Letters

research systems, institutions and per-sonnel. As a result, research activities in many low- and middle-income coun-tries reflect more closely foreign and global health research priorities than the research needs of the countries in which research is being conducted. As externally funded research is virtually monopolised by HIV/AIDS, tubercu-losis and malaria,3 little if any funding or research capacity is left to deal with other diseases, conditions or the im-provement of health systems, let alone for research with a more expanded goal of social and economic development (i.e.“research for health”). The concept of “responsible verti-cal programming”4 defines a health research programme as “responsible” if it “succeeds in building the capac-ity of a country’s researchers and the national research system – in the process of achieving its own research goals”. It sets out some practical steps that decision-makers in countries and in research programmes can take to increase the synergy between national research capacity and research pro-gramme implementation. Countries have to take responsi-bility to put in place and resource a basic national health research system that provides mechanisms for research governance, identifies national priori-ties and formulates and implements a policy framework to enhance the effec-tiveness of the national research effort. Vertical programmes have to realize that their research cannot be conducted in isolation from national contexts and that their contributions to the research infrastructure from which they benefit will enhance research output and quality in the future. They can do this by ensuring that – as a minimum – activities align with, rather than fragment, national research sys-tem needs and by investing in equitable partnerships that strengthen the capaci-ties of national researchers, research institutions and research systems. It is clear that health system strengthening needs both information and research. Stated in another way, national health information systems and national health research systems are key tools in generating the evidence needed to guide health and health sys