The Health Knowledge Gap – and how to fill it

There is a knowledge gap in health. A big one. And this gap is what prevents our knowledge about disease and how to treat it from achieving its potential impact on health burdens. Let’s take an example. Tuberculosis. This bacterial scourge has been destroying lives for centuries and has now won the dubious accolade of number one killer in South Africa[1] – quite a feat in such a multi-burdened nation. Globally, 8.6 million people got TB last year, and 1.3 million died (25% of these deaths can be blamed on HIV).[2]

We have known about the bacterium and how it causes illness since Nobel Laureate Robert Koch’s history-making lecture[3] in 1882, in which he demonstrated a staining technique that made the organism visible for the first time. Effective drugs have been available since the 1940s – the first discovery was streptomycin, then a sleuth of new discoveries through the 1950s and 60s led to the combination regimens still used today.[4] So if both disease knowledge and treatments are available, why is TB still a global emergency? That is the health knowledge gap. We simply do not know how to use our health knowledge to achieve the maximum benefits of medical innovations.

The health knowledge gap is about health systems. And health care delivery. How to organise the infrastructure, human resources and operational aspects of health services so that sick people can reap the full benefits of available treatments, and that healthy people can benefit from our knowledge of diseases to avoid them. There are lots of examples of what works and what does not, but systems are not studied in the same systematic way that diseases and medicines are. As a result, there is very little evidence – in the scientific meaning of the word – to help governments decide how to organise and reform their health systems to improve the health of their populations.

Strengthening Health Systems has been set up with the aim of addressing this knowledge gap. By helping to capture the knowledge that exists in the minds of practitioners and documenting it so that others can learn; by forging links between academics, policy makers and implementers to ensure that research targets policy and implementation-relevant questions; and by creating a strong, relevant evidence base that policy makers, programme designers and funding organisations can draw on to make better, more informed decisions. We hope you will join us in supporting this cause.

Further reading: Kikaya H. Can there really be a ‘science’ of health systems? Strengthen Health Sys 2014; 1(1): 3 SHS EDITORIAL




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