A SucceSS Story in danish development Aid. dbl ( ) Editors: Annette Olsen, Niels Ørnbjerg, Klaus Winkel - PDF

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A SucceSS Story in danish development Aid dbl ( ) Editors: Annette Olsen, Niels Ørnbjerg, Klaus Winkel A succes story in Danish Development Aid DBL ( ) A succes story in Danish Development

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A SucceSS Story in danish development Aid dbl ( ) Editors: Annette Olsen, Niels Ørnbjerg, Klaus Winkel A succes story in Danish Development Aid DBL ( ) A succes story in Danish Development Aid DBL ( ) Editors: Annette Olsen, Niels Ørnbjerg, Klaus Winkel 1. udgave 2013 DBL 2013 Omslag: Annette Olsen Sats: SL grafik, Frederiksberg (www.slgrafik.dk) Tryk: Narayana Press, Gylling (www.narayana.dk) ISBN Photos were provided by former and present staff members Jens Byskov, Solveig Danielsen, Peter Furu, Maria Vang Johansen, Thomas K. Kristensen, Henry Madsen, Pascal Magnussen, Peter Nejsum, Annette Olsen, Erling Møller Pedersen, Claus Reimert, Paul Erik Simonsen, Anne-Sofie Steensgaard (maps), Hanne Strandgaard, Birgitte Jyding Vennervald and Jens Aagaard-Hansen. Also collaborators Gautam Biswas, Andrew Seidu Korkor, Faustin Lekule, Kabemba Evans Mwape, Harriet Namwanje and Ambrose Onapa (map) provided photos. In addition, a few photos from the archives of DBL, where the photographer is unknown, are included. Svanemærket tryksag A succes story in Danish Development Aid DBL ( ) Contents A succes story... 3 Preface... 7 By Annette Olsen, Niels Ørnbjerg, Klaus Winkel 1. Introduction... 9 By Niels Ørnbjerg 2. Danida s support for health research for development By Klaus Winkel, cand.polit., former head of department for evaluation and research, Danida 3. The early history of the Danish Bilharziasis Laboratory By Flemming Frandsen, professor, Dr. scient., former director of DBL 4. An overview of DBL By Niels Ørnbjerg 5. Capacity development for health and health research By Niels Ørnbjerg and Peter Furu 6. No impact without good governance and efficient administrative support By Christian Gregart and Kirsten Grønlund Andersen 7. Research on schistosomiasis providing the evidence and tools for disease control By Birgitte J. Vennervald and Pascal Magnussen 8. The role of snails in schistosomiasis research from taxonomy to forecasting disease outbreaks By Thomas K. Kristensen, Henry Madsen and Anna-Sofie Stensgaard 9. The laboratory facility at DBL By Birgitte J. Vennervald, Susanne Kronborg and Thomas K. Kristensen 10. Treatment against schistosomiasis now includes toddlers, but By Maria Vang Johansen and Annette Olsen 11. Research and capacity-building for lymphatic filariasis control By Paul E. Simonsen and Erling M. Pedersen 12. Research on intestinal worms providing the evidence for optimising control By Annette Olsen and Pascal Magnussen 13. Malaria research and control capacity building By Pascal Magnussen 14. Anthropology and cross-disciplinarity at DBL By Jens Aagaard-Hansen, Head of health promotion, Steno Diabetes Center; Erick Nyambedha, lecturer, Maseno University; Simiyu Wandibba, professor, University of Nairobi and Isaac Nyamongo, professor, University of Nairobi 15. Including plant health in the one health concept in theory and in Uganda By Solveig Danielsen, Plantwise Programme Co-ordinator, Monitoring and Evaluation at CABI 16. From 180,000 to zero cases in 23 years eradication of Guinea worm disease from Ghana? By Annette Olsen and Pascal Magnussen 17. The Cysticercosis Working Group of Eastern and Southern Africa (CWGESA) By Maria Vang Johansen and Samson Mukaratirwa, professor, University of KwaZulu- Natal, Durban, Republic of South Africa 18. Health impact assessments in the Mekong Basin for promoting health as a cross-cutting issue By Peter Furu and Robert Bos, World Health Organization 19. Strengthening knowledge-management systems in The Gambia By Paul Bloch, senior researcher, Steno Diabetes Center and Ayo Palmer, Senior Technical Co-ordinator, CIAM 20. Priority-setting in health systems By Jens Byskov 21. Value for money has been high By Niels Ørnbjerg Appendix Appendix 1: DBL staff list from 2004 to 2012 Appendix 2: Research publications from 2004 to 2012 Appendix 3: Selected knowledge management publications from 2004 to 2012 Appendix 4: 4a: South PhD study completions from 2004 to b: South Master study completions from 2004 to c: North PhD study completion from 2004 to d: North Master study completions from 2004 to 2012 Preface 7 Preface This book describes aspects of the history, performance and lessons learned of an institution that was established in 1964 under the name Danish Bilharziasis Laboratory (DBL). The name was later changed to DBL Institute for Health Research and Development to embrace its broader public health profile. When DBL merged into the University of Copenhagen in 2007, the name changed again to DBL Centre for Health Research and Development. In an earlier book published in 2004, DBL s first 40 years of existence were thoroughly described to mark this anniversary. When quantifying the results, we have therefore, in this book, paid particular attention to achievements since 2004, while the historic and scientific chapters sometimes go back to the beginning. Obviously, it is not possible to cover everything DBL did, but we have asked our colleagues to give representative examples and to focus on the stories that they found most illustrative, interesting or successful during their working years at DBL. The chapters are thus written by different authors and can be read independently from each other. As editors, we have made no attempt to harmonise the different approaches taken in the individual chapters. We consider such diversity as indicative of the particular strengths that made DBL a success. The good stories are supplemented with some appendices summarising key output parameters such as PhD and Master studies and publications of different kinds since We thank our colleagues for taking time to write their stories and science journalist Michael de Laine for thoroughly editing our English language. Annette Olsen, Niels Ørnbjerg, Klaus Winkel 8 A succes story in danish development aid dbl ( ) 1. Introduction 9 1. Introduction By Niels Ørnbjerg Areas of work The DBL-Centre for Health Research and Development was established in 1964 as a private foundation under the name Danish Bilharziasis Laboratory (DBL). With effect from 1 January 2007, the centre was integrated into the University of Copenhagen. Throughout its life, the institution was involved with the control of poverty related diseases, such as schistosomiasis, malaria, lymphatic filariasis, intestinal helminthiasis, cysticercosis and infections caused by Guinea worm and fish-borne flukes. Geographically, this has occurred in many countries in Africa and in a few countries in southeast Asia. Such diseases are of major public health concern because of their high morbidity and their negative effect on school attendance, cognitive development and growth. From an initial narrow focus on the snail-borne disease schistosomiasis, DBL developed over the years into an institution addressing health research and development more broadly as a contribution to achieving the health-related Millennium Development Goals. An appropriation in the annual finance act, including a performance contract with the Ministry of Foreign Affairs and its development-aid programme, Danida, has been the crucial core funding for DBL at all times. High-impact contribution As documented through repeated international reviews and evaluations, DBL has made a relevant, effective and efficient high-impact contribution to health development through its coherent research, capacity building and knowledge-management programmes. In close collaboration and in an equal partnership with its many partners, DBL has been instrumental in generating new knowledge through research; in translating and communicating research for input to policies, strategies and practices; in building human, managerial, organisational and social capital to carry out and use research in controlling diseases; in building research centres and supporting individual researchers of excellence; and in training cadres of disease-control personnel and planners, enabling nationwide parasite control programmes to be rolled out in many countries in Africa. 10 A succes story in danish development aid dbl ( ) Change in Danida policies and strategies Danida s policies and strategies have changed dramatically over recent years in terms of supporting research for development. Although external funding has always supplemented Danida s funding of DBL, a serious change happened in From this year, funding from Danida gradually decreased and the demand for more external funding to support the activities of DBL correspondingly increased. Danida s funding of DBL came to a final conclusion at the end of DBL as an institution funded by development aid money thus ceased to exist. Although many elements of the DBL programme will be carried on by former DBL staff now employed at the University of Copenhagen and elsewhere, an era has come to an end. DBL book With this book, DBL wishes to present a brief outline of this era. We will describe DBL s history and we will document its activities, outputs and impact. It is obviously not possible to cover everything DBL did. But the intention is, by presenting some representative examples, to provide a picture of the challenges in research for development and in capacity building, of DBL s outputs and impact and thus of an institution that made a difference. The examples span from snails and mosquitoes over domestic animals to man; from the freshwater environment to health systems; from molecular biology to health impact assessments and medical anthropology; and from research over capacity building to knowledge management. Many disciplines and approaches are presented. They all share the common goal of improving health and livelihood among marginalised population groups in the least-developed countries. Sincere thanks go to A sincere thanks go to present and former DBL staff, European, American and Danish collaborators, and not least to institutions and individual staff at DBL s network of collaborating institutions and networks in Africa and Asia. It has been a privilege to work together in our shared wish to assist in improving health in developing countries. Despite the challenge of finding the necessary funding, DBL staff are determined to continue the collaboration with the starting point in their employment at the Faculty of Health and Medical Sciences at the University of Copenhagen. Sincere thanks go to Danida for its collaboration over the years. Danida s support has allowed DBL to perform well in the interest of improved health in developing countries. The University of Copenhagen is also thanked for efforts to integrate DBL. We will have to face the fact that universities have difficulties in fully integrating an institution like DBL with its focus on service provision to developing countries. DBL has documented its activities throughout its life. Annual reports have thus 1. Introduction 11 been published and a 40 th anniversary publication was published in 2004 (ISBN ). DBL hopes that its approach, as characterised by development relevance, equity, accountability, partnership, empowerment, stewardship and gender equality, will become essential core values on which new programmes will be built. DBL is doing whatever possible to ensure that future programmes will learn from DBL s comprehensive experience. The publication of this book is an element of such efforts. 12 A succes story in danish development aid dbl ( ) 2. Danida s support for health research for development By Klaus Winkel DBL as one of the Projects in Denmark DBL has always been Danida s flagship when it comes to supporting health research for development. It has been most encouraging to follow the development of DBL itself since I first attended DBL board meetings in as acting observer and later as a member nominated by Danida. Danida (initially its predecessor, the Secretariat for Technical Assistance) has supported development research almost from its start 50 years ago, but the allocations were modest during the first few years. Special support was given to three research institutions in Denmark, later to fall into the category Projects in Denmark. All of them were the result of the work of outstanding and high-profiled scientists in the case of DBL it was Dr Georg Mandahl-Barth. Having been established in 1964, DBL got its first general budget support, DKK 75,000, from Danish aid funding in That was a relatively significant amount considering that the Council for Development Research (CDR) in the same year had at its disposal just DKK 300,000, and that most research grants from CDR around that time amounted to DKK 10,000-30,000 per year. The first major project grant For several years very few of the grants were in support of health research, but in 1971 DBL landed its first major project grant from CDR, DKK 72,000, to finance trials with the biological control of snails transmitting schistosomiasis in Egypt and Tanzania. The number of health research projects grew steadily and came to represent 20-25% of allocations under CDR. There were good reasons for this. The main function of research is to get more out of available resources, and the most important resource is people. Health research that will assist in releasing people s full potential is therefore a powerful means to increase a nation s productive capacity and combat its poverty. More support to partners in developing countries Research got a boost at Danida with the establishment of a department for evaluation and research in One year later, an internal working group started to analyse needs and potentials for an expanded Danida effort in the field of research. Its report formed the basis of a major conference in 1988, which demonstrated that the Danish 2. Danida s support for health research for development 13 research community was keen to play a more active role as a resource base for Danish development assistance. It was realised that Danida s support of research had almost exclusively financed the work of the Danish researchers; the time had now come to acknowledge, support and reward the research partners in developing countries and their institutions. Enhancing local research capacities would represent a valuable form of development aid for many reasons: it would increase a country s ability to make use of the immense global knowledge pool, to find solutions to specific, local problems, to keep good brains in the country, and to ensure that training at its universities achieved quality as well as relevance to local conditions. Also, a good local research capacity would increase the benefits of Danish researchers when co-operating with the local research capacities. ENRECA was born Against this background, Danida decided to establish a programme for research assistance. It differed from what CDR had been doing for years its primary objective was not to support research as such, i.e. to generate new knowledge, but to strengthen partner institutions in developing countries through collaborative research. At a meeting at DBL, where we had gathered a good number of Danish researchers to discuss the programme, one of the participants suggested calling the programme ENRECA: Enhancement of Research Capacity in Developing Countries. It is surprising what a good name can do. In no time, ENRECA had become a household word in the international aid community dealing with research, and people generally thought it to be much larger than it actually was. An annual amount of DKK 10 million had been set aside for the first years, but within 10 years the amount had increased to DKK 60 million. Increasing funds for health research When the programme was advertised it met with an enthusiastic response. The big attraction was that, from the beginning, it was announced that a successful project could expect support for up to 12 years. The first project became active in Throughout ENRECA s 20-year life, health research projects were the most important part of the programme by far, with more than twice as many projects as the number two field, agriculture. This was partly the result of a special allocation for health research that added DKK 5 million a year to ENRECA s budget for a five-year period starting in The basis for this expansion was an analysis, carried out by Jens Aagaard Hansen from DBL, of the potential for greater involvement of the Danish health research community in capacity building. This new money supported three projects, including the large KEDAHR (Kenyan-Danish Health Research) project with Kenya, where DBL was the primary Danish partner. 14 A succes story in danish development aid dbl ( ) In addition, the special allocation permitted a doubling of the ENRECA staff, with the employment of Bente Ilsøe, and provided finance for the ENRECA health research network. After the ENRECA programme as such came to an end in 2009, the name survived for another four years in that network, which for 20 years had made an essential contribution to informing and mobilising Danish health researchers for work on third-world health problems. Who should pay for the activities in Denmark? As mentioned above, DBL fell into the category termed by Danida Projects in Denmark, which has also included research institutions on seed pathology and forest seeds. Over the years, Danida and its board discussed whether it was proper to support activities located in Denmark when the aid funds were meant to further development in poor countries. Those of us who were in favour of supporting projects in Denmark argued that it was necessary to nourish Danish resources that were required to provide development assistance of good quality. In certain cases, this aim could best be pursued by having centres of excellence concentrating on important third-world challenges. Competences could be built up in such centres over the years, and one important way to do this was to provide a relevant working place in Denmark for researchers who worked alternately in Denmark and in partner countries. Certain skills, such as research capacity building in poor countries, were so special that they would be hard to come by unless provided by institutions such as those in question. This has been clearly demonstrated by DBL, which has spearheaded research capacity building from its early days and thus a long time before the ENRECA programme put the subject on the Danish aid agenda. The argument against supporting projects in Denmark was that funding for maintaining and developing competences in Denmark, whether they are third-world relevant or not, should come from other parts of the state budget. However, other ministries have looked to the sizeable aid allocations and have generally not been prepared to spend their own money on activities not directly benefitting Danes. There has also been uneasiness in Danida about having a direct responsibility for institutions, no matter whether they are abroad or in Denmark. New Danida strategy for development cooperation Recently, Danida has adopted a new strategy for Denmark s participation in international development co-operation. The guiding theme in the strategy is that the cooperation must be based on the rights of people in partner countries. Among these is the right to good health. This noble aim will surely not be achieved without heavy investments in research into poor people s health problems, and most of this research will have to be done in the poor countries. So, the case for supporting 2. Danida s support for health research for development 15 local health research capacities remains as strong as ever. Thanks to the work over the years of DBL and a few other institutions, a resource base has been built up that will enable Denmark to continue to play a significant role in this important area. My expectation is that the demand for such services will grow in the years to come. It remains to be seen to what extent Danida will comply with this demand. Reading the new strategy suggests that it will take an extra effort from the stakehold
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