title: National expenditure on health research in South Africa: what is the benchmark?
abstract: The Mexico (2004), Bamako (2008) and Algiers (2008) declarations committed the South African (SA) Ministry of Health to allocate 2% of the national health budget to research, while the National Health Research Policy (2001) proposed that the country budget for health research should be 2% of total public sector health expenditure. The National Health Research Committee has performed an audit to determine whether these goals have been met, judged by: (i) health research expenditure as proportions of gross expenditure on research and development (GERD) and the gross domestic product (GDP); and (ii) the proportion of the national health and Department of Health budgets apportioned to research. We found that total expenditure on health research in SA, aggregated across the public and private sectors, was R3.5 billion in 2009/10, equating to 16.7% of GERD. However, the total government plus science council spend on health research that year was only R729 million, equating to 3.5% of GERD (0.03% of the GDP) or 0.80% of the R91.4 billion consolidated government expenditure on health. We further found that R418 million was spent through the 2009/2010 Health Vote on health research, equating to 0.46% of the consolidated government expenditure on health or 0.9% of the R45.2 billion Health Vote. Data from other recent years were similar. Current SA public sector health research allocations therefore remain well below the aspirational goal of 2% of the national health budget. We recommend that new, realistic, clearly defined targets be adopted and an efficient monitoring mechanism be developed to track future health research expenditure.
authors.affiliation: Director, Cardiothoracic Intensive Care Unit, Department of Anaesthesiology and Division of Critical Care, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; member, Human Research Ethics Committee, University of the Witwatersrand; member, National Health Research Committee, Department of Health, South Africa. fathima.paruk@wits.ac.za.
authors.forename: Fathima
authors.initials: F
authors.lastname: Paruk
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Blackburn
authors.forename: Irwin B
authors.initials: IB
authors.lastname: Friedman
authors.forename: Bongani M
authors.initials: BM
authors.lastname: Mayosi
mesh_terms: D019985:Benchmarking / Q000379:methods*; D035843:Biomedical Research / Q000458:organization & administration*; D005375:Financial Audit / Q000706:statistics & numerical data; D005380:Financing, Government / Q000706:statistics & numerical data; D015276:Health Care Rationing / Q000458:organization & administration*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D011634:Public Health / Q000191:economics; D012109:Research Support as Topic / Q000706:statistics & numerical data; D013019:South Africa