|Global Forum 2015: ASEAN-NDI initiates collaboration in Health R&D|
The ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI) conducted two activities during the pre-conference of the Global Forum on Research and Innovation for Health on 24 August 2015 at the Philippine International Convention Center (PICC), Manila. These are the ASEAN-NDI Communities of Practice (CoP) on Drugs, Diagnostics and Vaccines Meeting and the Regional Consultation on R&D Collaboration on Environment and Health.
The meetings were organized by the ASEAN-NDI Secretariat with financial support provided by the International Commitments Fund (ICF) of the Department of Foreign Affairs (DFA) and the ASEAN Science Fund (ASF).
The principal objective of the meetings was to convene ASEAN Health Research and Development (R&D) experts and discuss Health R&D priorities in the field of Drugs, Diagnostics, Vaccines, and Environment and Health and develop the agenda that will serve as the guide for the development of ASEAN collaborative programs and projects.
The meetings were attended by 62 participants including representatives from all ten ASEAN Member States (Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam), Department of Science and Technology, Department of Health, ASEAN-NDI Secretariat, World Health Organization, and private and public institutions.
The international delegation was composed of the ASEAN Subcommittee on Biotechnology (SCB) National Focal Points’ nominees who were identified based on their experience in conducting / managing researches on Drugs, Diagnostics, Vaccines, and Environment and Health.
The presentations focused on the current global health R&D landscape and the initiatives that some of the leading global research institutions perform to advance research and innovation in their respective regions.
Dr. Takele Geressu, Technical Officer of the African Network for Drugs and Diagnostics Innovation (ANDI), presented in behalf of Dr. Solomon Nwaka, ANDI Executive Director. Dr. Geressu shared ANDI’s key strategic directions and progress in mapping the African health innovation landscape and development of programs and projects in support of its advocacy to promote innovation in Africa.
Dr. Jaime Montoya, DOST-PCHRD Executive Director and ASEAN-NDI Lead Coordinator also presented the ASEAN-NDI as the health R&D innovation platform in ASEAN. Areas of collaboration with ASEAN-NDI, such as strengthening cooperation among ASEAN member states and with other regional innovation Networks in health R&D, development of programs and projects which address public health concerns most especially in ASEAN, and development of strategies to strengthen capacity and competitiveness in the development and delivery of health related products and services, were highlighted.
Parallel sessions were conducted on two tracks: the Drugs, Diagnostics, and Vaccines Communities of Practice and Environment and Health workshops.
Communities of Practice on Drugs, Diagnostics, and Vaccines Meeting
The Drugs, Diagnostics and Vaccines CoP Workshop involved presentations on the current R&D landscape, as well as the current trends in drug discovery and diagnostics by Dr. Hakim Djaballah of Institut Pasteur Korea and Dr. Cynthia Goh of University of Toronto, respectively.
This was followed by a presentation by Singapore’s Dr. Sidney Yee, which showed how the government’s strong support for health R&D has helped fast-track the process of converting researches into products ready for transfer to industry.
A project proposal on the use of heparin as therapy for infections due to its anti-inflammatory properties was also presented. Creating novel approaches to widespread diseases using existing drugs was emphasized.
The CoP workshops that focused on discussions on capacity building strategies and approaches for multi-sectoral collaboration were conducted. Common themes in the group presentations included the lack of researches geared towards addressing actual needs of the people, and the lack of coordination between different researchers and different sectors of society. Discussions also centered on how private interests impede collaborations between researchers from different institutions.
Coordination among countries is identified as one of the cornerstones to further enhance the innovation strategies in the region. ASEAN-NDI was considered to be the platform to enhance research capacities and implement a more specific forum for identification of solutions and further collaborations. A healthy relationship between researchers and commercial partners may help determine where each player in the whole R&D spectrum can strengthen each other and the levels of synergies.
The workshops confirmed that the member states have different levels of capacity in health R&D: capacity for basic R&D, capacity for more sophisticated R&D, and capacity to take the whole R&D stream up to commercialization. These are the capacity gaps that need to be taken into consideration when developing capacity-building programs. A fourth level of capacity is manifested through effectively dealing with bureaucracy and making the whole environment conducive to research. This includes better access to resources to conduct R&D.
The following strategies in closing the R&D gap were identified: exchange of experts, conduct of proper forum to discuss specific common diseases/problems, building of new linkages from old ones, evaluation of modes of partnerships, and identification of champions.
The member states also agreed to focus on three disease priorities, namely, dengue, tuberculosis, and antimicrobial resistance. Specific projects such as: development of bio-banking facilities and conduct of trainings on bio-banking, development of “half-way” technologies into commercializable products, policy formulation on Information management including sharing of and access to information especially in projects under collaborative agreements, development of the database of researchers who can give assistance to young researchers, and development of rapid, low technology driven innovations which converts complex technologies into devices that are effective but easy to operate, were discussed and agreed upon by the member states as possible collaborative projects.
Each country has their own funding sources that can be tapped in case the Network pushes for match funding agreement with the countries. Most of the funds come from government institutions such as the Ministry of Science and Technology and Ministry of Health.
Institut Pasteur Korea and ASEAN-EU were also present in the discussion and offered funding opportunities that are available and may be utilized for ASEAN collaborative projects.
Consultation on R&D Collaboration on Environment and Health
The environment and health session started with a presentation by Dr. Bernadette Ramirez of the Special Program for Research and Training in Tropical Diseases of the WHO (WHO-TDR), on the role of environment in the context of human health and how environmental conditions affect the transmission of vector-borne diseases.
This was followed by a presentation by Dr. Bruce Wilcox of Thailand’s Mahidol University, on challenges on innovations in environment and public health. Dr. Wilcox discussed that the challenge involves marrying medical and public health sciences with climate change; mainly exploiting existing environmental health frames, concepts, and methods.
He added that researchers and stakeholders need to: go beyond the biomedical model and ‘normal’ public health paradigms, learn to work across disciplines and integrate them, use systems thinking, and move from typology and descriptive science of climate change-health linkages to dynamic process-focused research and hypothesis testing — incorporating systems thinking and complexity theory.
The workshop was divided into four major topics for discussion: green (sustainable technologies)–mitigation and adaptation, adaptive capacity building–community participatory approaches, linking policy and practice across scales–local to regional, and multi-sectoral collaboration–toward integrated approaches.
Green (Sustainable) Technologies – mitigation and adaptation
The design of disease control technologies typically does not take into consideration the complexity of social-ecological systems. Current solutions to vector-borne diseases generally involve procedures and processes that are environmentally uninformed, and also do not take into account social/cultural context and the need for capacity building. Thus, existing approaches often compromise effectiveness and sustainability
Adaptive Capacity Building – community participatory approaches
An agency’s (government, NGO or academic program) role is to facilitate adaptation initiatives employing a community participatory approach. Ideally, the agency will not presume to pre-define/prescribe or describe the specific variables that represent exposures, sensitivities, or aspects of adaptive capacity, but seeks to identify these empirically from the community.
Current government policies and approaches are often limited in their orientation toward local empowerment nor adapted to communities’ social, cultural characteristics and needs. Therefore, there is a need for a more balanced top-down and bottom-up approach to the implementation of intervention programs. Understanding how interventions maybe adopted by communities is necessary for sustainability and taking into account the social and cultural dimensions maybe critical to the design of sustainable interventions. This should also consider gender equity.
Linking policy and practice across scales – local to regional
Among the environment and public health challenges commonly facing communities are external influences over which they often have little control, and frequently reflect a ‘disconnect’ between the provincial or national government. These may be beneficial (in the long or short term), but they can frequently be unaligned with communities’ perceived needs (which includes gender equity issues). Similarly, they may not integrate well with the local social and ecological circumstances. In these cases, which are common if not widely prevalent, vulnerability reduction/adaptive capacity strengthening will not be successful on any scale—including nationally.
Approaches are needed for linking policy and practice across all scales. This similarly requires assessment and planning of organizational, including administrative and management procedures. This may include but are not limited to review of policies and procedures, personnel capabilities and human resources development.
Coordination at all levels of governance is key to effective and sustainable interventions. More in-depth discussion on the review of relevant policies related to health and environment, importance of communication across sectors and scales, identification and engagement with key stakeholders including informal community groups, development of communication strategies and plans, and moving towards integrated holistic approaches may be helpful in identifying effective strategies to link policy and practice across scales.
Multi-sectoral collaboration – toward integrated approaches
It is clear that environment and health challenges, particularly involving climate change and vector borne diseases involve issues and responsibilities of multiple government agencies including those responsible for environmental quality, natural resources and public health as well as private industry and NGOs and the general public. The latter typically includes a heterogeneous collection of many groups including not only representing different socioeconomic levels, but urban and rural and those relatively economically privileged and well-integrated into society and those marginalized for social, political, economic, ethnic or religious reasons.
To do this, it is important to make health an agenda item in all sectors, promote and facilitate multi-sectoral collaboration, and support interagency collaboration that links environment and health.
In conclusion, ASEAN-NDI will facilitate the following: