Summary
Clearly, the most important priorities for medical research are development of more effective health delivery strategies for developing countries and control of the common and intractable communicable diseases. In this context, the argument has been that much of the medical research that has been carried out in industrial countries, with its focus on noncommunicable disease and its outcomes in high-technology practice, is completely irrelevant to the needs of developing countries. This view of the medical scene, however, is short term. Although some redistribution of effort is required, every country that passes through the epidemiological transition is now encountering the major killers of industrial countries. Learning more about those killers' basic causes, prevention, and management is crucial. Although the initial costs of providing the benefits of this research are often extremely high, they tend to fall as particular forms of treatment become more widely applied. Hence, because we cannot completely rely on our current preventive measures to control these diseases, medical research must continue.
Research in basic human biology and the biomedical sciences is entering the most exciting phase of its development. However, it is difficult to anticipate when the gains of this explosion in scientific knowledge will become available for the prevention and treatment of the major killers of mankind. Thus, medical research must strike a balance between the well-tried approaches of epidemiology, public health, and clinical investigation at the bedside with the application of discoveries in the completely new fields of science that have arisen from the genome revolution.
If this balanced approach toward the future provision of health care is not to continue to worsen the gap between North and South, however, a complete change of attitude is necessary toward health care research and practice on the part of the industrial countries. A major effort will be required to educate all parties—international nongovernmental organizations, governments, universities, and the private sector—in global health problems (Weatherall 2003). Equally important will be a major change of emphasis in the universities of industrial countries toward education programs in science and medicine to provide medical scientists of the future with a more global perspective of health and disease. If this transformation can be achieved—if it can form the basis for the establishment of networks for sustainable research programs between universities and related bodies in the North and South—much progress will be made toward distributing the benefits of biomedical research and good practice among the populations of the world. However, the great potential of advances in the biomedical sciences for global health will not come to full fruition without much closer interaction between the fields of basic and clinical research and the fields of public health, health economics, and the social sciences.
