The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives

Document Type : Original Article


1 Department of Health Policy, London School of Economics and Political Science, London, UK

2 Recherche-Santé & Développement (RSD Institute), Yaoundé, Cameroun

3 The Centre for Rapid Evidence Synthesis, College of Health Sciences, Makerere University, Kampala, Uganda

4 LSE Health, London School of Economics and Political Science, London, UK


Regional cooperation on health in Africa is not new. The institutional landscape of regional cooperation for health and health research, however, has seen important changes. Recent health emergencies have focussed regional bodies’ attention on supporting aspects of national health preparedness and response. The state of national health research systems is a key element of capacity to plan and respond to health needs – raising questions about the roles African regional bodies can or should play in strengthening health research systems.

We mapped regional organisations involved in health research across Africa and conducted 18 interviews with informants from 15 regional organisations. We investigated the roles, challenges, and opportunities of these bodies in strengthening health research. We deductively coded interview data using themes from established pillars of health research systems – governance, creating resources, research production and use, and financing. We analysed organisations’ relevant activities in these areas, how they do this work, and where they perceive impact.

Regional organisations with technical foci on health or higher education (versus economic or political remits) were involved in all four areas. Most organisations reported activities in governance and research use. Involvement in governance centred mainly around agenda-setting and policy harmonisation. For organisations involved in creating resources, activities focused on strengthening human resources, but few reported developing research institutions, networks, or infrastructure. Organisations reported more involvement in disseminating than producing research. Generally, few have directly contributed to financing health research. Informants reported gaps in research coordination, infrastructure, and advocacy at regional level. Finally, we found regional bodies’ mandates, authority, and collaborations influence their activities in supporting national health research systems.

Continued strengthening of health research on the African continent requires strategic thinking about the roles, comparative advantages, and capability of regional organisations to facilitate capacity and growth of health research systems.



Commentaries Published on this Paper


  • The Geopolitics of Health Science Research; Comment on “The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives”

        Abstract | PDF


  • Health Science Research at a Regional Level: Insights From South America; Comment on “The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives”

        Abstract | PDF



  • epublished Author Accepted Version: February 8, 2022
  • epublished Final Version: March 8, 2022
  1. Nikogosian H. Regional integration, health policy and global health. Glob Policy. 2020;11(4):508-514. doi:1111/1758-5899.12835
  2. Riggirozzi P, Yeates N. Special Edition Issue. In: Global Social Policy. Volume 15. 2015:211-368.
  3. Herrero MB, Tussie D. UNASUR Health: a quiet revolution in health diplomacy in South America. Glob Soc Policy. 2015;15(3):261-277. doi:1177/1468018115599818
  4. Penfold ED, Fourie P. Regional health governance: a suggested agenda for Southern African health diplomacy. Glob Soc Policy. 2015;15(3):278-295. doi:1177/1468018115599817
  5. Amaya AB, Rollet V, Kingah S. What's in a word? the framing of health at the regional level: ASEAN, EU, SADC and UNASUR. Glob Soc Policy. 2015;15(3):229-260. doi:1177/1468018115599816
  6. Onzivu W. Regionalism and the reinvigoration of global health diplomacy: lessons from Africa. Asian J WTO Int Health Law Policy. 2012;7(1):49-76.
  7. Havik PJ. Regional cooperation and health diplomacy in Africa: from intra-colonial exchanges to multilateral health institutions. Hist Cienc Saude Manguinhos. 2020;27(Suppl 1):123-144. doi:1590/s0104-59702020000300007
  8. Ouma S, Abe O. Regional integration, public health capabilities, and the place of the World Health Organization in Africa. Albany Law J Sci Technol. 2017;27:232-257.
  9. Amaya AB, De Lombaerde P. Regional cooperation is essential to combatting health emergencies in the Global South. Global Health. 2021;17(1):9. doi:1186/s12992-021-00659-7
  10. Jabłecka J, Lepori B. Between historical heritage and policy learning: the reform of public research funding systems in Poland, 1989-2007. Sci Public Policy. 2009;36(9):697-708. doi:3152/030234209x475263
  11. Kinyanjui S, Fonn S, Kyobutungi C, et al. Enhancing science preparedness for health emergencies in Africa through research capacity building. BMJ Glob Health. 2020;5(7):e003072. doi:1136/bmjgh-2020-003072
  12. Patterson AS, Balogun E. African responses to COVID-19: the reckoning of agency? Afr Stud Rev. 2021;64(1):144-167. doi:1017/asr.2020.122
  13. Ahanhanzo C, Johnson EAK, Eboreime EA, et al. COVID-19 in West Africa: regional resource mobilisation and allocation in the first year of the pandemic. BMJ Glob Health. 2021;6(5):e004762. doi:1136/bmjgh-2020-004762
  14. Commission on Health Research for Development. Health Research: Essential Link to Equity in Development. Oxford: Oxford University Press; 1990.
  15. UK Clinical Research Collaboration. Health Research Classification System. 2018.
  16. European Science Foundation. Health Research Classification Systems – Current Approaches and Future Recommendations. 2011. Accessed September 30, 2018.
  17. Simpkin V, Namubiru-Mwaura E, Clarke L, Mossialos E. Investing in health R&D: where we are, what limits us, and how to make progress in Africa. BMJ Glob Health. 2019;4(2):e001047. doi:1136/bmjgh-2018-001047
  18. Jones CM, Ankotche A, Canner E, et al. Strengthening National Health Research Systems in Africa: Lessons and Insights from Across the Continent. 2021. doi:6084/m9.figshare.14039807
  19. Wenham C, Wouters O, Jones C, et al. Measuring health science research and development in Africa: mapping the available data. Health Res Policy Syst. 2021;19(1):142. doi:1186/s12961-021-00778-y
  20. Alemnji G, Edghill L, Guevara G, et al. Development and implementation of the Caribbean laboratory quality management systems stepwise improvement process (LQMS-SIP) towards accreditation. Afr J Lab Med. 2017;6(1):496. doi:4102/ajlm.v6i1.496
  21. Nwaka S, Ochem A, Besson D, et al. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent. BMC Int Health Hum Rights. 2012;12:11. doi:1186/1472-698x-12-11
  22. Jones CM, Hedquist A, Mijumbi-Deve R, Sobngwi-Tambekou JL, Wenham C, Parkhurst J. Strengthening Health Research Systems in Africa: A Regional Analysis. London: LSE Health; 2021. doi:6084/m9.figshare.14618238
  23. Pang T, Sadana R, Hanney S, Bhutta ZA, Hyder AA, Simon J. Knowledge for better health: a conceptual framework and foundation for health research systems. Bull World Health Organ. 2003;81(11):815-820.
  24. Hanney S, Kanya L, Pokhrel S, Jones T, Boaz A. What is the Evidence on Policies, Interventions and Tools for Establishing and/or Strengthening National Health Research Systems and Their Effectiveness? Copenhagen: WHO Regional Office for Europe; 2020.
  25. Kennedy A, IJsselmuiden C. Building and Strengthening National Health Research Systems: A Manager’s Guide to Developing and Managing Effective Health Research Systems. Geneva: Council on Health Research for Development (COHRED); 2006.
  26. D'Souza C, Sadana R. Why do case studies on national health research systems matter?: identifying common challenges in low- and middle-income countries. Soc Sci Med. 2006;62(8):2072-2078. doi:1016/j.socscimed.2005.08.022
  27. World Health Organization Regional Office for Africa. Research for Health: A Strategy for the African Region 2016-2025, Report of the Secretariat. World Health Organization Regional Office for Africa; 2015:10.
  28. Kirigia JM, Ota MO, Motari M, Bataringaya JE, Mouhouelo P. National health research systems in the WHO African Region: current status and the way forward. Health Res Policy Syst. 2015;13:61. doi:1186/s12961-015-0054-3
  29. Kirigia JM, Ota MO, Senkubuge F, Wiysonge CS, Mayosi BM. Developing the African national health research systems barometer. Health Res Policy Syst. 2016;14(1):53. doi:1186/s12961-016-0121-4
  30. Kirigia JM, Wambebe C. Status of national health research systems in ten countries of the WHO African region. BMC Health Serv Res. 2006;6:135. doi:1186/1472-6963-6-135
  31. Rusakaniko S, Makanga M, Ota MO, et al. Strengthening national health research systems in the WHO African region - progress towards universal health coverage. Global Health. 2019;15(1):50. doi:1186/s12992-019-0492-8
  32. Nabyonga-Orem J, Asamani JA, Makanga M. The state of health research governance in Africa: what do we know and how can we improve? Health Res Policy Syst. 2021;19(1):11. doi:1186/s12961-020-00676-9
  33. Signal LN, Bowers SG, Edwards R, et al. Process, pitfalls and profits: lessons from interviewing New Zealand policy-makers. Health Promot Int. 2018;33(2):187-194. doi:1093/heapro/daw065
  34. African Union Development Agency (AUDA-NEPAD). Health Research and Innovation Strategy for Africa (HRISA): 2018-2030. 2019.
  35. Sombie I, Bouwayé A, Mongbo Y, et al. Promoting research to improve maternal, neonatal, infant and adolescent health in West Africa: the role of the West African Health Organisation. Health Res Policy Syst. 2017;15(Suppl 1):53. doi:1186/s12961-017-0209-5
  36. Aidam J, Sombié I. The West African Health Organization's experience in improving the health research environment in the ECOWAS region. Health Res Policy Syst. 2016;14:30. doi:1186/s12961-016-0102-7
  37. Chauvin J. The transition of SAT from a regional project to an independent regional organization. Can J Public Health. 2008;99(Suppl 1):S42-S48. doi:1007/bf03403796
  38. Mandil A, ElFeky S, Rashidian A. Assessment of World Health Organization collaborating centres in the Eastern Mediterranean region. East Mediterr Health J. 2017;23(10):711-714. doi:26719/2017.23.10.711
  39. Kickbusch I, Szabo MM. A new governance space for health. Glob Health Action. 2014;7:23507. doi:3402/gha.v7.23507
  40. Fidler DP. Asia's participation in global health diplomacy and global health governance. Asian J WTO Int Health Law Policy. 2010;5(2):269-300.
  41. Lamy M, Phua KH. Southeast Asian cooperation in health: a comparative perspective on regional health governance in ASEAN and the EU. Asia Eur J. 2012;10(4):233-250. doi:1007/s10308-012-0335-1
  42. Akami T. A Quest to be Global: The League of Nations Health Organization and Inter-Colonial Regional Governing Agendas of the Far Eastern Association of Tropical Medicine 1910–25. Int Hist Rev. 2016;38(1):1-23. doi:1080/07075332.2015.1018302
  43. Faria M. Unasur Health Council: an emerging global actor in health policy and governance. Glob Soc Policy. 2015;15(3):341-344. doi:1177/1468018115600123c
  44. Wenham C. Regionalizing health security: Thailand’s leadership ambitions in mainland Southeast Asian disease control. Contemp Southeast Asia. 2018;40(1):126-151. doi:1355/cs40-1f
  45. Juma PA, Jones CM, Mijumbi-Deve R, et al. Governance of health research in four eastern and southern African countries. Health Res Policy Syst. 2021;19(1):132. doi:1186/s12961-021-00781-3
  46. Yeates N, Surender R. Southern social world-regionalisms: the place of health in nine African regional economic communities. Glob Soc Policy. 2021;21(2):191-214. doi:1177/1468018120961850
  47. Happi CT, Nkengasong JN. Two years of COVID-19 in Africa: lessons for the world. Nature. 2022;601:22-25. doi:1038/d41586-021-03821-8
  48. The African Academy of Sciences is in crisis - responsibility must be shared. Nature. 2021;599(7883):8. doi:1038/d41586-021-02991-9
Volume 11, Issue 11
November 2022
Pages 2672-2685
  • Receive Date: 31 May 2021
  • Revise Date: 11 January 2022
  • Accept Date: 07 February 2022
  • First Publish Date: 08 February 2022