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  • The two statements from the

    2019-04-11

    The two statements from the BRICS partnership could help to inform how best emerging economies can contribute to achievement of ambitious global targets for tuberculosis control. BRICS and other economies in transition have a great responsibility and the potential to contribute to all aspects of care, prevention, and research for tuberculosis. Middle-income countries will need to enhance investments in social protection, including universal health coverage, to ensure prompt diagnosis of tuberculosis and completion of treatment. As the economies of these countries further improve, more countries will join this AMG 925 front, leaving fewer in need of substantial external assistance (). Countries of the Organisation for Economic Co-operation and Development and international financing mechanisms (eg, the Global Fund to fight AIDS, Tuberculosis, and Malaria) should coordinate their efforts and adjust aid flows towards the lowest-income countries and fragile states while leveraging domestic resources in the BRICS and other emerging economies to address equity and support vulnerable populations in the lowest-income quintile.
    Electronic waste (e-waste) is an emerging environmental health issue in regions of Asia and Africa. Kristen Grant and colleagues (December issue) reviewed possible associations between exposures to e-waste and adverse health consequences in southeast China. We agree with Grant and colleagues that well designed epidemiological studies are needed to explore weak associations reported in ecological investigations. However, comprehensive exposure assessment is equally important to establish causal associations.
    National health research agendas are important for helping to allocate funding to research areas of greatest need, and for aiding countries that receive donor funding to develop ownership and control over their national health research portfolios. However, before 2013, Papua New Guinea did not have an agenda of this kind. Here, we describe the development of the Papua New Guinea National Health and HIV Research Agenda (NHHRA) for 2013–18. The Papua New Guinea Health Research Policy calls for research in the country to target national health priorities. The NHHRA is the answer to this call. It includes the first high-level research agenda for all areas of health in Papua New Guinea. Under this high-level agenda, grasslands biome is envisioned that more detailed lists of strategic research priorities for specific health areas can subsequently be developed (such as for tuberculosis, cancer, HIV, child health, or environmental health). The NHHRA also includes the first list of strategic research priorities for HIV. By starting with HIV, this priority-setting exercise drew on the lessons learned from developing and implementing the National Research Agenda for HIV and AIDS in Papua New Guinea 2008–13. The strategic research priorities for HIV are intended to function as an example for the future development of research priorities for other health areas. Overarching guidance for the development of the programme and the methods that led to the establishment of the NHHRA were derived from the checklist on health research priority setting. A three-stage consultation process was developed to enable the inclusion of a broad range of different stakeholders. In stage one, four workshops of 1 day each were held. Each focused on a different research domain: reproductive, maternal, and child health; communicable diseases; healthy lifestyles; and health systems. These four research domains are aligned with the key result areas of the Papua New Guinea National Health Plan 2011–20. During these workshops, technical experts brainstormed on the values that should underlie the development of the agenda, discussed which health areas were relevant to the agenda within each research domain, and identified 10–15 research topics for each research domain. In stage two, during a workshop of 2 days, senior technical and policy stakeholders refined and prioritised these topics. In stage three, during a 1-day workshop, specialised technical experts developed a more detailed list of strategic research priorities for HIV. A more detailed description of how the agenda was developed will be published on the website of the Papua New Guinea National Department of Health. The report can also be obtained from the corresponding author.