Operational and implementation research within Global Fund to Fight AIDS, Tuberculosis and Malaria grants: a situation analysis in six countries

Abstract

BackgroundOperational/implementation research (OR/IR) is a key activity to improve disease control programme performance. We assessed the extent to which malaria and tuberculosis (TB) grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (“Global Fund”) include support for OR/IR, and discuss the implications of the current Global Fund operating mechanisms for OR/IR support.MethodsThe situation analysis focussed on malaria and TB, while HIV was excluded. Stakeholder interviews were conducted at the Global Fund secretariat and in six purposefully selected high disease burden countries, namely the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Myanmar and Zimbabwe. Interviewed in-country stakeholders included the relevant disease control programme managers, project implementation partners, representatives from international organisations with a stake in global health, academic and governmental research institutions, and other relevant individuals such as members of the country coordination mechanism. Additionally, documentation of grants and OR/IR obtained from the Global Fund was reviewed.ResultsThe Global Fund provides substantial resources for malaria and TB surveys, and supports OR/IR if such support is requested and the application is well justified. We observed considerable variations from one country to another and between programmes with regards to need, demand, absorption capacity and funding for OR/IR related to malaria and TB. Important determinants for the extent of such funding are the involvement of national research coordination bodies, established research agendas and priorities, human and technical research capacity, and involvement of relevant stakeholders in concept note development. Efforts to disseminate OR/IR findings were generally weak, and the Global Fund does not maintain a central OR/IR database. When faced with a need to choose between procurement of commodities for disease control and supporting research, countries tend to seek research funding from other donors. The Global Fund is expected to issue more specific guidance on the conditions under which it supports OR/IR, and to adapt administrative procedures to facilitate research.ConclusionsThe importance of OR/IR for optimising disease control programmes is generally accepted but countries vary in their capacity to demand and implement studies. Countries expect guidance on OR/IR from the Global Fund. Administrative procedures specifically related to the budget planning should be modified to facilitate ad-hoc OR/IR funding. More generally, several countries expressed a need to strengthen capacity for planning, negotiating and implementing research.Electronic supplementary materialThe online version of this article (doi:10.1186/s12992-017-0245-5) contains supplementary material, which is available to authorized users.

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

“…A recent publication reviewed the situation of OR among Global Fund grantees across six countries and concluded that countries had varied capacities for implementing OR and required more guidance for the same [59]. This is the first time that an experience of promoting OR through a Global Fund grant is documented.…”

Incorporating operational research in programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in four sub-Saharan African countries.

“…Yet, OR and other evidence-based approaches are not being routinely embedded in control activities funded by the Global Fund despite the effort and advocacy from different stakeholders such as the Special Programme for Research and Training in Tropical Diseases (TDR) and local research organisations. The reasons for this have been previously explored by Kiefer and colleagues [12] revealing considerable variations from one country to another and between programmes with regards to the needs, demands, absorption capacity and funding for OR related to malaria and TB. The study by Kiefer and colleagues remarked the necessity of the involvement of national research coordination bodies, established research agendas and prioritizing human and technical research capacity to strengthen OR locally.…”

“…Building on the ndings from Kiefer and colleagues [12], the Swiss Tropical and Public Health Institute (Swiss TPH), commissioned by TDR, undertook a follow-up investigation to nd out if and how an OR tool could become an integral feature in the Global Fund grants. The Structured Operational Research and Training IniTiative (SORT IT), a global partnership coordinated by TDR and implemented with partners, was the main OR reference tool for this investigation of four recipient countries in sub-Saharan Africa.…”

“…However, based on the OR results by Kyaw and colleagues showing a low incidence of renal toxicity of the drug ( [14,15]), the national HIV programme adopted a low cost screening method for renal dysfunction, saving resources to be allocated elsewhere. The current study, therefore, builds upon Kiefer and colleagues' previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational research and implementation research (OR/IR) activities in recipient countries [12]. The objective of this follow-up study was to identify approaches and pathways to implement an OR component into grants to the Global Fund, in four sub-Saharan African countries with a special focus on the SORT IT as a vehicle to increase OR capacity.…”

Clinical academic research in the time of Corona: a simulation study in England and a call for action

“…and data science(30), with rapid-response calls from major funders(5,(31)(32)(33). However, our data signal a need for a far broader paradigm shift in research design and implementation.…”