The state of the National Health Research system in South Africa : leadership and governance

Abstract

Knowledge produced by health research contributes to the improvement of the health of individuals and populations. This knowledge also contributes to the development of evidence-informed policies and the enhancement of performance of health systems. Using existing and new knowledge adapted to local conditions is particularly crucial in achieving the Millennium Development Goals. To achieve these and other health-related goals, a well-functioning health system must be able to produce, access and utilise research-based knowledge and the products of research. The purpose of this chapter is to assess the performance of the national health research system that was envisaged by the Health Research Policy of 2001, and to highlight the recommendations of the National Health Research Summit of 2011 on the strengthening of research and development in South Africa (SA). The health research enterprise in SA is dominated by a small core of productive researchers, who are largely externally funded and focus on HIV, AIDS and tuberculosis. The representation of black research leaders is low. The key priorities for strengthening the health research system are related to increasing funding from local governmental and non-governmental sources, developing human resources for health research, building the infrastructure for clinical research in academic health complexes, providing dedicated funding for priority health conditions, and improving the national regulatory framework for clinical trials. Furthermore, there is a need for the development of a national system for the planning of research and its translation into policy, programmes, and practice. Finally, the health research system requires a mechanism for monitoring and evaluation to serve as a 'feedback loop' for the development of a robust health research system that is geared to addressing the priority health needs of South Africans.