Glossary
Classification of countries by income level
Essential national health research
Health policy and systems research
Low- and middle-income countries
National health research system
Research capacity development/strengthening
"10/90 gap"
In 1990, the Commission on Health Research for Development estimated that only about 5% of the world's resources for health research (which totaled US$ 30 billion in 1986) were being applied to the health problems of low and middle-income countries, where 93% of the world's burden of "preventable mortality" occurred. Some years later, the term"10/90 gap" was coined to capture this major imbalance between the magnitude of the problem and the resources devoted to addressing it. While not representing a current quantitative measure, the "10/90 gap" has become a symbol of the continuing mismatch between needs and investments.
Applied research
Translates the knowledge emanating from basic research into the creation of products, processes or services.
Basic research
Leads to understanding of the nature of diseases, processes and conditions.
Burden of disease
An indicator that quantifies the loss of healthy life from a disease, injury or condition.
Classification of countries by income level
For operational and analytical purposes, the World Bank’s main criterion for classifying economies is gross national income (GNI) per capita. It classifies all World Bank member countries (185) and all other economies with populations of more than 30 000 (209 total). Classification by income does not necessarily reflect development status. In the tables below, economies are divided according to 2007 GNI per capita. The groups are:
- low income, US$935 or less;
- lower middle income, US$936 - US$3705;
- upper middle income, US$3706 - US$11 455;
- high income, US$11 456 or more.
Condition
The term condition has a number of meanings in a biomedical or social context, including the following:
- An unhealthy state, such as in "this is a progressive condition."
- A state of fitness, such as "getting into condition."
Cost-effectiveness (of a health intervention)
Analysis of the net gain in health or reduction in disease burden resulting from a health intervention in relation to the cost of that intervention. Cost-effectiveness analysis helps identify interventions that are likely to produce the greatest average improvements in health status for the available resources (as distinct from, e.g., those interventions that may produce the greatest improvement in health equity, where targeting the least advantaged may be more expensive).
DALY (Disability-adjusted life year)
An indicator developed for the calculation of disease burden which quantifies, in a single indicator, time lost due to premature death with time lived with a disability. The DALY indicator has attracted criticism as a measure that incorporates inequitable assumptions about the relative value of life to people in different circumstances. Other measures such as QALY and HEALY have also been used.
Determinants of health
Factors that have positive or negative impact on health, including: employment, nutrition, transport, water and sanitation, environmental resources, eco-systems, legal protection of rights, governance, systems and economic equity and growth.
Disease
A disordered or incorrectly functioning organ, part, structure or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.
(Source: Dictionary.com)
Double burden of disease
The "epidemic" of noncommunicable diseases being experienced by low- and middle-income countries in tandem with the continuing problem of infectious diseases, malnutrition and maternal mortality.
Equality
Equality means that all people enjoy equal status in society and equally realize their full human rights and potential to contribute to national, political, economic, social, personal and cultural development, and to benefit equally from them.
(Adapted from M.A. Burke in Health Canada's Policy on Gender-based Analysis, Health Canada, Ottawa, 2000)
Equity
Equity is the process of being fair to all people, respectful of differences and free from discrimination. Equity means social justice or fairness; it is an ethical concept, grounded in principles of distributive justice and is consonant with and closely related to human rights principles.
(Adapted from M.A. Burke in Health Canada's Policy on Gender-based Analysis, Health Canada, Ottawa, 2000)
Essential national health research (ENHR)
The core of an essential national health research (ENHR) strategy is to promote research on country-specific problems that could underpin national and community decisions on health policy and management. It involves researchers, decision-makers and community representatives, who jointly choose the priorities to be addressed. It is aimed at improving the effective use of existing knowledge and technologies. Country-specific research may have limited transferability to other countries or situations, but it guides the wise use of internal resources and strengthens national sovereignty. It places a country in a much stronger position to judge and, if necessary, seek adjustments to external development assistance. Furthermore, it gives each developing country an informed voice in establishing priorities for research on the global scientific agenda.
(Source: Commission on Health Research for Development 1990)
Evidence
Knowledge obtained by measurement, observation or research, helpful in reaching a conclusion, proving a fact or making a decision.
Health
A state of complete physical, mental and social well-being and not merely the absence of disease.
(World Health Organization)
Health equity
Health equity is the absence of disparities in health (and in its key social determinants) that are systematically associated with social advantage/disadvantage. Health inequities systematically put populations who are already socially disadvantaged (for example, by virtue of being poor, female, disabled or members of a disenfranchised racial, ethnic or religious group) at further disadvantage with respect to their health. Equity in health means equal opportunity to be healthy, for all population groups. Equity in health thus implies distributive justice — that resources are distributed and processes are designed in ways most likely to move towards equalizing the health outcomes of disadvantaged social groups with the outcomes of their more advantaged counterparts. To this end, health equity calls for the (re)distribution and (re)design not only of health care resources and programmes, but of all resources, policies and programmes that play an important part in shaping health, many of which are outside the immediate control of the health sector.
(Adapted from: P Braveman, S Gruskin. "Defining equity in health". J. Epidemiol. Community Health 2003;57;254-258)
Health policy
A formal statement or procedure within institutions (notably government) which defines priorities and the parameters for action in response to health needs, available resources and other political pressures.
(Source: World Health Organization)
Health policy and systems research (HPSR)
The production and application of knowledge to improve how societies organize themselves in order to achieve health goals. It encompasses how societies plan, manage and finance health services as well as investigation of the role and interests of different actors in the health system.
Health research
Research that creates new knowledge and technologies to more effectively protect and promote health and reduce disease. Health research plays a major role in improving health and health equity and can contribute to equity and the fight against poverty by promoting development and growth.
Health sector
The health sector consists of organized public and private health services (including health promotion, disease prevention, diagnostic, treatment and care services), the policies and activities of health departments and ministries, health-related nongovernmental organizations and community groups and professional associations.
(Source: World Health Organization)
Health system
Consists of all actors, institutions and resources that undertake health activities whose primary purpose is to promote, restore or maintain health as a state of complete physical, mental and social well-being.
(Source: World Health Organization)
HEALY (Healthy life years)
An indicator that measures the number of remaining years that a person of a certain age is still supposed to live without disability.
(Source: European Commission)
High-income country
See "Classification of countries by income level".
Incidence
The number of new cases of a given disease diagnosed during a given period in a given population.
Innovation
The creation, development and implementation of a new product, process or service, with the aim of improving efficiency, effectiveness or competitive advantage. Innovation may apply to products, services, manufacturing processes, managerial processes or the design of an organization.
Innovation for health
Innovations in technology (such as drugs, vaccines and diagnostics), environment, economy, society and policy that improve health and health equity.
Low- and middle-income countries
See "Classification of countries by income level".
National health research system
System that enables governments, health-care providers, communities, media and others to obtain the type of information needed for health and health system improvements – and that is not available elsewhere. The national health research system is a structured approach to collecting relevant evidence as a basis for decisions.
(Source: Council on Health Research for Development)
Neglected diseases
Diseases that affect large but poor populations and for which effective, affordable or easy to use medical treatments are limited and not commensurate with the disease burden. They can be classified into 3 types: type I: incident in both rich and poor countries, with large numbers of vulnerable populations in each; type II: incident in rich and poor countries but with a substantial proportion of the cases in poor countries; type III: overwhelmingly or exclusively incident in developing countries.
Operational research
Research on factors affecting functioning of programmes, effectiveness of targeting, impact on behaviour, disease burdens and public health.
(Source: European Perspectives on Global Health, A Policy Glossary, European Foundation Centre)
Orphan drug and disease
The term orphan drug refers to a pharmaceutical agent that has been developed specifically to treat a rare medical condition, the condition itself being referred to as an orphan disease. The assignment of orphan status to a disease and to any drugs developed to treat it is a matter of public policy in many countries, and has resulted in medical breakthroughs that would not have otherwise been achieved due to the economics of drug research and development. In the United States, the Orphan Drug Act of January 1983 defines an orphan disease as one that affects less than 200 000 individuals. The European Union (EU) has enacted similar legislation, in which pharmaceuticals developed to treat rare diseases are referred to as "orphan medicinal products." The EU's definition of an orphan condition is broader than that of the United States, in that it also covers some tropical diseases that are primarily found in low- and middle-income countries. Orphan drug legislation also exists in Australia and Japan.
(Adapted from: www.medterms.com)
Policy-makers
Decision-makers in governments and international agencies who have the power to determine or directly influence policies at local, national or global levels. Policies relevant to health include those on a wide range of issues such as trade, science and technology, transport, the environment, intellectual property, law, human rights, aid and the financing of development.
Principal Investigator
The Principal Investigator (PI) is the lead researcher on a research team/research proposal. They may not actually conduct the research, but they would supervise the research team and are responsible for reporting back to their funders.
Priority setting in research
A process by which health problems are identified and ranked, research topics selected and/or research resources allocated. Key components that influence the outcomes of priority setting include the selection of stakeholders who take part; the types of evidence considered and sorting tools adopted; and the context and values applied when options are considered.
Promotion of health equity
Promotion of equity requires ensuring that all people, regardless of ability, ethnicity, gender, location, race or social standing, have adequate protection against the factors that cause ill-health; have access to knowledge, products and services that will enable them to reduce risk factors and obtain advice and treatment; and are not prevented by lack of resources or by other obstacles from utilizing what is available to achieve and maintain good health and optimal self-development.
QALY (Quality-adjusted life years)
A measure that combines mortality and quality of life gains (outcome of a treatment measured as the number of years of life saved, adjusted for quality).
(Source: World Bank)
Research
Scientific research involves performing a methodical (systematic and rigorous) study to investigate a phenomenon, prove a hypothesis, or to answer a specific question. In a general sense, research is the process of gathering data, information and facts and exploring cause-and-effect relationships to advance knowledge.
Research capacity development/strengthening
Process by which individuals, organizations, institutions and societies develop/strengthen abilities (individually and collectively) to perform research functions effectively, efficiently and in a sustainable manner to define and solve problems.
(Adapted from UNDP)
Research for health
Research that is undertaken in any discipline or combination of disciplines that seeks to:
- understand the impact on health of policies, programmes, processes, actions or events originating in any sector – including, but not limited to the health sector itself and encompassing biological, economic, environmental, political, social and other determinants of health;
- assist in developing interventions that will help prevent or mitigate that impact;
- contribute to the achievement of health equity and better health for all.
Research system
The entirety of institutions, networks, persons and resources that potentially could contribute to scientific research production.
(Source: UNESCO)
Resource flows
Funds invested in health research by public or private sources.
Social sciences and behavioural research (for health)
Research on social, political, economic, environmental determinants of health and their relation to equity, access, lifestyle and health-seeking behaviours.
(Source: European Perspectives on Global Health, A Policy Glossary, European Foundation Centre)
Stakeholder
A person or an organization that has a legitimate interest in a project or entity, or would be affected by a particular action or policy.