Phire – Public Health Innovation & Research in Europe

Establishing contacts and collaboration with National Public Health Associations

Getting involvement of the National Public Health Associations (NPHA) was a major objective for the project, along with obtaining the required information. In general, no National Public Health Association designated a responsible person for the project. Information was gained, however, from individuals within and outside National Public Health Associations (where there was not a NPHA) that collaborated with valuable contributions, thoughts and opinions.

The strategies used to overcome the objections and difficulties have already been presented on the Methods section.

National Public Health Associations members of EUPHA regretted the lack of clear information on financial support for the research, because most of the countries do not have the information on public health research commissioners and programmes/calls well organized.

DISCUSSION

From the 30 countries inquired we obtained information from 25 countries. Of these 16 reported at least one call or programme on public health research announced in 2010, while nine found no call or programmes opened. The number of calls or programmes analysed was 75. There was a median of 2 calls per country while France and United Kingdom held more than 50% of total.

This first phase of PHIRE, WP5 aimed to describe thematic areas of public health research (research fields) which are currently being financed through national programmes and calls. Some public health research continues to be funded directly, through negotiation between commissioners (generally ministries) and providers (institutes and universities). However, research is increasingly funded in response to competitive calls. In general the potential beneficiaries of these competitive grants are public institutions. In all cases where private institutions could apply also public ones also could. In general, only national researchers working in the country are eligible to apply to these calls or programmes. However, there are examples of eligibility of foreign researchers especially if initiative is from a national team and if no national expertise is available.
Methodology issues

In the first year of PHIRE, information had been drawn together on national health and public health research systems, based upon financial flows from research commissioners to research performers. No country, except for France, had well-organized information on competitive public health research calls and programmes. Almost all the countries claimed that to obtain the information on calls opened in 2010 was not possible without a specific and significant allocation of time to that task.

Comparisons by country

The two countries with large numbers of call or programmes identified were France and UK. In France, a national system for collecting research calls and programmes – and projects – has been operating within the national research council INSERM for 7 years (through the ground-breaking initiative of Professor Alfred Spira). This database draws on 28 funding organisations, including national, regional and local, and across public, charity and commercial funders. The UK information derives from the national research councils, ministry of health and disease-based charities, and shows segmentation to give specific support to public health themes. The Netherlands and Denmark also had differentiated research programmes.

One of the reasons for the strength of health research in these countries is that they draw some funds from their health system. This is not the case in most other European countries. Germany’s programmes for disease / topic groupings are funded directly by the Ministry of Science and Education (more generic national programmes for ‘Prevention’ and ‘Patient Research’ were closed in 2010). Spain reported only for a single national programme, funded from the Ministry of Science through the National School of Health Carlos III (although regional funding was not reported). No call or programme was reported for Poland, where the national scientific institutes are still directly funded, rather than by open calls and programmes. There were open calls for general research in 2010 for Romania, Slovakia and Slovenia, but these were not directed towards public health topics. In Cyprus and Ireland calls had been made in the previous year, while in Latvia, Malta and Portugal expected calls were not announced in 2010.
Comparisons by theme

Programmes and calls may be i) thematic, focused on a defined subject area; ii) open to any subject in the area of public health; or iii) general, such as to reinforce research capacity (scholarships, seminars, training, grants for visiting researchers) ⁴. The classification of research calls and programmes into themes had, as its main difficulty, the decision on how to allocate a call within a single theme – public health research often (and appropriately) stretches across scientific and medical fields. The choices were influenced by authors, by the information provided in the forms (original information was limited when transcribed) and by the structure of the classification scheme itself.

The groupings of public health calls and programmes made for this analysis were quite broad, reflecting the need to accommodate to different traditions in different countries, and also the broad categories typically seen grouping research papers in relevant journals (eg European Journal of Public Health) and at conferences (eg European Public Health Conference annually).
Clinical research classically divides by diseases, while public health research is concerned with prevention and organisation of services more generally. Nevertheless, much public health research can be – and still needs to be – undertaken within ‘disease-specific’ fields. Cancer featured more prominently than heart disease, perhaps surprisingly as these both have strong public health aspects, as well as other ‘chronic diseases’. It was welcome to include ‘rare diseases’, stimulated in 2010 by the European coordinating project ERA-RARE, for which there are very significant public health research aspects. Environmental and occupation health were perhaps under-represented (WHO has coordinated a separate inventory of this field at ERA-EnvHealth). The grouping of health services, statistics, screening and organisation was pragmatic, reflecting the interface of this field with ‘clinical’ research across health system lines. Finally, the categories for age-related research, although cutting across typical research methods and fields, are potentially relevant for wider public interest in the research agenda.