Fifth EDCTP Forum – Blog

Partnerships in health research

Posted by Daniela Pereira-Lengkeek on 5 November 2009 at 09:35

By Ochieng’ Ogodo

Global partnerships and collaborations are crucial to achieving results that impact the medical field. With an increasing number of initiatives and organisations involved in health research & development, forming networks and establishing collaborations is now more important than ever. In the Global Partners session on the final Forum day, various EDCTP partners presented themselves and their collaborations with EDCTP.

UVRI: model of complementing networks

Dr Pontiano Kaleebu of the Uganda Virus Research Institute (UVRI) said at the Fifth EDCTP Forum that over the last few years, the emphasis on collaboration and networking in order to maximise resources and synergies has gained prominence in the medical profession.

A case in point, according Dr Kaleebu, is the partnership between with the UK Medical Research Centre (MRC UK) and the International AIDS Vaccine Initiative (IAVI) to build clinical trials and basic research capacity. He said, “Additionally, two other organisations, the African AIDS Vaccine Programme (AAVP) and EDCTP have provided resources leading to the creation of excellence in HIV prevention research.”

UVRI is a government institution established in 1936, which conducts studies through its different departments and through international collaborations. Dr Kaleebu said this international collaboration includes MRC-UVRI Research Unit, Rakai Health Sciences Program, Center for Diseases Control, CDC-Uganda and UVRI-IAVI Vaccine Program.

UVRI has delivered more than 40 completed studies and trials including Phase I & II trials on microbicides, intervention studies in sexually transmitted infections and microbicides, antiretroviral (ART) delivery studies, social science studies and basic science studies aimed at HIV vaccine research & development and better ART delivery.

UVRI is part of the East African Clinical Trial Partnership (EACTP), a capacity building network of excellence and training for the conduct of clinical trial in Africa funded by EDCTP for which Dr Kaleebu is coordinator. UVRI’s collaboration with EDCTP has also been crucial in microbicide trial capacity building among high-risk women. In addition, three Senior Fellowship studies have been funded by EDCTP. Currently, a large HIV vaccine trial capacity building project is ongoing, enrolling a highly mobile and often neglected study population: fisher folk. “The aim of this project is the strengthening of long-term clinical and laboratory research capacity, cohort development, and collection of epidemiological and social science baseline data in Uganda and Malawi, to prepare for future HIV vaccine trials.”

ESSENCE: Harmonisation and synergy in research capacity

Dr Garry Aslanyan, Manager Portfolio Policy in WHO/TDR speaking on behalf of Professor Hannah Akuffo of Sida, on Enhancing Support for Strengthening the Effectiveness of National Capacity Efforts (ESSENCE) said that this is a collaborative framework between donors and funding agencies, committed to providing synergy to address research capacity needs.

“ESSENCE for health research is also aimed at improving the impact of investment in institutions and enabling mechanisms and addressing identified needs and priorities within national strategies on research for health,” he said.

ESSENCE provides a framework for development agencies, philanthropists, charities and multilateral initiatives, and aims at strengthening the research capacity and conditions for doing research that need strengthening in Africa. There are many efforts in this area, but these tend to be fragmented and they may not achieve sustainable impact when each funding agency works alone.

Fragmentation, he said, is being caused by both funders and countries, and ESSENCE aims to have donors’ actions to be more harmonised, transparent and collectively effective.

In most African countries, he remarked, the push for a sector-wide approach, notably in the health and education sectors is advocated and implemented. In these successful approaches donor working groups exist to help in coordinating and harmonising the efforts of the donors. The majority of research supported in Africa, Dr Aslanyan said, is from funders and agencies whose management and coordination are mainly based at their headquarters outside of Africa.

He said harmonisation, alignment and coordination of capacity building efforts for health research capacity cannot be organised in the same way as for other sectors, and ESSENCE was initiated to find mechanisms for such efforts.

“It is important to distinguish the needs of countries that have attained their targets for research capacity with those that are struggling to attain such targets. The emphasis of ESSENCE is on low-income countries in Africa with insufficient capacity for research for health,” he said.

The Bill & Melinda Gates Foundation’s partnerships with EDCTP

Ms Siobhan Malone, a Program Officer working on HIV Vaccines with the Bill & Melinda Gates Foundation, said the Foundation shares a common interest with EDCTP in ensuring the development and delivery of new and affordable prophylactics and therapeutics for TB, HIV and Malaria for those most affected in developing countries.

“In October of last year,” she said “the Gates Foundation partnered with the EDCTP to fund a consortium to conduct clinical trials on new drugs to shorten and simplify the treatment of TB. The consortium formed around this program, PanACEA, is a great example of the type of collaborative research effort the foundation is keen to see succeed in accelerating research and development efforts.”

The Gates Foundation and the EDCTP first partnered in October 2006 with a joint call to provide research consortia with an opportunity to apply for necessary funding to build capacity in preparation for the conduct of preventive HIV vaccine trials. A call for proposals was made in December 2006 and 6 applicants were funded.

Examples of the projects include; the development of an infant vaccine initiative against mother-to-child transmission of HIV-1 through breast milk. There is also the Uganda and Malawi fisher folk study and capacity development and strengthening in preparation for HIV vaccine trials in Tanzania and Burkina Faso.

The partnership is also supporting the African-European HIV Vaccine Development Network (AfrEVacc), HIV vaccine trial capacity building in Tanzania and Mozambique and preparing for adolescent HIV vaccine trials in South Africa.

“These are important projects to build clinical trials capacity and we hope that there will be opportunities for more HIV vaccine trials on the continent that build on the learnings of the recent results from the Phase III RV144 trial in Thailand,” she said.

“In the past few years, we have seen many sectors come together to tackle some of the world’s most complex problems. The HIV and TB co-funding initiatives involving the Gates Foundation and the EDCTP are concrete examples of important ways that funders with common strategies and goals can work together to ensure that funding gaps and priorities areas in global health are addressed in collaboration,” said Malone.

The Wellcome Trust: Increasing international activities

Dr Val Snewin of the Wellcome Trust said the Trust is involved in international funding and supports over 3000 health researchers in more than 50 different countries. The Wellcome Trust have a total spending of approximately £600 million annually with £70 million for international activities.

“We will continue to fund internationally and expect that this element of our funding will increase,” she said.

Under the Grand Challenges in global health, she explained, the Wellcome Trust are cofunding three projects with the Bill & Melinda Gates Foundation: Antigen design and delivery for mucosal protection against HIV-1 infection, drugs for treatment of latent tuberculosis, and genetics of protective immunity against malaria (MalariaGEN).

Global partnerships were hailed as a fundamental noble effort that could result in building the much needed capacity both at institutional and individual levels for the betterment of health research with the net turnover of better lives for majority of Africans.

European Vaccine Initiative (EVI): Contributing to controlling malaria

Dr Egeruan Babatunde Imoukhuede, Director, Clinical and Regulatory Affairs, European Vaccine Initiative (EVI) said they want to contribute to the global efforts to control malaria.

They are doing this by providing a mechanism for accelerated development of malaria vaccines in Europe and developing countries and promotion of affordability and accessibility of malaria vaccines in developing countries.

To achieve this, they have entered into partnership with various bodies. These include a clinical network that has in its fold, among others, EDCTP, ECRIN and AMANET. There are also the Malaria Vaccine Scientific Community, Industry & SMEs, international organisations such as World Health Organisation, donor funders and the USA Stakeholders like MVI, NIH and USAID.

“EVI,” said Dr Imoukhuede “has been a partner in the EDCTP funded GMZ2 Consortium and is coordinator of the recently approved Vectored Vaccines Consortium.”

“EVI will continue to adhere to its core mission of accelerating the development of vaccines for poverty-related diseases especially malaria,” Imoukhuede told the forum.

It will also increase its presence in the global coordination and harmonisation of activities related to the poverty related disease

Medicines for Malaria Venture (MMV): Long term view of clinical development

According to Dr Stephan Duparc of the Medicines for Malaria Venture (MMV), they are partnering with others as a way of looking for success in the long term view of clinical development of antimalaria drugs. MMV has pioneered three new fixed-dose artemisinin combination therapies (ACTs): Coartem-D (artemether-lumefantrine), with Novartis; Eurartesim (DHA-piperaquine), with Sigma Tau; and Payramax (pyronaridine-artesunate), with Shin Poong.

Through partnerships MMV is seeking to support generation of evidence to respond to countries’ questions. Examples of such work include Phase IV studies to determine safety and effectiveness of various combination antimalarials such as Coarsucam (artesunate-amodiaquine) ongoing in Côte d’Ivoire

MMV is already working with like-minded organisations like Drugs for Neglected Disease Initiatives (DNDi) and EDCTP among others.

Dr Duparc further shared information on advantages and challenges of various antimalaria products in development.

The International Partnership for Microbicides (IPM)

Dr Annaléne Nel, Chief Medical Officer of the International Partnership for Microbicides (IPM), said that IPM was established in 2002 and was committed to supporting the development and availability of safe and effective microbicides for use by women in developing countries for prevention of HIV transmission.

Talking on Progress on the Path to HIV Prevention: Building Capacity and Partnerships in Africa, Dr Nel said a main focus of IPM is to build capacity at research centres. Areas being tackled include community engagement, referral networks for medical care, treatment, support, infrastructure and equipment.

Staff training and development, communications, messaging, tools, financial management support, and HIV incidence studies are also on the card.

“There are several African countries in which IPM conducts studies and site development activities. There are about 20 clinical research centres in seven countries conducting or planning to conduct research on behalf of IPM, and discussions are ongoing on possible site development and clinical activity in Namibia,” said she.

Dr. Nel said a large-scale efficacy trial for dapivirine vaginal gel and/or dapivirine vaginal ring, with an adaptive trial design is planned for late 2011. The trial, she explained, will be aimed at taking the best product into Phase III, focusing on safety, early looks for harm and futility, and improved adherence.

“The objective is reduction of HIV-1 infection among HIV-negative women and safety.”

The African Malaria Network Trust (AMANET): Training researchers

The African Malaria Network Trust (AMANET) has had a partnership with EDCTP resulting in various activities. Through EDCTP funding, Wen Kilama, Managing Trustee of AMANET, said they are now providing free otherwise costly training to many researchers in Africa and beyond.  Available courses include Basic Health Research Ethics (HRE), Advanced HRE, HRE in French, and Good Clinical Practices.

In promoting capacity building and networking of malaria research and development in Africa, Professor Kilama said that AMANET carried out a survey and needs assessment of malaria research institutions across Africa. Their findings showed that most of them had weak capacity and limited experience hence the need for holistic capacity strengthening to enhance Africa’s participation in product development.

“AMANET is the first, and so far the only African organisation ever to sponsor trials of candidate malaria vaccines,” said Kilama, adding that, “Strengthened African research and development (R&D) in African countries is crucial in order to undertake trials at internationally acceptable standards.”

AMANET is sponsoring an EDCTP funded multicentre clinical trial involving GMZ2 candidate malaria vaccine. This project includes significant capacity strengthening and networking work at the participating centres.

Aeras Global TB Vaccine Foundation

In order to make effective contribution in TB vaccine development, Aeras Global TB Vaccine Foundation has partnered with several organisations bringing in the much needed synergy. Aeras has partnership with various African Institutions conducting clinical trials, many of which also receive funding from EDCTP.

Examples of these include Makerere University in Kampala, Uganda and the Kenya Medical Research Institute (KEMRI) in Kenya.

Dr. Tony Hawkridge of Aeras Global TB Vaccine Foundation said their partnership with EDCTP co-funded capacity development for the conduction of phase IIb and III efficacy trials of new TB vaccines in Africa.

Global partnerships, scientists recognise are important as they bring complimentary capacities and strengths and are already bearing fruits but there is need to ensure that all partners are heading in the same direction.