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Blog

Drinking together - and fixing health systems

Future Health Systems

BY SARA BENNETT, JOHNS HOPKINS SCHOOL OF PUBLIC HEALTH

Photo of Sara BennettAccording to Wikipedia the term symposium comes from the Greek word “sympotein”  - to drink together. More than 1000 people are on the point of packing their bags and boarding planes to head to Montreux, Switzerland for the First Global Symposium on Health Systems Research.....they clearly have more than a quick communal drink in mind. But, as a seasoned participant in these grand global meetings it is difficult to prevent the wisps of cynicism from creeping into my mind: what difference do these big meetings really make? Will this just be another talking shop for those who can afford airfare and expensive Montreux hotel rooms?

So, what can and should the Symposium try to achieve? I have three big “asks” from the Symposium, but would be interested to hear what you want out of this meeting too.

First, the main theme of the Symposium is Universal Health Coverage, and the meeting is perfectly timed to lead into the launch of the 2010 World Health Report on Universal Health Coverage . Having got a sneak preview of this, I can testify that it is well worth reading. Moreover this is an agenda that every health person I know is passionate about. It would be great to turn the Symposium into the launch event for a really serious push towards extending basic health services to all – an issue that researchers, policy-makers and advocates could all get behind.

Second, health systems research is typically very applied, and its value comes from its application to policy and decision making. Over the past decade there has been an increasingly exciting movement to systematize the way that we go about linking evidence-to-policy. I have bemoaned elsewhere the fact that funding for this kind of bridging and knowledge translation work too often slips between the cracks. It would be great if the Symposium served to show case this work, help it step into the limelight and receive the type of support it deserves.

Third, my personal pet issue – research capacity for learning health systems. A recent paper estimated that there were 13,000 health service researchers in the US, compared to our estimate of about 6-7,500 in all low and middle income countries combined. We desperately need more skilled people across low and middle income countries to help analyse and steer health systems, and more strong research organizations to accommodate them. The best prospects for achieving this seem to be a fundamental shift in how many development agencies do their work so that they seriously support local institutional capacity development, particularly by providing core funding to the think tanks, research organizations and institutes in developing countries that conduct health systems research.

There looks like there will be a lot of great sessions at the Symposium: colleagues Gerry Bloom and David Peters from FHS are organizing sessions on Beyond Scaling up and on Evidence to Improve Health Service Delivery – which speak particularly to the theme of extending basic health services. I will be participating in a plenary session on research capacity development.

And what if the “Symposium” does not live up to our expectations? Well, maybe we can find solace in the original meaning of the term. I do happen to know a cozy bar in Montreux where perhaps we can take a drink together and debate what is really needed to fix health systems.