. "6 Institutional Arrangements for Research and Development." Control of Cardiovascular Diseases in Developing Countries: Research, Development, and Institutional Strengthening. Washington, DC: The National Academies Press, 1998.
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Streptokinase and t-PA (tissue plasminogen activator) for Occluded Coronary Arteries (GUSTO), among others.
Research on CVD has gradually expanded through the International Ten-Day Seminars on the Epidemiology and Prevention of CVD, sponsored by the ISFC with participation from WHO; U.S. and other national programs; and other short courses. The submission of nearly 1,500 scientific abstracts for the fourth ICPC in Montreal demonstrates the growth in CVD research. Several developing countries now have a critical mass of qualified health professionals to meet the challenges of the global CVD epidemic. In many others, however, the trained scientists and infrastructure are too few to address already urgent tasks.
It has become increasingly important to consider the organizational arrangements under which CVD prevention and control around the world can best be facilitated. This chapter outlines the need for appropriate institutional arrangements and identifies the functional requirements for achieving global CVD prevention and control. Based on these considerations and examples of successful models, the chapter concludes by proposing an immediate and long-term answer to the question, How can global R&D for cardiovascular health best be institutionalized?
Formal institutional arrangements for R&D in cardiovascular health are important for three reasons:
Many organizations and programs are engaged in activities relevant to CVD prevention and control. The impact of their work can be enhanced, and duplication avoided by effective exchange of information on CVD activities.
Activities in new and existing programs can be strengthened through a central agency that provides communication, coordination, and technical and material support.
A widely recognized central agency is needed to advocate for CVD prevention, to set R&D priorities, and to acquire and allocate resources to meet R&D priorities.
EFFECTIVE RESEARCH AND DEVELOPMENT AT LOCAL OR NATIONAL, REGIONAL, AND GLOBAL LEVELS
The immediate goal for cardiovascular R&D is to enhance local capacity through education and training; development of networks where appropriate; and conduct of local research that is comparable with other centers and applicable internationally. For activities in CVD prevention and control to be successful, it is essential that nonhealth sectors—for example, education, agriculture, industry, and environment—are also included in development of the program. Potential partnerships should be identified and integrated into the action plan.