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Africa’s potential in science and innovation remains largely untapped because of a severe shortage of trained scientists. Africa has less than 200 researchers per million people, far fewer than many middle-income countries. Therefore, EDCTP is consistently investing in efforts to narrow this deficit. EDCTP-funded research consortia must have at least one partner from sub-Saharan Africa and the EDCTP capacity developing programme has supported more than 600 African researchers.
Promoting a new generation of African scientists
The large EDCTP-funded clinical research projects as a rule offer integrated and collaborative post-graduate training for master’s and PhD students, as well as post-doctoral mentorship. Beyond this is a comprehensive fellowship scheme for current and aspiring African scientific leaders. To date, EDCTP has invested in more than 160 fellows from sub-Saharan Africa who are connected through the EDCTP Alumni network established in 2017. Our multiple-level fellowship scheme bridges various difficult spots in scientific career paths.
The first level fellowship is offered in partnership with the Africa Research Excellence Fund; it aims to hone the skills needed to compete for research grants. At the second level are the Clinical Research and Product Development Fellowships jointly implemented with TDR. They offer researchers and key members of clinical research teams the opportunity to acquire technical and project skills in clinical R&D through placement in pharmaceutical companies, PDPs and CROs. At the third level, Career Development Fellowships support early and mid-career scientists to develop their individual clinical research skills, providing an opportunity for talented scientists to establish themselves as independent researchers and team leaders. The fourth level is formed by the Senior Fellowships which support experienced researchers to advance themselves as leaders in clinical product development and closely related fields while also training and mentoring junior researchers.
In addition to the 67 fellowships, 41 researchers from sub-Saharan Africa were supported in obtaining an academic degree, postdoctoral training or other forms of long-term training (diploma, certificates and internships). This brought the total number of EDCTP2-supported researchers to 108. The majority (74) of them is based in the southern and eastern African regions. The gender ratio is 37% (40) female to 63% (68) male trainees.
Through short-term training and workshops (including training of trainers), EDCTP beneficiaries trained nearly 2000 people, such as laboratory technicians, medical personal, researchers and governmental staff. Integrated in the RIA-projects, short-term training covered topics such as study protocol development, specimen collection, research administration or Good Clinical Practice. Under the CSA grants, training covered research ethics, epidemic preparedness, and knowledge translation to give direct research support to health policy.
By the end of 2018, EDCTP had awarded 89 fellowships to support current and aspiring African scientific leaders; 67 fellows were working on or had already completed their project. Profiles of current and former EDCTP fellows are available on the EDCTP Alumni Network platform.
Senior Fellowships, 25 grants
Career Development Fellowships,
Clinical Research and Development Fellowships,
Since completing my first EDCTP Senior Fellowship (2012-2014) numerous opportunities arose due to what we were able to accomplish with that fellowship. The fellowship enabled me to establish a research group with both clinical and laboratory expertise around the research project on clinical efavirenz pharmacogenetics. The work resulted in the publication of four papers in international peer-reviewed journals and the training to completion of one PhD student.
The quality of our work on this project enabled us to attract other research grants such as the International Science Program (ISP, Sweden) to train Master’s and PhD students in the field of pharmacokinetics and pharmacogenetics. With funding from Novartis Pharmaceutical Company, we established our now world-class phase I Clinical Trial Unit. Funding from SANBIO-BIOFISAII (NEPAD) permitted to develop for commercialisation the pharmacogenetics testing algorithm arising from our efavirenz clinical pharmacogenetics work. AstraZeneca funded our investigator-initiated clinical study on the pharmacogenetics of rosuvastatin in people of African origin.
I can, therefore, say that the first EDCTP Senior Fellowship was catalytic in my institute’s capacity to conduct clinical pharmacogenetics research. The results of our and other researchers’ studies on efavirenz pharmacogenetics are having an impact on clinical guidelines on the use of this drug for improved safety. Our work has resulted in the development of a pharmacogenetics test and dosing algorithm called GeneDose-Efavirenz. This contribution has been recognised through several awards including the Gauteng Accelerator Program (GAP, South Africa) 1st Prize Innovation award; the Robert Mugabe Award for Outstanding Research (Zimbabwe) and the Human Genome Organisation (HUGO) African award.
The new EDCTP fellowship (2018-2022) that I have been awarded, will again strongly further my career and AiBST’s capacity to conduct clinical pharmacogenetics studies. This is a much-needed capacity to translate the many findings from the currently running Human Heredity for Health in Africa (H3Africa) genomics project. This project is uncovering clinically relevant genomic diversity of African populations which needs clinical research for its validation and translation to medical solutions.
Through this fellowship, I will develop the required highly-skilled human capacity through the training of ten MSc students in genomics and precision medicine and two PhD students in clinical pharmacogenetics. The two clinical studies will contribute to safe and efficacious use of praziquantel (an anti-schistosomicide) and efavirenz (an antiretroviral drug). This fellowship will enable me to both establish new international partnerships and strengthen old ones in pharmacogenomics and precision medicine. It will enhance my global standing as one of the pioneers and champions of pharmacogenomics and clinical research in Africa.
The first EDCTP fellowship was catalytic in our capacity to conduct clinical pharmaco-genetics research.
Professor Collen Masimirembwa
African Institute of Science and Technology, Zimbabwe
I’m hoping I will achieve an impact on two issues of global health. The first – and most obvious – is to improve our understanding of the multifactorial early-life risk factors associated with poor lung health in sub-Saharan Africa. Respiratory diseases, including pneumonia, asthma, and TB are an enormous burden in the region, where exposure to air pollution, pathogens and late or limited treatment are common.
We hope to use sophisticated statistical models to understand the multiscale effects of these exposures and will focus on pregnancy and early childhood as these may represent the best opportunities for intervention. I will work with clinical investigators to design intervention and modelling studies for future work.
Capacity development in biostatistical methods would enable keeping data analysis in Africa.
Professor Maia Lesosky
University of Cape Town (UCT), South Africa
Therefore, the second area of impact is capacity development in biostatistical methods. The fellowship will give me the opportunity to offer training to early-career clinical biostatisticians across Africa, as well as students coming to the University of Cape Town. I’m excited about this, as there is a huge need for the development of people to work with African clinical researchers. It would enable keeping data analysis in Africa which grows the degree of the local ownership and relevance of scientific research.
I’m at a unique stage in my career where I am transitioning from working alone to leading larger research projects. This fellowship provides an opportunity to develop the leadership and management skills which large research projects require, and dedicate time to develop a research theme. In addition, this fellowship has already contributed to broadening my network among researchers, especially those based in sub-Saharan Africa, with whom I am able to collaborate.
Photo: Prof. Lesosky and her team during a training.
The EDCTP Career Development Fellowship is a great opportunity for early-career scientists in Africa. The focus of my fellowship was community tracing of HIV-positive mothers in order to understand the effect of and reasons for disengaging from care on estimates of mother-to-child transmission.
Preliminary findings from my ongoing research fellowship demonstrate higher rates of mother-to-child transmission among women who disengage from HIV care, compared to those retained in care. Several psychosocial and structural barriers are associated with the high drop-out rates in this vulnerable group. There is a continued need for interventions to retain all HIV-positive pregnant and breastfeeding women in care, as well as strategies that foster disclosure of HIV status and reduction of stigma.
The findings of this research project will provide a basis for further research that involves designing and testing effective interventions to enhance retention of HIV-infected pregnant and breastfeeding women in sub-Saharan Africa.
My fellowship will enable me to further develop my research profile through new skills and expertise. I am confident that the skills I will obtain through the fellowship, will help me to become an advanced researcher and a role model for African women interested in research. I will use these skills to mentor other African women that are involved in research as well as junior scientists in Uganda and beyond.
The fellowship will help me become an advanced researcher and a mentor of young African women in research.
Dr Agnes Kiragga
Infectious Diseases Institute Ltd (IDI), Uganda
My fellowship focuses on characterizing drug interactions between antimalarials and antiretroviral drugs in settings where malaria and HIV co-infection is common. Previous research work has shown that sulfadoxine-pyrimethamine, the currently recommended drug for the prevention of malaria in pregnancy, does not adequately prevent malaria in pregnant women due to the resistance of malaria parasites to this drug.
Another antimalarial drug, called dihydroartemisinin-piperaquine (DP), has been shown to be a potential alternative for the prevention of malaria in pregnancy. However, there is limited evidence to inform its use in sub-populations such as pregnant women receiving antiretroviral therapy. In this sub-group, both the pregnancy and the drugs used to treat HIV can reduce blood levels of the antimalarial drug and prevent its ability to clear existing malaria parasites in the pregnant woman.
As most countries with a high burden of malaria and HIV co-infection are now beginning to use a new HIV treatment drug, dolutegravir, it is important to understand its contribution, if any, to the reduction of the level of DP given to pregnant women for prevention of malaria. Additionally, there is a need to understand if the antimalarial drug affects blood levels of dolutegravir. This fellowship, therefore, provides a unique opportunity to contribute to the evidence needed for the recommendation of DP as a preventive treatment of malaria in pregnant women living with HIV in regions where the malaria burden is high.
I aim to become a clinician-scientist in a field that focuses on the rational and safe use of medicines (clinical pharmacology). I particularly focus on drugs to treat poverty-related diseases in Africa, as well as the intersection of communicable and non-communicable diseases. Furthermore, I would like to train the next generation of academic clinicians and research scientists in the field.
This fellowship will allow me to gain or strengthen research skills, in addition to providing me with a platform to grow in research and academic leadership. The fellowship has also allowed me to strengthen local collaborations with investigators both at my institution, the College of Medicine in Malawi, and at its affiliated research institution, the Malawi Liverpool Wellcome Trust Clinical Research Programme. I have also established a south-south collaboration, with the University of Cape Town’s Division of Clinical Pharmacology in South Africa, and a south-north collaboration, with the Liverpool School of Tropical Medicine in the United Kingdom. Combined, these collaborations will be key in capacity building in the field of clinical pharmacology in Malawi in the next five to ten years.
My fellowship focuses on drug interactions in settings where malaria and HIV
co-infection is common.
Dr Clifford Banda
University of Malawi, Malawi
I received my EDCTP-TDR Clinical Research and Development Fellows in its first round and I was placed at the Clinical Sciences and Innovation division of the Novartis Institutes for BioMedical Research. During this time, I have broadened my knowledge and skills in clinical trial operations, ethics review processes and regulatory affairs functions.
On the completion of this hands-on training, I returned to Addis Ababa University to share these skills with postgraduate students and work with faculty members to improve clinical research management. I also contributed to the establishment of a phase I clinical trial unit.
Currently, I am serving on the Institutional Review Board (IRB) as a member and secretary and I am engaged in reviewing institutional and national university curriculums regarding clinical research. Moreover, my university hosted a workshop on “medicines development and regulation”, which I conducted as a contribution to a national human workforce in clinical drug development.
I conducted a workshop on “medicines development and regulation” to support national clinical drug development.
Dr Solomon Mequanente Abay
Addis Ababa University, Ethiopia
All in all, the fellowship has had a significant impact on my professional career and institutional development as regards planning and conduct of clinical trials. The fellowship has also stimulated me to try and improve how the Institutional Review Board functions. In return, this helped me to be admitted and complete the Global Bioethics Training Program at Johns Hopkins Berman Institute of Bioethics. I am happy to have become a resource person for our IRB.
The fellowship prepared me to work with established clinical researchers. In line with the above-mentioned undertakings, I applied for an EDCTP Career Development Fellowship with a proposal to generate evidence for optimal treatment of a neglected tropical disease in a special population. The proposed clinical study will assess the pharmacodynamics, pharmacokinetics and pharmacogenetics of praziquantel in preschool-aged children infected with Schistosoma mansoni.
It will also create a window of opportunity for bringing stakeholders together to discuss how to implement an inclusive mass drug administration comprising preschool-aged children. This Career Development fellowship would allow me to work with senior researchers in neglected tropical diseases and develop my career as an independent researcher and team leader in Ethiopia and the region while mentoring graduate students to increase our pool of junior researchers in neglected tropical diseases.
Photo: The facilitators and trainees of "Medicines development and regulation" training workshop.
When I received the EDCTP-TDR Clinical Research and Development Fellowship, I was a junior medical researcher at Centre MURAZ heading the Department of Clinical Research. I had just completed my PhD and had experience as field coordinator of HIV research, and in monitoring several clinical trials conducted in Africa.
From my field experiences, I had learnt that to move forward more quickly and efficiently with the Centre MURAZ Department of Clinical Research, I needed to acquire advanced knowledge and skills in clinical trials, and to develop training modules in key topics.
The EDCTP-TDR Fellowship gave me a great opportunity to get first-hand experience of cutting-edge aspects of clinical trials at Merck in Germany. After my placement, I started to apply what I had learnt to my work at Centre MURAZ. The skills in project oversight I have gained at Merck are now applied to overseeing two research projects: an international HIV prevention research programme in West Africa funded by the Canadian Institutes of Health Research (CIHR), and a capacity development project funded by the Belgium Institute of Tropical Medicine.
At the end of the grant in July 2018, Centre MURAZ merged with two other research centres to form the National Institute of Public Health (INSP) of Burkina Faso. Thanks to the skills and knowledge I gained in clinical trial design and operations at Merck, I was appointed as the Technical Director of Centre MURAZ into the INSP in January 2019.
My placement at Merck also made me more confident and productive in writing research protocols, in planning, conducting and overseeing clinical trial activities. The experience also helps me to develop training modules that I use and share with the other young and junior researchers at Centre MURAZ. And, of course, I am working to build a long-term partnership between Merck and the new Department of Clinical Research of Centre MURAZ.”
The Fellowship gave me a great opportunity to get first-hand experience of cutting-edge aspects of clinical trials at Merck.
Dr Isidore Traore
Clinical Research Centre MURAZ, Burkina Faso