“Clinical research in a developing country like South Africa contributes to health care at all levels by identifying the causes of problems, facilitating diagnosis, improving the efficiency and effectiveness of care, and promoting good policy-making,” says the report. “It also supports the training of competent health professionals of all kinds, and contributes to global knowledge about locally, as well as generally, prevalent diseases in terms of prevention and treatment.”

The report goes on to say that South African clinical research is in dire need of revitalisation. “There is little likelihood that continuation of the present situation is compatible with rebuilding and sustaining solid research capacity in the clinical domain, nor can the ideal of well-coordinated state support for a health system, built on the ‘intelligence’ of good clinical research, ever be realised.” The report suggests that government should consider investing more resources in clinical research, as more than half of the funding currently comes from the private sector.

While the report recommends a number of government-level strategies, requiring commitment and partnership, for the improvement of South African clinical research, it also makes many suggestions for health science faculties and the pharmaceutical industry. The report laments the failure thus far to include clinical medicine in the key ‘stimulus packages’ introduced by the government for most other disciplines, in the form of research chairs, centres of excellence, major equipment , and a ‘PhD-driven system’.

The report also says that there must be a closely cooperative and mutually trusting relationship between researchers and health policy-makers, funders and other implementers. Efforts should also be targeted at building and maintaining indigenous research capacity in the country, based on a ‘national culture’ with key features such as research-led leadership in health care systems, recognition of both the organisational and intellectual complexity of clinical studies and the great value of patient-based investigations, a balance between basic and applied clinical studies, an emphasis on public service and benefit, and the enhancement of new intellectual property development. Overall, better strategic planning and coordination of health research is required, for which specific proposals are made.

The full report is available on www.assaf.org.za.