Global Ministerial Forum on Research for Health November 2008 Implementation Research in TDR Special Session

Brief overview of TDR Created in the early 1970s with two interdependent objectives - To develop improved tools for the control of tropical disease - to strengthen the research capability of countries affected by these diseases In 2007 TDR made some adjustments to its objectives - To harmonise global research efforts through stewardship - To Increase DEC leadership in research through empowerment - To enhance access to superior interventions through innovation, intervention development and evaluation and through implementation research The vision is to "Foster an effective global research effort on infectious diseases of poverty in which disease endemic countries play a pivotal role"

Why TDR focuses on IR Many proven disease control tools fail to produce results when implemented as programmes because delivery methods are ineffective, untested, unsuitable, or incomplete. Implementation is a dynamic process needing evidence-based adaptation to different settings and scale Ways to improve the quality and the equity aspects of care, to maintain coverage of established programmes over time and to effectively build health systems are researchable through IR Building local capacity for the design, conduct and use of IR is important for improving health programmes

New and improved tools New and improved strategies New knowledge / discoveries New and improved interventions IR is a relatively neglected area New and improved interventions New and improved strategies New knowledge / discoveries New and improved tools GAELF Trachoma RBM StopTB Global Fund APOC New and improved tools EDCTP New and improved tools MMV Microbicides DNDi GATB IAVI FIND NIH, Trust, Research councils, etc… Grand Challenges

Types of IR that TDR supports Research to improve the implementation of tools, policies, programmes or practices Research to identify and overcome barriers to scale-up and disease elimination Research that creates knowledge of processes that can be applied across settings. Research on how to most effectively package and deliver multiple interventions

IR defined key elements of the Malaria Home Management Strategy Effective, pre-packaged, user- friendly, unit-dosed, antimalarials (ACTs) made available close to the home through a network of trained community-based providers backed up by a communication strategy for behaviour change

IR demonstrated CDI can deliver multiple interventions At least 4 to 5 interventions could be effectively implemented through the CDI process Ivermectin ITNS Vit A supplementation HMM Coverage increased over time reflecting maturation of the CDI process CDI is cost efficient to the health system