RESEARCH IN AFRICA

“Health research is increasing in quality and quantity in Africa.”

This was the message of hope by Dr. Mickael Maganga; the Head of the Africa office of the European and Developing Countries Clinical Trials Partnerships (EDCTP).It was during the celebration of 10 years of excellence of DNDi in June, 2013.

He went on to explain how Africa’s research and regulatory bodies are doing a commendable job. First, the ethics and Regulatory reviews bodies have increased.

Few examples include the Tropical Disease Research (TDR), the Swedish International Development Agency (SIDA) and Department for Research Cooperation (SAREC), the European Union, the Bill & Melinda Gates Foundation, the International Clinical Epidemiology Network (INCLEN), the Fogarty International Center of the US, National Institutes of Health (NIH) and the Welcome Trust. This has led to better governance and accountability for health projects. Operation is more organised.

Other initiatives:

• Courses on ethics are being offered. We have the South African Research Ethics Training Initiative (SARETI) and West African Bioethics Initiative (WAB).
• Capacity Building is through formal education projects networking long term and short term training. “The staffs are even sent abroad in some cases,” confirmed Dr. Ahmed Musa of the Gedaref State Ministry of health and DNDi.
• Online training programmes from TRREE and ERECCA project that allows people to take refresher courses on Good Clinical Practice (GCP).
• A Regulatory pathway formulated by the MARC project –AVAREF- was launched in 2006 in collaboration with WHO.
• Operations of the EDTCP Ethics activities are now in 23 countries in Africa They work at institutional and national level. The most successful response is coming from Nigeria ,Uganda and Tanzania with 33, 15 and 13 applications respectively. This can be attested to the theory that the population of an area is equally proportional to   the level of training. It is lowest in Liberia.

The sources of data include Surveys, Clinical trials, Routine check up, Pre-trial population and evaluation. The variables include Anthropometry, Spirometry, Cardiovascular, Biochemical, Age, Psychological status

“These are useful for evaluating products for optimum individual cares and preventing study teams from removing good product from the market and adding bad ones, ”said Dr. Bernhards Ogutu, the Chief research officer at KEMRI.

They are all meant to increase capacity for research in Africa. They are effective so the bodies should be trusted.

Esnart Mwape, The Director of the Zambia Medicines Regulatory Authorities added that the legal frameworks guiding the regulatory authorities are not up to date.

“The NMRA’s are also poorly funded therefore semi-functional. This leads to poor or even non-existent co-ordination”

It could be the reason why Samvel Azatyan, the Manager of the Medicines Regulatory Support Programmes, WHO, mentioned that “90% of Africa NMRA’s lack capacity to guarantee quality safety and efficacy which results in lack of medicine affordability and availability.”

This leads to financial strains since they raise funds from the resources they provide which means they give much and retain little.

More challenges include shortage of skilled human resource, poor infrastructure, poor co-ordination between ethics, and regulatory structures and donors lack of awareness of gaps and potential and inadequate collaboration.

We can only hope that in the next years, things change for the better.