Research can be promoted and, to a certain extent, directed and coordinated by a variety of means, including scientific and technological competition, intellectual stimulation and financial incentives. Coordinating mechanisms vary in nature: medical or health research councils, scientific research councils, publicly or privately funded national institutes, and international research groups can all contribute to shaping priorities and stimulating research. Also, a move towards integration with health system research is gaining ground and should be viewed as an opportunity to maximize impact.
A variety of tools have been developed for operational research on various components of a national drug policy. Examples are standardized indicators for monitoring national policies, standardized indicators and sampling methods for measuring rational drug use in health facilities and in the community.57,58 Many of these can be adapted for use in different settings. The standard indicators and sampling methods have created a standardized measure for change, and also make comparisons possible between various countries or regions.
Multi-country collaborative research projects can also be a useful approach. Working together, countries can share expertise, compare results and develop common strategies to solve shared problems.
Drug research and development
This is a highly complex area and strategies will vary greatly, depending on a country’s level of economic development and its research capacity. Development of a drug is extremely costly, and is mostly done by the pharmaceutical industry.
In most low-income countries it is neither feasible nor cost-effective to carry out drug research and development. However, the national drug policy can also cover areas such as clinical trials and the rights of individuals participating in trials. In any country, clinical trials should be undertaken only when they are necessary and when there are appropriate facilities and regulations to protect participants. They should be organized on the basis of scientific criteria and in accordance with good clinical practice, and be approved by the competent national authority. There is growing awareness that it is unethical to undertake clinical trials in developing drugs that the participants will never be able to afford to continue taking after the trial has ended.53-55
In middle-income countries it may be important to develop priorities for research and development that are supportive of the drug policy’s goals. For instance, research and development to support generic manufacturing could be considered to be a priority in some countries. In industrialized countries it may be a priority to stimulate research and development in areas of importance to public health, such as developing new drugs for infectious diseases affecting poor populations. It is important to maintain good collaboration and communication between industry and academia while maintaining the independence of academic research.