Photo: © CCP, Courtesy of Photoshare

For more than 30 years, USAID has played a global leadership role in supporting research that advances public health programs and tackles the main causes of under-five mortality and morbidity in developing countries. Notable examples of USAID's achievements in child health research are vitamin A supplementation of children to prevent blindness, morbidity, and mortality; field testing of delivery systems for ivermectin, the most effective drug against onchocerciasis; field testing of insecticide-treated bed nets, and the development and testing of oral rehydration salt solutions (ORS).

USAID's Child Health Research Project (CHR), 1996-2003, focused on research that addressed the major causes of morbidity and mortality in children. Through CHR support, coordinated, multi-country trials were conducted, leading to the development of global standards, guidelines, new tools, approaches and interventions. Major accomplishments of CHR included the field testing of ORS for the treatment of diarrhea; identification of and new treatments for the threat posed by antimicrobial resistance; field testing of new vaccines against Hemophilus influenza type B for the prevention of pneumonia in children; the validation of the verbal autopsy for determining causes of infant mortality, and the identification and development of zinc as a treatment for diarrhea. Learn about CHR's Achievements and Project Highlights.

In 2002, in anticipation of a design for a new generation of health research activities, USAID commissioned an external evaluation of CHR. The main recommendations were:

• USAID should continue to support the current focus on child health research as a priority activity and support research capacity building in developing countries.
  
• A follow-on child health research activity should invite competition/participation by a range of US academic/research institutions, developing country and international research institutions, and international organizations to maximize flexibility and access to technical and country-specific expertise.
  
• A new activity should have a greater emphasis on collaboration and consultation with a wider spectrum of USAID and global public health priorities (e.g. malaria and HIV/AIDS) and involve increased formal partnerships with US and international organizations, UN agencies, and foundations.
  
• A support contractor should be used to facilitate managerial and administrative functions including communication and project coordination.
  
• A technical advisory group should be established to review progress, help facilitate research agenda setting, and coordinate with other key stakeholders.

As a result of the evaluation, a new framework was designed under which it planned to carry out a significant part of its future health research activities. This framework takes into account the recommendations of the evaluation for increased capacity building; competition and participation from a wider range of partners, and collaboration and consultation with a wider spectrum of USAID and global priority initiatives.

Building on the successes and findings from CHR, and the external evaluation of CHR, the Health Research Program (HaRP) was established in 2003. HaRP is comprised of the Global Research Activity (GRA) and Country Research Activity (CRA), and provides USAID with mechanisms by which to conduct health research for the development and testing of new and better tools, technologies, approaches, policies and/or interventions to improve the health status of infants, children, mothers, and families in developing and transitional countries. These two research activities fall under the newly developed health research framework. The GRA and CRA, along with a range of other existing and future USAID health, nutrition and family planning research activities, provide USAID with important mechanisms to address critical global health issues.