1. S&T systems and regional research priorities for the Health field in Albania. WBC Meeting on May 12-13, 2009 in Tirana, Albania. Mr. Genard Hajdini Health Specialist Institute of Public Health (IPH)

2. Genard Hajdini 2 INTRODUCTION “The greatest wealth is health.” ~Virgil  The Albanian Health situation in regards to R&D efforts needs a lot of institutional and organizational support. The National Background Report on Health for Albania has been conducted based on the… 1) National Program for Research and Development 2007-2009; 2) National Strategy for Health in Albania 2007-2013; 3) Draft National Strategy of Science, Technology and Innovation of Albania on 27 February 2009; and 4) Cross-sectional data gathered by different ministries in the Albanian government.

3. Genard Hajdini 3INTRODUCTION  Public R&D institutions in Albania:  Institute of Public Health (IPH)  Founded on the basis of the Research Institute of Hygiene and Epidemiology and Immune-biological Products (created in 1969).  Faculty of Medicine at UT (Est. 1957).  Mother Teresa University Hospital Center.  Private R&D institutions in Albania:  Lady of Good Council (Catholic) University (accredited)  U.F.O University (not accredited).  Kristal University (not accredited).  Medikadent (not accredited).  Private R&D Clinics and Laboratories:  Lady of Good Council Clinic  Orthodox Clinic  IKEDA Clinic  Globus Clinic  Didaktalba (Science Equipments Store), etc.

4. Genard Hajdini 4 The Albanian Health Policy Framework The National Strategy for Health in Albania 2007-2013 states four main priorities: 1. Increase of capacities to manage services and institutions in more efficient way, 2. Increase of access toward the effective health services, 3. Improvement of health systems financing, and 4. Improvement of governance in the health system.

5. Genard Hajdini 5 R&D Capacity in S&T Field: HEALTH Table 1. R&D Capacities in S&T field of Health. 1990200220072015 Total number of research organizations 3 4 5 10 Of which universities 1 1 3 4 Of which public research organizations 2 2 2 3 Of which private research organizations 0 0 1 3 Number of PhD students graduated - 12 15 100 Total number of R&D personnel - - 500 950 Percentage of women in the total number of R&D personnel - - 40 50 Total number of employees on a Full-Time-Equivalent (FTE) basis - - 400 850 Total number of researchers - - 352 700 Percentage of women in the total number of researchers - - 35 49 Total number of researchers on a FTE basis - - 300 650 Number of researchers with Ph.D. degree or higher 265 400 Number of researchers with Ph.D. degree or higher on a FTE basis 240 390 Number of researchers under the age of 35 120 250 Number of researchers under the age of 35 on a FTE basis 110 230

6. Genard Hajdini 6 R&D Organizational Infrastructure of IPH in Albania DREJTORI ISHP MINISTRIA E SHËNDETËSISË Zv/Drejtor Shkencor Zv/Drejtor Ekonomik Zv/Drejtor Shërbimesh Mbështetëse Sektori i Administratës Sektori i Burimeve Njerëzore Sektori i Financës Asistent i Drejtorit Departament i Epidemiologjisë dhe Kontrollit të Sëmundjeve Infektive Sektori Survejancës të Sëmundjeve Infektive Sektori Vaksinimit Sektori Kontrollit të Vektorëve Sektori Programit Kombëtar të HIV/AIDS/SST Qëndra e Këshillimit Sektori Laboratorëve 1. Laboratori i Virologjisë 2. Lab. i Imunologjisë (HIV/AIDS dhe hepatite) 3. Lab. i Bakteriologjisë dhe Mykologjisë 4. Kontrolli i Infeksioneve Spitalore 5. Lab. i Biologjisë Molekulare 6. Laboratori i Parazitologjisë 7. Laboratori i Preparatorisë 8. Lab. i Prodhimit të Antigeneve dhe Serumeve Diagnostike Departament i Ekspertizës Sanitare Seksioni i Ujit Sanitetit Seksioni i Fizikës Sanitare Seksioni i Kontrollit të Cilësisë së Ajrit Seksioni i Shëndetit në Punë Seksioni i Ujit Sanitetit Seksioni i Laboratorëve 1. Zyra e Sigurimit dhe Kontrollit të Cilësisë; 2. Lab. i Mikrobiologjisë së Ushqimeve dhe Mykologjisë; 3. Lab. i Biokimisë; 4. Lab. i Kimisë së Ujit dhe Sanitetit; 5. Lab. i Kimisë së Ushqimeve; 6. Lab. i Kimisë Analitike Instrumentale; 7. Teknika Kromatografike; 8. Teknika e Absorbimit Atomik. Departament i Epidemiologjisë dhe Kontrollit të Sëmundjeve Kronike dhe Sistemeve Shëndetësore Seksioni i Epidemiologjisë dhe Indikatorëve Shëndetësor Seksioni i Shëndetit Riprodhues Sektori i Politikave dhe Sistemit Shëndetësor Departament i Edukimit dhe Promocionit të Shëndetit KËSHILLI SHKENCORKËSHILLI DREJTUES Seksioni i Shëndetit Komunitar Seksioni i Shëndetit në Shkolla Seksioni i Shëndetit Riprodhues Seksioni i Shëndetit Mendor Seksioni i Abuzimit me Substancat Sektori i Merëmbajtjes së Kafsheve (Vivarium) Sektori i Botimeve Sektori i Radiombrojtjes Qëndra e Trajnimit

7. Genard Hajdini 7 R&D Financing in Health Sectors/Year 2007 GDP (000 €) (Sector GDP/ Total GDP) % National economy 15,0000.2 I sector: Health 3,7430.05 II sector: Education 5,2400.07 III sector: Agriculture 4,4910.06 IV sector: Environment 1,4970.02 V sector: -- -- Table 2. Performance of economy and sectors relevant for S&T field:

8. Genard Hajdini 8 R&D Projects Table 3. List of Completed and Continues Projects at Institute of Public Health (IPH) in Albania. Title of Project:Financed ~(USD)Donor Organization 1.Demographic and Health Survey 2.Behavioral & Biological Survey (HIV/AIDS) 3.School Surveys (YRBS, ESPAD) 4.Hepatitis Sero-prevalence Survey 5.PHC Service Capacities and Gaps a.Vaccination b.Cancer c.CVD 6.Iodine Deficiency Survey 7.Nutrition and Obesity Surveys 8.Stress and Mental Health at the Workplace 9.Other Research (outbreak investigations, air & water pollutions, health indicators) 10.Virology Laboratory 11.Molecular Biology Lab. 12.Chemistry (iodine) 13.Clinical Lab. 14.Air Pollution 15.New Vaccines 16.Detection Programs STI (VCT) 17.Detection Program Chronic Disease 18.New Surveillance Systems (abortion, STI, birth defects) 19.Family Planning 20.Food Safety Assessment $1,000,000 100,000 30,000 100,000/40,000/10,000 100,000 20,000 10,000 50,000 100,000 30,000 10,000 100,000 1,000,000 50,000 10,000 20,000 x 3 = 60,000 100,000 15,000 USAID/Swiss/UNFPA Global Fund (GF) UNFPA MASH (MOES) GAVI/UNFPA/MoH UNICEF MASH (MOES) MoH World Bank MoH WHO MoH + GAVI Global Fund MoH UNFPA MASH (MOES) (Source: IPH)

9. Genard Hajdini 9 R&D Projects Table 4. Projects financed for R&D by the Ministry of Education for year 2008. Budget of Ministry of Education for the Year 2008 in R&D: In Lek/~Euro 130 Lek = €1 Title of Project University of Tirana. Faculty of Medicine Q. S. “Nene Teresa” Tirana. 456,000/3,500 Brain mapping in surgery of cerebral brain cancers. Ridvan Alimehmeti University of Tirana. Faculty of Medicine Q. S. “Nene Teresa” Tirana. 44,000/350 Brain mapping in surgery of cerebral brain cancers. Ridvan Alimehmeti University of Tirana. Faculty of Medicine Q. S. “Nene Teresa” Tirana. 500,000/3,850 Risk factors for the cardiovascular diseases in Albanian autochthon population and in those immigrated in Italy. Mihal Tase University of Tirana. Faculty of Medicine Q. S. “Nene Teresa” Tirana. 400,000/3,080 The organization of an Albanian center for diagnosis of early pregnancies and prevention of genetic malformations. Vahe Mokini University of Tirana. Faculty of Medicine Q. S. “Nene Teresa” Tirana. 100,000/770 The organization of an Albanian center for diagnosis of early pregnancies and prevention of genetic malformations. Vahe Mokini University of Tirana. Faculty of Medicine Q. S. “Nene Teresa” Tirana. 500,000/3,850 The improvement of diagnostic methods and the formation of medical scientific personnel in the field of infectious diseases. Arjan Harxhi. (Source: MOES).

10. Genard Hajdini 10 R&D Challenges & Opportunities S.W.O.T Analysis Strengths Strong laboratories infrastructure. Tradition and Knowledge Transfer. Some Human Capacities. Strong Logistics in the Field. Center of Information on PH. Weaknesses Fragile Quality Assurance System In Process of National & International Accreditation. High Turnover Rate-Brain Drain. Lack of R&D Coordination Office. Low Absorption of Funds for R&D. Opportunities Strong National Network with DPH. Well-positioned between University and MOH. Supportive Legislation in Progress. International Networks & Partnerships. R&D has become a Priority: National & International Funds Threats New Governmental Structures overlapping with IPH Functions. PH Emergencies & Program Administration diverts energy & resources. Aid Funds & “Easy Money” create a dependency on low expectations and impedes competitiveness

11. Genard Hajdini 11 Health Research Priorities on the Basis of the Country’s Readiness Health research priorities on the basis of the country readiness are: 1) Prevention of diseases and risk factors; 2) Mental health; 3) Non-infectious diseases with special importance; 4) Infectious disease; 5) Quality Assurance of Health Systems. Also other points to be considered are: 1) Emergency alert and quick response toward natural and humanly caused catastrophes, accidents, and urgent situations; 2) Response to epidemics and pandemics in the country and region; 3) Allocation of resources toward public health research and response; 4) Clinical studies toward the most killing disease in the country both: infectious and non-infectious; 5) Accreditation and quality assurance of the laboratories and medical facilities in the country; 6) Public health and medical personnel capacities for country’s readiness; 7) Facility and infrastructure building with contemporary standards with a good health systems information network in Albania.

12. Genard Hajdini 12 Health Research Priorities on the Basis of Future Potential  The health research priorities on the basis of future potential are: 1. Public Health (Genetic Screening); 2. Health Information Systems—the build up of Database Warehouses; 3. Biotechnology and clinical research; 4. Accreditation and Quality Assurance of all healthcare system: hospitals, clinics, institutes through the national and international entities; 5. Establishment of high financial management of the Hospital and University Hospital Systems; 6. Albanian Centers for Excellence; 7. New Departments in Albanian Universities for PhD accredited programs in health sciences.

13. Genard Hajdini 13Q&A You have questions, And I have answers… The End…