Acharya T
Rockefeller and Gates Foundations.
Glob Public Health. 2007;2(1):53-63. doi: 10.1080/17441690600673833.
It is now widely accepted that the developing world needs to invest in science and technology or risk falling behind as the technology gap between the North and South widens. However, these investments must be balanced by continued investment in basic population-wide services, such as healthcare and water supply and sanitation. Achieving this balance is a matter of ongoing debate in policy circles, and leaders and policy-makers in developing countries often have to make difficult decisions that pit investment in new technologies and capacity-building in science and technology against basic population-wide services such as healthcare and water supply and sanitation. The tension is underscored by evidence which suggests that rapidly industrializing economies, like in China, India and Brazil, are actually experiencing a rise in economic and health disparities among their populations. The fact that poor people in an industrializing country must fall behind while the rest of the country marches ahead does not have to be an inevitable outcome of industrialization. This article shows that science and technology can make an important and vital contribution to development, using public health as an example. It suggests the need to focus investments in science and technology in such a way that they can have a positive impact on public health. For instance, the use of simple, hand-held molecular diagnostic tools can help unskilled health workers rapidly and accurately diagnose diseases, thus helping to reduce healthcare costs due to delayed or incorrect diagnoses. Recombinant vaccines can mitigate the risk of infection associated with live or attenuated vaccines, while needle-less delivery methods can help contain the spread of blood-borne infections. Critical to making technology investments work for population health are government policies and strategies that align public health goals and technology priorities. Such policies can include cross-sectoral training programs to improve dialogue between the technology and health sectors, setting up technology transfer cells to increase commercialization of health research relevant to local needs, and leveraging the phenomenon of low-margin high-volume marketing for health products.
现在人们普遍认为，发展中世界需要投资于科学技术，否则随着南北技术差距的扩大，就有落后的风险。然而，这些投资必须与对全民基本服务的持续投资相平衡，比如医疗保健、供水和卫生设施。在政策圈子里，如何实现这种平衡一直是个争论不休的问题，发展中国家的领导人及政策制定者常常不得不做出艰难抉择，在新技术投资和科技能力建设与医疗保健、供水和卫生设施等全民基本服务之间权衡利弊。有证据表明，像中国、印度和巴西这样快速工业化的经济体，其民众之间的经济和健康差距实际上正在扩大，这凸显了这种紧张关系。工业化国家中穷人必须落后而其他民众却在前进，这不一定是工业化不可避免的结果。本文以公共卫生为例说明，科学技术可以为发展做出重要且关键的贡献。文章指出，有必要以能对公共卫生产生积极影响的方式来集中科技投资。例如，使用简单的手持式分子诊断工具可以帮助非专业卫生工作者快速准确地诊断疾病，从而有助于降低因诊断延误或错误而产生的医疗成本。重组疫苗可以降低与活疫苗或减毒疫苗相关的感染风险，而无针注射方法有助于遏制血源性感染的传播。要使技术投资对民众健康发挥作用，关键在于政府的政策和战略，这些政策和战略要使公共卫生目标与技术重点保持一致。此类政策可以包括跨部门培训项目，以改善技术部门与卫生部门之间的对话；设立技术转让部门，以提高与当地需求相关的卫生研究的商业化程度；利用健康产品低利润高销量营销的现象。
