Almeida with Rodrigo Pires de Campos, Paulo Buss, José Roberto Ferreira and Luiz Eduardo Fonseca Technological innovation incentives: “push” and “pull” 110 Giving innovation a push: public and philanthropic R&D funding Mary Moran with Javier Guzman, Klara Henderson, Alina McDonald and Brenda Omune ealth research institutions and g 116 Government and philanthropic funding for technological innovation to develop new and better tools for neglected diseases Catherine M Michaud 119 Between pull and pools, where’s the “push” for global health R&D? Anthony D So 123 PDPs as social technology innovators in global health: operating above and below the radar Joanna Chataway with Rebecca Hanlin, Lois Muraguri and Watu Wamae 127 Innovation in life sciences Where do technologies come from? Vijay K Vijayaraghavan 131 Financing social entrepreneurship: innovation awards to cross the “Valley of Death” Charles W Wessner 138 Global health partnerships: a “pull” mechanism for innovation and new products Michel D Kazatchkine with Rifat Atun and Mary Ann Lansang 142 The pneumococcal Advance Market Commitment (AMC): innovative finance to help the poor Tania Cernuschi 147 Comparative advantages of push and pull incentives for technology development: lessons for neglected disease technology development Cheri Grace and Margaret Kyle 153 Emerging innovation practices and policies for the health-care needs of resource-poor people Raghunath Anant Mashelkar, with Bhushan Patwardhan and Shiladitya Sengupta Global Forum Update on Research for Health Volume 6 7 09 Foreword:gf6 23/10/09 14:19 Page 9 Foreword Innovation for health and health equity Article by Gill Samuels Chair of the Foundation Council, Global Forum for Health Research, Switzerland nnovation doesn’t just happen. It is a process driven by people with vision and with creative ideas that are often borrowed from across diverse sectors and disciplines. IWhether this involves social or technological innovation, or both, recognizing such people as innovators, applauding the new ideas that they often risk their reputations to champion, and helping them to scale up their efforts – this is how to change the world. This Global Forum Update on Research for Health focuses on incentives that drive people to innovate. For new technologies, we are generally familiar with “push” and “pull” incentives. Push incentives include public funding for research and tax breaks for private sector R&D. Pull incentives include intellectual property, private markets, public procurement and prizes for innovation. Policy-makers have a long menu of options to encourage technological innovation and to steer such innovation to improve health and health equity, addressing the needs of poor people. For social innovation, we are in less familiar territory. Perhaps funding social science research, social entrepreneurship and leadership training, and knowledge translation platforms are all “push” incentives for social innovation. Similarly, aid support for health services, increasing civil society and community participation, educating policy-makers on the value of evidence to inform policy decisions, new information and communications technologies and prizes can be seen as “pull” incentives. The Global Forum believes that the language of innovation (and concepts that surround it) may help build the bridges that are needed between researchers and implementers, and between those who focus on improving health technologies and those who focus on strengthening health systems. It may give us a common language for stakeholders to partner and cooperate more effectively to improve health services, products, methods, management practices and policies to bring better health for all. J Global Forum Update on Research for Health Volume 6 9 011 intro:gf6 26/10/09 14:41 Page 11 Introduction Introduction Article by Charles A Gardner Global Forum for Health Research, Switzerland he majority of papers in this edition of the Global Forum Update for Research Tfor Health focus on “push” and “pull” Technological innovation system incentives for innovation. Such incentives are most often discussed with regard to Possible incentives to improve global health equity technological innovation. Push Pull But technological innovation brings little Regulation Intellectual Procurement benefit unless it is linked to social innovation, Research Manufacture of safety & property & distribution including improvements in product and efficacy (products) service delivery, and the management