ABSTRACT: Changes are underway in the global health research architecture that mirror, though to a lesser extent, the shift in the world economy through the growth of emerging markets. Prominent in the development of new centres of knowledge production are the so-called innovative developing countries such as China, India, Brazil, Mexico and South Africa. Not only is their share of global health research publications and patents growing, but they are increasingly becoming funders of health and health research, primarily within their own country, but also to multilateral agencies such as the Global Fund. In pharmaceuticals and biotechnology they have begun the shift from reverse engineering of drugs developed in the west; to nations with vertically integrated research and development industries culminating in local manufacture and in some instance export around the world of their products. In a few cases new chemical entities have been developed and advanced biological products developed and tested – such as the novel HIV vaccine that entered phase I clinical trials in South Africa in 2009 after 9 years of government-funded R&D.
Developing countries then are no longer merely testing sites for products developed in rich countries; nor mere recipients of technology transfer. A strong policy drive at regional and global level has spawned research and innovation in nodes of research in Latin America, Africa, and Asia. Such policies include WHO`s recently endorsed Global Strategy and Plan of Action for Public Health, Innovation and Intellectual Property. Particularly controversial in these policy debates has been the issue of intellectual property; and the ownership of products derived from the rich biodiversity found primarily in developing countries.  
These global health research policy imperatives have been partly driven by the realization that in the biological world there are no national barriers; and threats to human health such as HIV/AIDS, drug resistant tuberculosis, HIN1 novel influenza A, and the health effects of climate change are shared by all regions of the world, sometimes with alarming rapidity.
Other mechanisms underlying these changes in the global health research architecture have been the `brain regain` policies adopted with great success by India and China; whereby scientists from these countries, who often formed the nucleus of many American research labs at doctoral and postdoctoral levels, have been encouraged to return to their  home countries to exploit their new found skills and technologies. This underscores the principal barrier to the development of health research in developing countries : human capital. Individual and institutional capacity in the biomedical sciences takes much longer to build than in many other sciences and technologies; and partly explains why the developing world has lagged further behind in these fields, than in for example engineering and  telecommunications.  
Contributing to the changing global health research architecture have been developments in the manner in which health research is conducted. With the exception of the pharmaceutical industry, the health sciences and technologies were slow to globalise in comparison to for example telecommunications and the automotive industries. Nevertheless health research is increasingly being conducted at regional and global levels, through transnational consortia, linked by the sophisticated   information and telecommunications systems at hand to aid the bioscientists` work. As scientists continue to mine the diversity of the human genome and that of other living organisms; and explore the interactions of these creatures with the environment in all its biodiversity, a global perspective will become ever more important. This holds true also for the  social sciences and public health as media and telecommunications export and globalise risk factors for disease and patterns of social interaction.
In this globalised health research landscape, the role of transnational bodies such as the Inter Academy Medical Panel and the Global Forum for Health Research will become increasingly important in providing platforms and mechanisms for the exchange of ideas and for collaborations of scientists from both high income and low/middle income countries – collaborations on an equal footing and for mutual benefit. It is possible therefore that mankind will not repeat in the 21st century the mistakes of the 20th century; where gross inequities in health status between developed and developing world  arose partly due to inequality in sharing the benefits of health research  and technology.

PROFILE: Professor Anthony Mbewu BA MBBS FRCP MD FMASSAf is  Executive Director as Global Forum for Health Research as of January 2010. He  was formerly President of the Medical Research Council of South Africa (MRC), Honorary Professor of Cardiology and Internal Medicine at the University of Cape Town and a Foreign Associate of the Institute of Medicine of the USA.
He  trained in medicine at Oxford and London universities, and on returning to South Africa in 1994, he was appointed Consultant Cardiologist in the Cardiac Clinic of the Department of Medicine, University of Cape Town. In 1996 he became Executive Director for Research at the MRC and its President and Chief Executive Officer in 2005.
In 2003 he chaired the Task team that developed South Africa’s Comprehensive Care, Management and Treatment for HIV and AIDS programme that has enrolled 871 914 patients on antiretroviral therapy.
Internationally, Professor MBewu is known for his work as co-chair of the Inter-Academy Medical Panel (a body that represents 66 of the world’s medical academies). He has served as a member of the Scientific and Technical Advisory Committee of TDR (UNICEF/UNDP/World Bank/WHO Special Programme on Research and Training in Tropical Diseases), has often served as a technical adviser to WHO and was a member of the Director-General’s External Reference Group for a Research Strategy for WHO.
He is currently Vice-Chair of the Board of the Global Alliance for TB Drug Development (TB Alliance); a member of the Strategy Working Group of the National Institute for Allergy and Infectious Disease; US National Institutes of Health; a trustee of Bioventures (South Africa’s only biotechnology venture capital fund); director of Linsela Investments (a social entrepreneurship company); a member of the Advisory Committee for FIND Diagnostics; of the Board of the African Clinical Research Organisation; and a member of the Taskforce for the African Network for Drug and Diagnostics Development (ANDI).