Summary, initial outputs and next steps Collaboration for Applied Health Research & Delivery

The consultation process started by selecting four areas of work where LSTM already has productive global collaborations with coordinating centres in all four of its research departments. This ensured inclusion of those departments expected to have a large portfolio of applied health research and delivery work (the departments of International Public Health and Clinical Sciences) and those more naturally associated with bench science (the departments of Vector Biology and Parasitology). The four workstreams chosen were lung health, maternal and newborn health, neglected tropical diseases, and health systems. Within each workstream a diverse group of individuals tackled the task of writing a discussion paper about the three issues that would be, for them, the major health challenges over the next 10 to 20 years, along with some initial ideas on pathways towards solutions for these challenges. The initial drafts were further developed through sharing and discussions with a wider community of collaborating, global partners from a wide range of institutions and disciplines. The 12 discussion papers were then shared between the four workstreams and thereby subjected to a range of internal and external peer-review. This process started the cross-disciplinary, cross-topic dialogue within LSTM and within existing collaborative networks.

The next stage was to invite a range of external panelists to help inform the initial strategic direction, by using the papers as a starting point for substantive discussion with as many of our colleagues from the Global South as possible. We circulated the papers [2–9] in advance and then set up a range of different discussion formats over a one and a half day meeting in Liverpool. On day 1 there were plenary presentations, introducing the four themes open to all, followed by moderated discussion in small breakout groups. Participants then came together once more in open plenary for the Leverhulme Lecture given by World Bank Director for Health, Nutrition and Population Tim Evans in Liverpool Town Hall. His topic was “Delivery Research” and he argued that the primary knowledge constraints to improving health lie less with “what to do” and much more with “how to do it”, which was in tune with the applied health research and delivery focus of the 12 discussion papers. He further argued that the emergence of a health goal of Universal Health Coverage within the post-2015 Sustainable Development Goals represents a unique opportunity to bring delivery research from the margins to the mainstream of research for health. Day 2 started with a debate in the format of the BBC's ‘Question Time’ programme in which questions submitted by the public are posed to a small panel of selected individuals to discuss with further contributions from the audience. Peter Sissons, one of the UK's most experienced broadcast journalists and a vice-president of LSTM, chaired the debate. This gave the chance for more junior researchers to mix with experienced colleagues on the panel, and allowed for in-depth debate around five questions which we selected from around 60 submitted in advance from across the collaborative networks. The consultation ended with feedback from the group work in an open plenary, with additional discussion on conclusions and next steps.

The consultation process was widely considered a success with lively, energetic discussion that generated new ideas and directions. Mwele Malecela, Director of the National Institute for Medical Research (NIMR) in Tanzania, said “CAHRD is an excellent example of developing policy and research in collaboration between the Global North and the Global South”. Himanshu Bhushan, Deputy Commissioner, Maternal Health, Ministry of Health and Family Welfare, Government of India, echoed Malecela and added that CAHRD might be a way to further efforts in developing countries to “reach the unreached with quality services”. Amuda Baba, representing Institut Pan-Africain de Sante Communautaire (IPASC) and from the fragile Ituri region of Democratic Republic of Congo, said that the consultation had reminded us all to think about “whose health system is it that we are talking about”, and called for local engagement and investment. Jeremiah Chakaya from the Kenya Medical Research Institute (KEMRI), and Ireen Namakhoma from Research for Equity And Community Health (REACH) Trust, Malawi, picked up this call and both look forward to the day when developing countries seriously invest in, and use, applied health research, matching resources generated from developed countries.

A CAHRD website has been created which has conference resources including conference documents, presentations and a full recording of Tim Evans' Leverhulme Lecture (http://www.cahrd-network.org/consultation/).

Colleagues in CAHRD at the University of Warwick are planning follow up meetings in 2016 to consolidate and develop the research programme and will include direct work in further development of applied health research and delivery proposals for funding. Colleagues in NIMR, Tanzania have volunteered to host the 2018 CAHRD Consultation in collaboration with other individuals and organisations in Africa, including Kenya, Uganda, Malawi and Democratic Republic of Congo.