It is a great honour for me to receive this honorary fellowship from such a highly respected institution. I see this honour as an acknowledgement of the efforts of all the dedicated people I have been fortunate enough to work with.

I see this fellowship as a recognition of the work and achievements in health research by the whole of WHO for many years - and by extension, all our collaborating centres around the world.

By and large we have been led to believe that it is primarily the cutting-edge research efforts in the industrialised countries which are responsible for the advances in medicine and that the poorer developing countries are largely spectators and passive recipients of this ‘intellectual largesse and generosity’ from the western world.

This is wrong. It is as good an occasion as any to debunk this outmoded, linear mode. Instead, let me propose an alternative view in which research performed in the developing countries is equally, if not more important to the future advancement of medicine and to the health of all people on our planet.

There are several reasons why I believe this to be true. First of all, developing countries possess a remarkable diversity of diseases which provide the necessary incentive and also the material for important research into various disease syndromes. Although many of these diseases are primarily problems of the poorer developing countries such as malaria and typhoid fever, many others are becoming - or have been - significant problems in the industrialised countries as well.

HIV/AIDS and tuberculosis are good recent examples. But this also extends to cardiovascular diseases, diabetes, cancer and mental illnesses, which are becoming important in many developing nations.

The increased volume and speed of air travel globally also means that tropical infectious diseases can rapidly spread to the far corners of the world. This phenomenon of the globalization of disease has made the developed countries pay renewed attention to many of the diseases that they believed would never touch them again. Together with the globalization of disease, we also have developed globalization of research, which means that with the vast improvement in communication methods, virtually the entire spectrum of health and medical research can be performed in the developing countries.

The past decade has witnessed, in the industrialised nations, remarkable and revolutionary advances in molecular biology, genomics and biotechnology. However, the ultimate development and translation of these scientific advances into useful products and interventions to benefit the poor will ultimately require detailed knowledge of the pathogenesis of the disease in humans and its field evaluation in areas where the need is the highest and the findings can directly be utilised and tested simultaneously on sufficient numbers of cases.

In short, research in developing countries is the crucial element in translating theoretic knowledge into practical innovations and drugs to improve health. It is also a fact that many developing countries, especially in the tropical regions of the globe, possess a remarkable and unparalleled biodiversity in its forests, soils and oceans which are the source of many novel therapeutic compounds for a wide range of diseases.

Another, often overlooked issue is the reality that, despite the international nature of the scientific method and culture, research in developing countries are best performed by developing country researchers themselves. They are in the best position to understand the local disease problems, health priorities and limitations in research infrastructure and thus be able to develop the most effective and creative approaches to the research problems on hand.

Our understanding of the human and humane aspects of research involving human subjects have also been greatly improved through promoting health research in developing countries. Recent controversies related to the ethical of human research and clinical trials in these countries have highlighted differences and problems but have also enhanced communication and understanding of the needs of peoples with different cultural, religious, educational and economic backgrounds. The ultimate benefit for the advancement of medicine is clearly an improvement in international goodwill and cooperation in the global research endeavour.

In addition to the scientific and intellectual aspects, there is also another dimension to the issue which links research to development. A rethink of the objectives of international development aid has focused on the importance of capacity building in research in developing countries as a more effective, long-term and sustainable way to promote self sufficiency.

Good research done in developing countries may ultimately be one of the best products of international development aid and will ultimately contribute to the advancement of medicine globally through the creation of centres of excellence - like this one, which has achieved world renown. Such centres will make unique contributions to new knowledge and add considerable value to the global body of scientific evidence.

Research in developing countries should thus be encouraged as this is ultimately one of the best ways of helping these countries help themselves through development of a critical mass of researchers. In turn, this will stimulate the development of a strong scientific culture and, ultimately, make significant contributions to the advancement of medicine on a global level.

The World Health Organization champions the health of the poor. In doing so, it is strongly committed to research. Research is at the core of its work and mission, especially health research performed in the developing countries.

We have been closely involved in the promotion and coordination of a variety of research activities, including the crucial activity of research capacity building. Through the TDR (Tropical Diseases Research) and HRP (Reproductive Health and Research) special programs, for example, WHO has worked closely with other agencies - such as UNDP, and the World Bank - and with Member States, to fund research projects and train numerous scientists-researchers in developing countries. I am happy to report that we have found this experience highly rewarding and some of our best trainers are from developing countries, including from India. I would urge the Government of India and the Director of AIIMS to continue to make available to WHO, the services of experts as and when they are needed. This, I can assure you will result in returns to the country that are much larger than the initial investments you made.

The recent creation of a Department of Research Policy & Cooperation in the Evidence & Information for Policy cluster, whose core mission is the promotion and coordination of health research, is firm proof of our commitment. The strong emphasis the organization places on the role of research in development is exemplified by its co-sponsorship of a major conference entitled the International Conference on Health Research for Development to be held in Thailand in October, 2000. This conference is expected to be a landmark event which will help to define health research for the development agenda of the next decades.

Jawaharlal Nehru (1889-1964), India’s first Prime Minister and a true visionary, long ago appreciated the importance of scientific research in his country’s development. He stated:

"I see no way out of our vicious cycle of poverty except through the means that science and technology has placed at our disposal". Nehru also said that "… because we are poor, we cannot afford not to do research …"

Nehru would doubtlessly be proud of what AIIMS and other Indian research institutions have achieved over the past 40 years. He would surely approve of the status and valuable contributions we have seen from developing country researchers to the global body of knowledge had he lived today.

Yet, The fact remains that although developing countries carry 90% of the disease burden, their total health expenditure makes only up ten per cent of the world’s total. There continues to be a serious brain-drain from developing country universities to campuses and corporate research centres in the richest countries. And research into the main diseases of the poor continue to receive far less attention and resources than even the most luxurious of the medical problems of the rich.

This has to change. I know this has been said over and over again during the past decades. But I am optimistic that the economic environment of our time can be exploited in our favour. We need to strike a new balance between national and international regulation on the one hand and economic incentives on the other. We need to clearly state our public health values, our priorities and our needs. And we need to broaden the mobilisation of resources and innovation.

Let me illustrate this by one concrete example. Together with a number of partners, WHO has set reduction of the burden of malaria as one of its main priorities. By doing this, we help Member States in setting their priorities, and we assist donors in focusing their financial assistance. Through concrete interventions and programmes, we also mobilize new resources, such as the many and generous foundations of the world’s richest families. Through innovative structures, such as the recently launched Medicines for Malaria Venture, we overcome market obstacles by creating incentives for research and development in malaria drugs.

There are other examples of such innovation, such as the Global Alliance for Vaccines and Immunization, which has its goal to drastically raise the number of children which receives adequate immunization coverage. In short, instead of cursing a system that does not work, we exploit it in creative new ways to achieve results.

Let me repeat my initial statement: developing country research has much to contribute to the advancement of medicine.

It can provide important scientific insights into disease mechanisms, risk factors and how to develop practical applications from scientific advances. In addition, it can make an even larger impact by ultimately contributing to economic development through research capacity building and the building up of human capital resources.

Most importantly, it can contribute to enhanced international goodwill, understanding and cooperation in medical and health research, surely a key ingredient in advancing medicine.

The All India Institute for Medical Sciences is a shining example of such achievements. Let me again thank you for bestowing on me such an honour, and let me wish you all the best for the future.