Scientists make strides researching on neglected and emerging diseases

Scientists at Kenya Medical Research Institute in Nairobi in a laboratory carrying out research on HIV/Aids vaccine. Photo by Lominda Afedraru

There are a number of people in Uganda both in urban and rural communities facing challenges from major health related diseases including neglected tropical diseases and emerging diseases such as Marburg and Ebola.

This is as result of sort falls in drug shortage and lack of service delivery by concerned parties in the health sector.

This scenario applies to communities in East Africa and Africa at large. Some of the major diseases include HIV/ Aids, Malaria, Tuberculosis, Diarrheal diseases, lower respiratory tract infections and Cancer among others.

The neglected tropical diseases are Elephantiasis and Hydrocele (limpphatic filariasis) caused by tiny thread like worms producing too much white cells, River blindness a disease spread by black flies, Bilharzia (Schistosomiasis) a parasitic worm infection that can change the urinary and intestinal tracts, intestinal worms such as roundworms and hookworms transmitted through poor hygiene and trachoma an infectious eye disease.

Others are  sleeping sickness spread by bites from inform infectious tsetse flies, plague spread by bacteria transmitted to human through bites from an infected flea, rabies a viral disease to both human and animals, jiggers caused by sand flea and guinea worms an infectious diseases attained from drinking contaminated water.

Research initiatives for better health service delivery

As such scientists from East Africa spear headed by Uganda and those in West and Southern Africa have teamed up in conducting research in a bid to come with solutions to help in treating and finding vaccines for some of the diseases.

This is done in collaboration with the European & Developing Countries Clinical Trials Partnership (EDCTP) under public partnership arrangement between institutions mandated by national governments in Europe and sub-Saharan Africa with funding from the European Union.

Dr Michael Makanga the executive director of EDCTP explaining about the research initiative at the launch of the East African second phase initiative at Uganda Virus Research Institute (UVRI) in Entebbe on January 24, 2018 noted that EDCTP is an innovative public–public partnership through which countries in Europe and sub-Saharan Africa are working together to alleviate the health and economic burden of infectious disease in Africa.

Founded in 2003, it has united clinical researchers, health professionals, policy-makers and other public and private partners advancing the development of drugs, vaccines and other medicinal products to control key infectious diseases affecting people in sub-Saharan Africa and strengthening the capacity of African medical research to address these challenges in the future.

EDCTP was established by the EU in 2003 and the first programme ran until 2015 which focused on HIV, tuberculosis (TB) and malaria with Uganda being the Centre of excellence for the East African countries, Kenya, Tanzania, Rwanda, Burundi, Ethiopia and Sudan.

The global member States are  in Europe are Austria, Denmark, Finland, France, Germany, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden and United Kingdom and Switzerland is aspiring

The African member states are Burkina Faso, Cameroon, Republic of Congo, Ethiopia, Gabon, Ghana, Mali, Mozambique, Niger, Nigeria, Senegal, South Africa, Tanzania, The Gambia, Uganda and Zambia

Others are Angola, Benin, Botswana, Burkina Faso, Cameroon, Central African Republic, Democratic Republic of Congo, Ethiopia, Guinea Bissau, Ivory Coast, Namibia, Sierra Leone and Zimbabwe.

The total grand for the entire project including phase one is 1.9 billion Euros. But EDCTPphase II is a ten-year programme with funding of worth 683M from the EU through its Horizon 2020 initiative matching the investments provided by European Participating States.

Out of which 30million Euros is allocated for the African countries. Health Institutions in the concerned countries are supposed to compete for grants and in Uganda scientists do it through UVRI

Makanga explained that numerous trials were conducted in the first phase by scientists in member states with significant impact on the diagnosis, treatment and prevention of these diseases.

However in light of significant unmet medical needs, the scope of the second phase has been extended, covering neglected infectious diseases, and emerging diseases in addition to the major diseases.

The programme funds all phases of clinical trials from phase I–IV with a particular focus on phase II and phase III studies on HIV/Aids.

Scientists who compete for grants are supported in research areas on full range of medical interventions, including diagnostics, drug treatments and vaccines and other preventive measures such as microbicides.

“Our second important goal is to strengthen the capacity of institutions in sub-Saharan Africa to carry out clinical research in established laboratories and clinical facilities and other infrastructure required for clinical research and associated studies. This has been possible through offering fellowships for scientists majoring in various health areas from Masters to PHD programmes in different institutions in the member states to better serve communities,” he notes.

The programme is also focusing to establish an enabling environment for research, particularly by helping sub-Saharan Africa countries to strengthen their ethical, regulatory and legal frameworks for research, ensuring they are able to host clinical studies consistent with international standards and respecting local regulations.

He noted that in Zambia Scientists have been able to carry out a study in evaluating recombinant retroviral drug for children affected with HIV/ Aids where characteristics of a combined peal to treat both HIV and Aids will be developed. The study is in the 4th phase and if results prove effective, this will be rolled throughout Africa.

The EDCTP Association, registered in the Netherlands, is the legal structure established to deliver the programme.  All member states have representatives and Uganda is considered number two after South Africa in winning grants.

Prof Pontiano Kaleebu the Director UVRI and Uganda Medical Research Centre (MRC) noted that Scientists in East Africa have been privileged under this research initiative because they have been able to find solutions for diseases which keep revolving by giving reconditions to Pharmaceutical Industries on improvement of drug quality to suit the right treatment for the right disease.

This has also enabled manufacturing of new drugs and new ways of diagnostics and administering treatments accordingly using new ways.

We collaborate with Pharmaceuticals Industries like Quality Chemicals in ensuring that they deliver retroviral drugs with minimum toxicity and minimum laboratory testing. International companies such as Johnson and Johnson are good at delivering quality drugs and we ensure children are well catered for,” Prof Kalebu noted.

  

Global disease burden and challenges arising

Explaining disease burden Makanga explained that in 2013 lower respiratory tract infections were responsible for some 2.7 million deaths, HIV 1.3 million, TB 1.3 million, diarrhoeal diseases 1.3 million and malaria 850 000.

Most of these deaths occurred in low-income countries, particularly in sub-Saharan Africa where the burden of infectious disease is highest.

In addition many millions of people are affected by multiple other neglected infectious diseases as well as emerging and re-emerging infectious diseases.

Diseases such as HIV and TB predominantly affect young and middle-aged adults in the prime of life while other big killers such as malaria, pneumonia and diarrheal diseases exact a high death toll among children.

As a result, infectious diseases are a leading contributor to poverty in Africa coupled with the challenge of weak health systems in sub-Saharan Africa, with limited research capacity presenting challenge in many countries.

Africa has another challenge of limited research capacity although there is now increasing research activity led by African scientists out of initiatives and collaborations with development partners.

The development and clinical evaluation of new medical interventions is expensive and commercial organisations are often reluctant to invest in diseases that mainly affect low-income countries.

The product development pipeline for poverty-related diseases is thus poorly stocked and progress is often slow.

Solutions

Nevertheless, innovative mechanisms have been established to accelerate the discovery and assessment of new medical interventions for poverty-related diseases, including major international public–private partnerships.

Encouragingly, several new medicines have been developed for common infections such as HIV, TB and malaria.

However, many groups – such as children and pregnant women – have yet to benefit fully from these treatments and preventive interventions.

There is also a growing need to identify the most effective and sustainable ways to deliver interventions to populations in need.

In addition, there is a continuing need for additional and more effective treatments, while the inevitable development of resistance demands a constant stream of new drugs.

Treatment and control programmes would also greatly benefit from affordable and easy-to-use diagnostics for identifying specific infections and drug resistance.

Individual projects involving multicentre clinical trials that are conducted by research consortia involving both European and African research teams with integrated capacity development and networking elements will be of help.