THE NEED FOR CENTERS OF HEALTH RESEARCH EXCELLENCE IN THE DEVELOPING-WORLD

Pervasive ill health and overpopulation impede progress in most develo ping countries but in recent years, programs providing aid to these re gions have de-emphasized health as a priority. Furthermore, support fo r building the health research capacity, so essential to the success o f efforts to promote improved health, has been lacking. This paper exa mines these policies as they relate to one developing country, one glo bal health program and a major Canadian development agency. Much has b een achieved in the past decade in one of the world's poorest countrie s, Bangladesh, but major health problems persist, particularly in mate rnal and child health. With the will to build effective health program s, Bangladesh lacks the resources and the research base needed for the ir development. The World Health Organization, (WHO) Diarrhoeal Diseas e Control (CDD) program, which addresses a major cause of child mortal ity in Bangladesh, promotes effective treatment but it contributes lit tle to a permanent research establishment in that country. The Canadia n International Development Agency (CIDA) which directs only a small p ortion of its $2.2 billion annual budget to health, lacks an influenti al level of technical expertise in health. This agency has no mandate to support health research in the developing world; research is the re sponsibility of the International Development Research Centre (IDRC), the Health Sciences Division of which closed in July, 1995. To upgrade the place of health and health research in development, the attitudes and policies of major donors must change and models of success are ne eded. Of the existing institutions or programs involved in health and health research in the developing world, the internationally funded he alth research centre, strategically sited in the developing world coul d provide the excellence around which relevant programs should flouris h. An existing example of this rare species, the International Centre for Diarrhoeal Disease Research, Bangladesh, merits particular conside ration in this regard.