The need for a US registry of HIV in foreign-born people

1 Zachariah R, Harries AD, Ishikawa N, et al. Operational research in lowincome countries: what, why, and how? Lancet Infect Dis 2009; 9: 711–17. 2 UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases. Health systems/implementation research. Geneva: World Health Organization, 2010. http://apps.who.int/tdr/svc/ topics/health-systems-implementation-research (accessed April 30, 2010). 3 Global Fund to Fight AIDS, Tuberculosis and Malaria; UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases. Framework for operations and implementation research in health and disease control programs. Geneva: The Global Fund to Fight Aids, Tuberculosis and Malaria, 2008 http://apps.who.int/tdr/svc/publications/ training-guideline-publications/framework-operation-research (accessed April 30, 2010). 4 UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases. Community-directed interventions for major health problems in Africa. Geneva: World Health Organization, 2008. http://apps.who.int/tdr/news-events/news/pdf/cdi-report-08.pdf (accessed April 30, 2010). 5 Ministers of health and heads of delegation of African countries. The Algiers Declaration. Ministerial Conference on Research for Health in the African Region; Algiers, Algeria; June 23–26, 2008. http://www.tropika.net/ specials/algiers2008/declaration/ALGIERS_DECLARATION_7_July_08_ English.pdf (accessed April 30, 2010). 6 Council on Health Research for Development; Global Forum for Health Research; Government of Mali; United Nations Educational, Scientifi c and Cultural Organization; World Bank; WHO. Communique. Global Ministerial Forum on Research for Health; Bamako, Mali; Nov 17–19, 2008. http:// www.bamako2008.com/dmdocuments/Bamako_Communique_v5.pdf (accessed April 30, 2010). 7 WHO executive board. WHO’s role and responsibilities in health research. Geneva: World Health Organization, 2009. http://apps.who.int/gb/ebwha/ pdf_fi les/EB124/B124_R12-en.pdf (accessed April 30, 2010). These study types equally aim to distinguish between effi cacy and community eff ectiveness, as described by Zachariah and colleagues. At TDR, we use the term “implementation research” concurrently with operational research. Further to this, implementation research should not be limited to communicable diseases. There is growing evidence of the importance of using the same methods described above for health research on noncommunicable diseases—eg, as shown for vitamin A supplementation in a set of studies delivered by “community drug distributors”. Also, in the context of health policy, the importance of implementation research has been highlighted in a series of high-level consultations, such as the Ministerial Conference on Research for Health in the African Region, the Global Ministerial Forum on Research for Health, and published in the WHO research strategy (WHO’s role and responsibilities in health research), as discussed by WHO’s executive board. We recommend therefore a broadened defi nition of operational research, including studies applying qualitative health research and cluster-randomised trials, and a widening of the scope of its application to include both non-communicable and communicable health issues.