you
you
you
and what I'd like to suggest is a program of hybridization I'm a hybrid
I was an academic somebody's also working with DFID so as an evidence
advisor and recently I've started a new initiative which is more about action
direct actions soapbox collaborative so I've hybridized and I've done that by
opportunities our next generation needs to be given those opportunities so I'm
passionate for them that's why I do it I do it for the cause of course less
women dying more women surviving less babies dying but I do it in particular
also the next generation need to carry on this role fantastic Rafael why do you
do it thank you very much and thank you organizers to bring me here this is a
marvelous country unfortunately no time to visit all the beautiful places I I
think Richard is a very good friend she told that because he mentioned and I am
a successful successful scientist thank you Richard you say that because I
publish but I think it's not a right metric because when we tried to measure
success publishing is one side but totally agree and support Wendy when we
talk about teaching mentoring guiding it is the only way that we can really
transform and change is making all the experience as a part of the reality when
they call herself materialist I I believe in things that happen after I prove
that things happen so I'm also have my romantic side but in general I think I
do the publication because I believe that I have to communicate all the signs
and I can all the answers of my questions all the passion that I get when I find
something different but the most important is to do this right even if
take time I think we have to publish everywhere the market is driving due to
the impact factor because there is no quality control about how to publish and
where to push so the market is impact factor we have to publish everywhere we
have you we don't have we have to be generous putting in papers and are not
recognized by impact factor. Excellent thank you now I want to turn to the
consumers of research represented here by our Minister of Health from Rwanda now
Marlene is in a slightly interesting position she's a poacher turned game
keeper because she's now working at WHO responsible for a huge research program
but I want us to think of Marlene to start with as a consumer of research as
a senator in the Belgium Parliament so to both of you to Agnes and to Marlene
you are both highly influential consumers of science are you getting what
you need from these two scientists Agnes? This one I have to say yes
because he helped me with his metrics and burden of disease to tell me where I
should put the budget to have the maximum impact and in fact I like the fact
that the grotesque health is a market we are all social entrepreneurs we are
buying life and welfare where should we go and go and do our market like we are
at home for the kitchen what is the best thing to do I have $1,000 why should I
invest it to get the maximum health and the maximum welfare that's why I need
this type of research to see why I have the best product the best quality the
smaller cost so this is right but unfortunately people like that are
very few we should see the amount of money spoiled in fake research that are
lining in cabbards and diploma of people that are even not suffering about the
problem so this is something they come in Africa they study something that we
have no clue sometimes we even don't know that we have that problem they go
back home with a lot of data and they do great publication they became very
famous and you are still dying with something else so ethics and research
go together we just should do research that helps us to save our people the
rest is spoiling money and is diverting money from the right problem thank you
very much indeed Marlene thanks Richard and good morning to all of you about
the Ghani as Richard said I'm an observation gynecologist I've been
working many many years in the field of maternal health in this part of the
world in Kenya I went back and worked as a professor at the Gantt
University and then I became a senator so I have been involved in research
community users of research and politics and I must say we organized a number of
meetings like this but more focusing on how to bridge the gap between research
and politics and there is a huge gap between I think we speak different
languages and maybe the maternal health field is doing better than other field
but still politicians that's what I learned from my years in the Senate need
to have very simple bullet point messages not complicated research report
they don't have time and they don't have interest to go through the
publications so we have to be able to translate and transform our publications
into very simple messages and it has to be simple I remember as a chair of the
IPU the Inter-Parliamentarian Union AIDS Group we made a handbook for
parliamentarians because we felt that in in their constituency parliamentarians
need to be aware and we made a handbook of 120 pages great handbook I'm sure
that not one parliamentarian read it it has been trans translated in many
languages but not read now we made a shorter one with just some bullet points
and that is used so we have to learn how to use each other because very often
politicians parliamentarians don't realize that there is a community of
academic community of researchers who could do the research for them but they
have to sit together and as the minister said the politicians the
researchers have to know what the the main issues are in any country and have
to be able to translate it my other lesson is that politicians very often
move and specifically parliamentarians when there is a benefit for them they
want an answer now if they have a question they are not happy to her to
hear from the research community yes we will do a randomized control trial and
then we will do this and this and maybe in four years time we will have some
results but that time they have to be reelected I mean they they want the
answer now I mean it's a short lifetime for for most of them and just to finish
one example what to move the agenda on maternal mortality forward in Europe and
in the Belgian parliament and to mobilize funding of course we organized
with the parliamentarian group of MDG parliamentarians an activity called
modern night and modern night is just before mother day mother day is
celebrated all over the world to put those women on the agenda I mean and in
the focus who cannot celebrate mother day anymore because they died in in
pregnancy and that initiative was celebrated in parliament with music
with plays and then politicians got interested because they could bring it
to the television and it would serve their own career which is important so
Wendy Raphael and actually me as well we have just come under the most sustained
attack from these two policymakers and politicians because we are not as
representatives of the research community doing what they need so what is
our responsibility should we not be aligning ourselves much more with the
needs and demands of policymakers we go off we do this stuff called
investigator led research which bears no relation to the needs of these
policymakers and politicians as representatives of the science community
we're letting them down so what is our responsibility Wendy our
responsibility is to respond to be responsive but I think the important
thing is research and researchers are a very diverse community and they're
getting more diverse and I think that I think there's room for all types and
that's what I would say I think where there's room for more is those
individuals who do believe passionately about the translational step
I just start saying we know when we don't or we start saying it's certain when
it's not then undermining the useful role that we can play but I certainly do
think there is more room there's what I would say loss in the value chain at the
end of research because we don't go what I call the extra mile can everybody go
the extra mile to all researchers want to do it no neither should they not all
research should be look this is what you should do that's not that's not
appropriate but there certainly is more room for this extra mile where more
value can be got out of the science that we do but we have to engage and we have
to understand there needs to be mutual I used to work in the Ministry of Health
in Mexico and now you work in an academic department in Seattle do you
recognize this tension between the demands of the policymaker and the
responsibilities of the scientists I used to work in the government and yes
there is a there is a tension then sometimes I believe that tensions are
good are productive not only negative sometimes are not sometimes are very
bad but let me let me express and the first question that a researcher should
make is not related exactly with science is related with what I should do
because usually the question to answer is what I want to do totally different
perspective and what should I do is exactly understand what I was saying
the Minister of Health what policy makers want to receive and what should I do
means that I have to apply all the information available but I need to
gain so when when I heard the word translation and I'm translating my
knowledge and probably it's not an agreement and we need to debate a little
bit what exactly we understand for translation because translation for me is
not only put simple terms than scientists make complex it is sometimes
you have a device in your hands you know the complexity and you use that so why
you don't try to understand the complexity of that you don't care
because it's useful so sometimes scientists need to make easy and useful
the things and finally I think we need to to take decision makers as part of the
research and the best way to do that is putting visualization tools in their
hands visualization tools and the decision makers the policy makers can
make the honest story with us we put the data we put the credibility but the
story can come from the policy makers and needs to make that change in the
reality great point and so let me now take that last point and put the
spotlight a little bit on our two politicians policy makers here because
you shouldn't get off too lightly as representatives of the political and
policy community it's often said and you two are exceptions but it's often said
that members of your cadre do not go out and seek evidence when you should seek
evidence you devise policies in an evidence-free zone and then when you
implement those policies you don't evaluate them properly now when you get
together with your Ministry of Health colleagues or when you got together with
your senatorial colleagues in Belgium did you discuss these issues the fact
that science should be a tool for you to make reliable policies and to evaluate
those policies and if you do what kind of reception do you get Agnes it depends
because that's true that the community of policy makers are not the also the
best one and but I'm privileged maybe I'm privileged to work in a country where
I cannot submit a policy result evidence evidence come from research so in the
policy I submitted new policy they are going to say my prime minister and
president will say what evidence do you base this and I have to quote people like
them when I quote them the second question will be what will be the impact
on the people and the last question is what is the budget implication the last
question because if the policy is good we don't have the budget we just put it
there and we all go to search money so that's mean when I talk with my colleagues
and they say how do you make it I say I talk about this principle and I'm so
convinced that I'm like you I'm a bright and I breathe I'm a pseudo
academic because I'm teaching and I have put all my ministry at school there is
nobody in my ministry who's not doing a master or PhD and I mobilized money for
that because what when they are doing that they are better decision makers
than don't give me nightmare to try to say why do it come because it became
automatically so the lesson I have learned is and they're all going to be
teachers in university too they are going to teach their portion of expertise
they have because we have also this problem in academic that people who
doesn't have a clue of what a community is who teach people who have a clue what
community is so I think yes and so we need this hybrid situation where we
and policy policymakers the understood what research is and that it's not
possible to do good policy without evidence and also this part of sociology
because we have to understand how to translate those research results in good
policy but we need also to find the words how to translate and made the
community by those because sometimes results are not good to see we can see
and and it happened often when we need to go for the truth and we can find after
five years hard work that we have done nothing good and we have to be ready to
change so be truthful I breathe use sociology are all those things that we
all need fabulous marlene that's a fabulous model we have tried also to
in to invite in our committees of health and development and and others to
invite as much as possible the researchers who came to present their
results but I think more has to be done you have to sit around the table and to
work from scratch to work together and I think we indeed we we can do better by
as Rafael was saying sometimes as researchers we we want to have the the
perfect results before we go out and communicate something we all want to have
our cities and other evidence at the very high level but I think we should not
let the perfect be the enemy of the good and as soon as we have results we have
to communicate them I'm not pleading for I mean they have to be correct and we
have to be allowed to say no we don't know but so on the other hand I think
also we have to make sure that all research trials everything that starts
is also properly reported on also the failures what didn't work because we
always publish and present what works but we keep quiet about everything we
try that doesn't work so I think that we can improve with the research and the
policy communities and something else I think we could do is to publish much
more on programmatic results I always try to convince people who are working in
programs in countries because they write sometimes they have great data then
they write nice reports but they should do one go one step further and also
publish it so then it's known for the otherwise it just it doesn't remain on
shelves anymore it's somewhere on the website but it's not highly visible
such as publication so there are ways to improve I think but the the model from
our colleague minister here is great we should we should try to follow that even
paid for publication one of my staff who published is got a performance based
financing for that yeah and it's so important because first of all they
are motivated to be to do the best thing
absolutely start a revolution here and ask the moderator a question panel
panelists agree let's I think this issue about sharing and learning from
experience but it's very hard to get something published when the findings
are no effect or lesser effect and I think this is a problem it's a problem
for lots of reasons but firstly it's very it's very underpowering because you
can't find an avenue for publication and publication is is not the beginning
nor the end so you have to always think about other avenues but the question is
if it doesn't get exposure it gets repeated and if it was something that's
not worth doing others need to know about it so why don't we have a journal
of negative findings no I think that's you know that that has been a scar on the
landscape of journals for decades I mean I think that's you know journals have
this bias to producing positive results and I mean we started about a decade
ago something we call protocol reviews where the scientists could submit a
protocol and they haven't got a clue what the answer is going to be and we
review that and judge that on the question not the result and then we
provisionally accept the protocol and when the result comes through we have a
bias to publish I mean if there's been some terrible flaw in the conduct of
the study you can't do it but but basically even if the result is and
even the words positive and negative are wrong actually that because it's still
new knowledge but even if the result is negative in quotation marks we'll still
publish it if they submit to that protocol surprisingly very few people
have taken up that opportunity of submitting a protocol it's very very
interesting actually and we've had editorials and put it on a website and
everything and it's a it's interesting the scientific community sometimes wants
to wait until they've got the results to decide where they want to go not
commit because of the sentence the New England Journal of Medicine first before
they send it to us so they I think there is a there's a cultural issue that
people are nervous about that but I want to come back on this point yeah we
should publish on Twitter that's a good idea I want to come back to this point
of the relationship between ethics and research that Agnes raised early because
we get sent around 10,000 papers a year for publication and we can only
publish a very small number and the truth is that you know if you were being
really harsh you wonder sometimes why some of that work has been done because
there's no clear objective purpose social goal and it's certainly true that we
see work where all of the authors are from Western countries when I'm talking
about in global health and there are no authors from the country where the work
has been done so there is a fundamental moral question about the way we do
research and Wendy first of all you must recognize that but second of all how
do we begin to address this problem in the research community oh go on Agnes
I have an idea refuse to to publish about the south what is not published with
people from the south I was so scared there are people who even work slightly
with us who have published on our non-communicable disease program one
Australian and one American and they were published and we read that that's
mean first of all it's stealing because it's our work yeah they became
celibate with our work that's mean it's a new way to be slaved intellectual
slavery so you should push all your colleague editor of other journal to
refuse that secondly when you have such a paper call the people who are running
the program and ask are you aware we have here some colleagues who have
post posters here without telling us I told them you will be blacklist in
Rwanda forever they have corrected they have put the people who are in but this
is a mentality we should stop it's another way to remain underdeveloped
because we are doing the work we are good and we will never emerge so I would
just add to that that journals that's a policy that journals could certainly
implement but also funders as well so you know every funding organization I
don't know what the policy of the Gates Foundation is but certainly whether it's
welcome trust or MRC or NIH all of these funders if the funders and the
journals are lined together in the way you're suggesting we could actually make
it a really big impact couldn't we on this question certainly and we have a
very good policy in Rwanda it's illegal to do research in Rwanda without a co-PI
Rwandan okay I can feel that there's a message coming out of this meeting here
just to support Richard I was going to say publications only is not enough
because what is done is that just for the sake of having a mixed group of
public of people who are publishing then we add some Kenyan or Rwandan names
that is not enough where are the centers or the big trials that are led by
people and groups in the community the PIs are very often north and then they
take on board for the publication in the best case some local names right local
contributors but that's not enough they should I think funding agency there is
enough capacity in the south since more than years decades we are talking about
capacity building at universities and so on so they can take the lead they are
ready for that and we should be in the second line I think and not always the
other way around absolutely when I say co-PI when I say a co-PI it's really
co-PI because if we discovered that there was just a name and a ghost
researcher then we shoot the Rwandan and the north one down because and also for
each research and each publication we need to know what is the skills leave
behind excellent Wendy and then Rafael I love the thought that we got some very
practical things coming out of this I mean codes of conduct are all very well
but people don't necessarily follow them but I agree I think it's an issue for
funders and for the and for the journals as well but but you could argue that in
the same ways when you apply for ethical approval if that committee looks to see
the configuration of the team they can deny research for example and that will
be another practical way to trip through the ethical committees they're in the
same way as they need to think about whether community advisory boards have
been set up is the community engaged in understanding what's being proposed here
in the same way this issue but I think the question is it's not it shouldn't be
seen as a punishment I regard it as a huge privilege to work alongside
colleagues from which I never stop learning we have some work doctor at
Nath who get a chew in the audience from Ethiopia WHO Ethiopia I learned so much
from working with them and many other people in the audience so I don't I
don't think I think there are mechanisms that cause this and you're
quite right there's some very bad practice at one end but I think there's
also there's also issues of not needing to create a false wish I'm sure most
people in this audience believe deeply that we have to work in a particular way
the question is it's the poor it's a few that spoil the party as it were Rafael
to two reactions first okay it's not the only a way of perpetuating the
Eslereans is also the typical colonial in the approach it is I want to know more
about you another topic that I want to take here is the language I don't know
how many languages we have in the world but for science only one mainly two but
I I can't tell you I want to tell you monolinguism can cure we need to speak
at least two languages only one and science only we can communicate in one so
that's another another problem that we need to take carefully because we have
an obstacle for a lot of scientists that don't speak English and there are
many or the way that we communicate from I don't like the idea of southern or we
are not talking about geography we are talking about people so I prefer to say
countries in X or Y area but in that in that in that in that case I think we need
to expand we need to expand and W chose sometimes make this effort to translate
but just abstract we need to expand because even Spanish journals are
published in English because why because they need to get more points in the
market because science is driving the market so I think also we have to protect
and ask Lancet why don't you start publishing and other languages why only
in English I know that you started in England you started in last century two
centuries ago but you you are making a lot of difference you accepted the paper
with one page of authors you accepted an issue with only one story why don't you
start also challenging with a different language thank you very good very good
so I think what we've got coming out of this we need to draft a code of
conduct I think that could be a very positive result coming out of this
meeting here in Arusha and I hope the four of you could be leaders in putting
that together now what I want to do is now I want to go back to the audience
now there are microphones every two or three rows of seats or so please get a
microphone please stand up and say who you are where you're from and ask your
question I hope you can all see the microphones and I will go straight to
that gentleman with the red shirt I think yes go on stand up it looks vaguely
red oh it's a tie very good microphone you have to have a microphone don't
stand up if you don't have a microphone good morning thank you my name is Jorge
Hermida and I come from Ecuador South America I've enjoyed very much listening
to the panel of researchers and policymakers I'd like to argue that at
least in the region where I work even though research and policymaking is
important I would think that it's not the most important aspects of changing the
healthcare situation for modern and newborns in my view the most important
aspect would be and the most difficult one would be putting the policies into
action make the policies really a reality beyond being written in paper
most countries have enough research to change the healthcare situation and
beautiful policies written in constitutions and official declarations
of governance still there's very little that translates into reality into action
but in this panel we haven't had the representation of implementers thank you
don't worry there's implementers right throughout the conference so please here
I'm called Hanifa from Uganda working with saving newborn lives for me I think
sometimes the researchers do not talk to the policymakers who actually do the
budgeting and awarding of the money for example if you come to my country and say
that in Uganda you lose 435 out of 1000 life but I mean as a politician I'll not
take it if you'd rather tell me that every day you lose 16 mothers I mean it
helps me to understand and then I can be able to implement my other
contribution is about the issue of dissociating the mother with something
inside her uterus if you do programs or research and you just talk about the
mother without her baby for sure you are increasing the risk because the moment
you talk about for example quality of care for the mother if you do not provide
quality of care for the baby I'll become pregnant today tomorrow and yesterday
and the risk that is related to pregnancy will increase so the issue of never to
dissociate the mother with her newborn is very critical otherwise you'd be
talking about any woman who is not maternal maternal is about the mother and
her newborn thank you thank you very much indeed for that gentlemen yes please
I think I'm going to do an exception to the room because everyone is an
anglophone I think we're going to be in the region of the Francophones from time to time
I'm called Dr. Demba Trauret so I come from Mali and I have a
Fistul project to extend an international effort I joined the Rwanda
there are two aspects because for me the mother's health is the result of the
population who contributed to the achievement there is a gap between the
research and the participation of the information even at the level of the
political men because very few know that there is such scientific evidence and
that it has improved the state of health of such a community so as long as this
is true and there the political men in any case the political decision makers are
meant to make decisions to improve the state of health of the population so
not enough information so that they can make the decisions that they need I think
that's an aspect that we should already look for in other countries to find a
means of communication between the politicians and the men and the men of
science there is another gap in regard research as it was mentioned so all the
researchers made they are made where they are published in the north whereas
the results that we are looking for are for the south how can we just resolve
resolve this kind of aspect I think we still need some preoccupation as regards
we still have concerns as regard maternal health
because they raise really important issues about both publication but also
about issues around maternal health and the philosophy around maternal health so
let me start perhaps with Agnes thank you so translate policy to actions this is
also science there is something that people like Richard still denied but
there is what me I call since four years now implementation science is is is
joining okay so that's mean we wanted to put that in but it's okay so
implementation science is answer to your question because if you implement you
have to measure the result of what you do it go to Gabrielle and this is
monitoring and evaluation we need to take it as a science give it so it will
answer your question and it involves also the people that are beneficiary the
second thing maternal health it's of course the the furtus the embryo and the
furtus and the neonates is concerned but the the problem we have in maternal
health is that for the time being many countries are focused on the woman because
she had other children she if she died there is more problem that if we lost the
newborn unfortunately but now that maternal health is improving look the
number of country that are turning to neonatology you see so we are getting
there we cannot solve everything because it's other equipment other knowledge a
newborn is not like you and me it's another physiology another another skills
but you are getting there and if you see the number of country who have already
done so big progress in neonatology it's we can have hope now for dr.
trauret it's correct you have to translate the results in language that
everyone can understand as well as the community that the politicians but it
already exists and I think that if all all the communities say this and this is
something we can spread out we no longer want policies that are not based on
the evidence it would work you will have your answer and that I think that the
politicians many have not yet thought but when they will live that they will
be first very reassured because even if it doesn't work they will say you know
it's not me there were some evidences we missed something so I think it's
just enough to go in this direction and the code of conduct should state all
article about ronda should be translated in at least another official language you
can take French you can take Kenya Rwanda but if they're published it should
be also in another language where the majority of the people understand so
this can be in the code of conduct the second thing to make a result available
open free access after publication one of the first article I publish myself I
discover it was in care and aid something like that that I have to pay to
read it after and I was so shocked because it was enthusiasm publication now
I'm very careful if it's not an open access at least for my people I don't go
there I have to say Lancet have make a step in that direction all the Lancet
is free for Rwanda at least fight for it when you are here Mali and get it
also now we're unfortunately pressed for time we have to finish at one but just
very brief comments not to all three of those questions but please choose one of
those that you can offer a brief comment to Marlene so do you want to go back to
the audience one more time just a very brief one to give an example how it can
work is the Kesho Bora study that was done in four or five African countries
looking and and to the question can HIV infected mother continue breastfeeding
without increasing the risk of transmission and continuing ARVs
antiretroviral medication so that study was done very well the results were
published in the Lancet and others were translated by WHO into guidelines so
the guidelines for breastfeeding and HIV were adopted and then recently the
researchers took this results to the Kenyan Parliament to Boongay house and
they contacted the committee and the Ministry of Health and the chair of the
Commission and it was used to reshape a bill on breastfeeding and and and bottle
feeding in Kenya so that makes the circle going around of course we still
have to follow whether now more women are indeed breastfeeding and less
children are infected and so on but this is a good example how it can work if
from the very beginning policy makers are involved in the research and vice
versa okay thank you I mean we definitely evidence of action and of
action I think that's the issue we're talking a lot about evidence to inform
action but we need this issue we need to know whether something changed and I
think that's a weakness in our in our evidence spaces so evidence of action
what changed if you think about maternal death reviews which are happening in so
many places but you just look at these reviews and the question is what happened
as a consequence of that and that I think speaks to this implementation
research however I think implementation research presents presents its own
challenges and I think what I'd like to put to the audience is I think we need a
learning movement a learning movement because the sort of materials that you
get out of implementation research are not necessarily suitable for
publication they need we need other frameworks other opportunities for
learning these lessons from implementation research and we need
evidence spaces that organize it by context because here it comes my three
favorite words context context context we've got big issues about general
izability we need a science of context to describe the context better so these
lessons from programs can be shared because we understand the context in
which they were learned but we need a learning move but we need to go beyond
journals we need to organize our evidence basically and we need to support
the next generation to do good implementation science very good well
I have one example very easy to show the politics into action and is a health
reform in Mexico it is we transform the Constitution we create a new right for
the for the population but this didn't come from the night to the day we spent
a lot of time in the National Institute of Public Health creating all the
knowledge behind and also there is another situation we didn't go in the
voluntarism we went in the direction of really try to find the change with the
activism however one of the problems is this is not enough we need
implementers every way and one of the reason that is failing the reform and
sorry to be very honest with all of you is because there are no connection with
the brains and the low level of the of the implementation of the of the
politics and we need to take care about all the process and this take a lot of
time the the most important instrument that you have you activities is
accountability the only way that you can ask why you propose that and what you
are not accomplished why you are using the money and you are not delivering an
accountable results to us okay let me go back to the audience please this
gentleman here and then I'm looking for and then that lady back there yeah yeah
my name is Abhijit from Center for Health and Social Justice in India and I'd
like to first thank the panel for sort of bringing up very interesting and
thought-provoking points but I'd like to also add a party that is not present and
that is when we are talking about panel of activism social movement and science
and I'm reminded of a statement by my friend Anand Grover who special report
your right to health who came to our maternal health meeting and said where
is the community so the question I ask is where is the community we are assuming
that politicians and policymakers will do activism impossible for us in
maternal health we are doing on behalf of ism with the affected community for
too long the second question that I want to ask around science and evidence is
activism is all about understanding power and hierarchies who does science
serve what are the hierarchies that are implicit in when we are talking of
knowledge-making science itself says that you know evidence and science
precludes a lot of the qualitative material precludes experience as being
valid and I tell you this from passion from my own work in India we are not
willing to acknowledge things are not working along the way that we think
they should and the way we have predicted it would work and at that point
unfortunately the activist does not find the formal scientist the scientist who
publishes in papers as a necessary ally so we activists have to go back to
evidence try to find our own evidence to find sometimes fight policy-making
which has been made in a vacuum policy-making which has been sometimes
not contextual so my plea to the scientist is if you want to become allies
of the activist you have to also find new friends and perhaps the donors will
also have to look for new places in which to make their investments
very good thank you very much okay or can we get a microphone to the back don't
worry it'll find you can we get that microphone to her back thank you don't
worry it's coming to you it's coming to you you're on hello okay I'm Belinda
from the University of Malawi in Malawi thank you so much for your comments my
comment will go to Agnes the Minister of Health in Rwanda maybe it's a comment
or maybe it's also food for thought what I've seen or observed is most of the
maternal health research which is being done in the south indeed maybe doesn't
have a bearing on what we want clear straightforward and we clapped hands for
that but my question is who approves such research isn't it us the research is in
here the politicians in here maybe it's high time would stand up and say no I
think for our country we don't want to this whether there is money attached to
it benefits attached to it I think it's high time for all of us in the south to
be able to say no thank you so much and then they go and then we choose what we
want thank you so very good I'm looking for I'm looking for another because I'm
going for gender equity here I'm looking for a woman there's a woman I think back
there who's been waving at me with a white a white something yes go on find
the microphone come down the microphone will find you hello my name is
Veronica Philippe I work at the London School of Aeternal Tropical Medicine and
I'm a researcher and I have a comment or maybe a food for thought as was said
earlier for the panel and it's about the independence of researchers because I've
been a bit worried about some comment that were made earlier I value the
independence of researchers I think it's extremely important sometimes the
findings we do are not comfortable for the policymakers and we cannot always
have policymakers on our team when we evaluate programs so I would like some
feedback on this from the panel okay we really have got so little time so I'm
going to very quickly go back to the panel about where's the community
researchers need to say no what about independence Wendy very quickly I take
one of those I think where's the community I think one of the things we've
not addressed in this panel is this question of the relationship between
science and activism around quality of care I would like to think I mean I think
the question is is there more tension in quality of care between science and
activism I think it's a great opportunity because you need voice if
you're going to really tackle quality of care and that's where the voice that's
what the activists can help us with so I'd like to see there's an opportunity as
we move forward with the quality care agenda to marry science and activism I
think in terms of the independence of researchers which very unique was
commenting on absolutely but I think this is the same way as managing conflict
of interest it has to be acknowledged and managed okay I think knowledge and
evidence is indeed essential but it is not sufficient and it can only move
forward if we build action and advocacy around it and so advocacy and contact
with the community is essential to move the agenda forward reaction to what
we're on exit absolutely policymakers have to be involved in the discussion
but that doesn't mean that they have to steer the research research has also to
be independent and applied and responsible to communities Agnes where is
the community I think the answer has been given the fact that the activists if
I want to recall the fight against HIV AIDS community will never had drugs
Africa will never had them without the activists around the globe around the
globe but why you got the movement is because you had scientific data that
it may keep people alive so scientists are your ally not your enemy guys just use
them properly now independence of research keep it but just do good research
when you are not independent is very dangerous that's totalitarianism don't
forget that are people who have proved that woman like me doesn't have a brain
like you huh with using science so just do good science a good research and
remain independent for all the others I like somebody who say in God I trust but
all the others bring me data I just want to add that independence is not only for
policymakers also is for donors sometimes donors drive the agenda of
researchers and that is improper we need to be independent wherever we are
unless we are not doing research we are doing something else so the
implications of what we do is probably the first step when we are trying to
produce our results okay let me make a few closing remarks if I may because
time is gone and if we go on then you won't be going home till nine o'clock
tonight this session had the phrase social movement in it and we've managed
to avoid answering the question what is the social movement a social movement
is you you are that social movement it's nothing more than a network of
organizations and individuals dedicated to a particular cause and science and
the scientific community is an indispensable part of any social movement
in reproductive maternal newborn and child health we're here talking about
maternal health so you are critical critical part of that movement so let
me make a proposal for this meeting could we use the occasion of this meeting
yes to write a code of conduct which would be a fantastic outcome but also
given what I said at the beginning about the approaching uncertainty that we are
facing with regards to the future of maternal health post 2015 could we write
a manifesto for all maternal health coming out of this meeting including I
hope the broader determinants of maternal health that lie within women's
health and also I do agree with colleague from Uganda the issue of
newborn health as well the well-being of the mother depends upon having a
healthy newborn child and the life of the newborn certainly depends upon a
healthy mother such a manifesto needs to be short it needs to be sharp it needs
to be powerful and to the point we might aim to publish it in or on every single
forum that we have within our power no copyright globally available covering
every medium that we can think of answering some quick key questions what
have we achieved in the past recent years what still needs to be done what
opportunities lie ahead for us and what are the costs of inaction if we did
write this manifesto over the next three days we should make sure that it
reaches the final health thematic consultation taking place for the SDGs
in Botswana on March the 5th and 6th over the next 12 months we have to renew
our pledge to ensure that the evidence and experience and knowledge that you
all create and report protects the gains for women but also accelerates
successes for their future and the results of this meeting and as this
panel has so ably shown can do just that so please let's write that manifesto
for maternal health thank you and please thank the panel
I'm manifesto of housekeeping please before we adjourn please lunch is now
served you have one hour for lunch reminder that we are 30 minutes behind
in our program today that means lunch is from one to two the next parallel
session begins from two ends at 3 30 there'll be a refreshment break from 3
30 to 4 the last parallel session of the day begins at 4 and ends at 5 30 at 30
minutes to every session today all the
