Date Published: November 25, 2008
Publisher: Public Library of Science
Author(s): Robert G. Ridley, Peter Ndumbe, Rolf Korte, Gavin Yamey
Partial Text: TDR recently published an historical review of three decades of the organization’s activities since its establishment as the Special Programme for Research and Training in Tropical Diseases in 1978 . There have been four external reviews of TDR during this time, each followed by reorganization, institutional-fine-tuning, and adaptation to changing circumstances in the world of science and research. Independent external review has thus been integral to TDR, supporting its mission as a steward in forwarding public research interests, most particularly research on infectious diseases affecting the world’s poorest and most disadvantaged populations.
The Fourth External Review called for an increased emphasis on “needy populations” as compared to “neglected diseases” and a move towards a more trans-disciplinary view of health, defined by social as well as biomedical determinants. The new TDR vision statement (Box 1) reflects this recommendation. In practice, TDR is now less driven by the concept of a disease portfolio and more driven by infectious disease–related research needs and TDR’s comparative advantage to address those needs.
The process of TDR’s strategy revision was dependent on its governance structure. This is depicted in Figure 2. TDR is governed by a Joint Coordinating Board (JCB) consisting of representatives of 30 national governments, equally divided between developed and developing countries, plus its four co-sponsoring agencies, the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank, and WHO. Its meetings are open to a wide range of observers that are identified as TDR cooperating parties and include representatives of additional national governments and representatives of academic and non-governmental institutions. TDR operates under the legal auspices of WHO as its executing agency. WHO is represented on the JCB through a special programme coordinator, normally an Assistant Director General to whom the Director of TDR reports. Two other significant bodies are (i) the Scientific and Technical Advisory Committee (STAC), which meets once a year to technically review the Programme and both advises the Director and reports to the JCB; (ii) the Standing Committee of the Joint Coordinating Board, which meets several times a year to monitor strategic and managerial issues in between the annual JCB meetings. The chairs of JCB and STAC also attend this committee meeting together with a JCB representative from both developed and developing countries.
The first of the Fourth External Review’s recommendations refers to the need for “ALL stakeholders to support TDR to evolve and grow to a renewed mandate that addresses the very neglected diseases and the health needs of the most needy populations”.
TDR faced some serious issues at the time of the Fourth External Review and has responded to these through its new strategy and business plan. However, it is worth taking a deeper look at the extraordinary changes that were happening in global health research between 1999 and 2005 and the pressures these were placing on TDR. Perhaps the biggest single area of change was in the area of product development.