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Making a Paradigm Shift the Bamako 2008 Global Ministerial Forum on Research for Health | PAGE 12 Special Programme for Research & Training in Tropical Diseases (TDR) sponsored by UNICEF/UNDP/World B a n k / W H O Special Programme for Research & Training in Tropical Diseases (TDR) sponsored by UNICEF/UNDP/World B a n k / W H O No. 82 - M a r c h 2 0 0 9 Making a paradigm shift The Bamako 2008 Global Ministerial Forum on Research for Health | PAGE 12 Also in this issue 29 • Empowerment SAC • ANDI Task Force PAGE 30 • Chagas disease protocol 4 Research briefs 19 • ASTMH and rectal artesunate 7 TDR briefly 32 • DEEP on ineffective diagnostics Liberia diary: 24 HAT research in Uganda • Biosafety courses launched ‘greening’ in Mali M eet IN G S clinical trials in 33 • Sudan adopts HMM strategy 27 • Stewardship SAC a remote site • Environment, agriculture and 34 Publications infectious diseases 36 Grants Letter from the editor Powering sustainable research page n TDR we speak a great deal about Solar power generation capacity not only would as- 9 using the research that we do in sure the sustainability of the infrastructure invest- countries not only for a particular drug ment in Bolahun for other trials for neglected tropi- trial or project, but also to build more cal diseases, but it could potentially power existing “sustainable” research and health services facilities of a nearby health centre, and also Bolahun capacity in poorly resourced locales. High School. Now, a drug trial of moxidectin, a potential drug The high school, founded by monks in 1925 and a for the eradication of onchocerciasis in Africa, to be focus of Peace Corps volunteer activity in the 1960s conducted in Liberia and the Democratic Republic of and 1970s, has an interesting history. It had a national Congo, is adding another dimension to the quest for reputation for academic excellence before the war, sustainability – an environmental dimension. and has recently been rebuilt thanks to the support page I of a network of distinguished alumni. 19 The clinical trial site in Bolahun, Liberia, in a remote northern border region that was once the scene of Kuesel recruited a master’s degree student to make civil war, offers the most dramatic example of the detailed engineering plans for a photo-voltaic system challenges involved (see page 19). sufficient to fuel the research and health centre and the school. Unfortunately, a donor has yet to be The trial site development in Bolahun has involved found. the construction of a major new research centre that will house the Phase III clinical trial activities. Capac- The fact that the sturdy, modern centre was built ity development at the Liberia trial site, as well as with sun-dried mud bricks and that other “green” those in DRC, has largely been funded through a measures have been considered, such as solar- US$ 6 million donation from Wyeth Pharmaceuticals, powered health waste disposal and re-use of biofuel page 24 owner of the moxidectin compound. waste from nearby banana and rice fields, make the Bolahun story a potential case study of efforts to However, despite the generous donation, guarantee- “green” health research facilities in remote locales. ing a power supply to the site has been an ongoing challenge. Charged by our Joint Coordinating Board to address climate change impacts and issues on neglected The centre, soon to begin recruiting patients, cur- diseases, we find the Bolahun story one of the most rently is powered by diesel fuel. However, diesel palpable examples of how TDR can be a leader of power capacity could be unpredictable, due to the Communications innovation in the research sector. Learning from the Manager site’s remote location, (a 10-hour trip from Monrovia, Liberian experience, we can explore how to incorpo- Jamie Guth partly over dirt roads in dry weather). Even though a rate environmental and climate change mitigation Managing Editor backup generator has been installed, any interrup- features into our field and clinical research activities Elaine Fletcher tion in fuel supply or failure of one of the generators – supporting the global drive for sustainable develop- Design and Layout could threaten the successful collection of data es- ment through our research work. Lisa Schwarb sential to the trial. Production Team But becoming a model requires us to first complete Also, once the trial is completed in three years’ time, Jocelyne Bruyère our work in Bolahun. And that means locating donors Pelthia Makgatho there is no guaranteed budget for supply of fuel to for a 15KW solar power generation system. Patrick Adams continue powering the array of laboratory, clinical, (reporter) ophthalmological and computer equipment, which Any takers, please tell us… Ali Bhanpuri (intern) could be used for further research or in the delivery of more routine health services. Cover photo: The Bamako In order to address such issues, TDR’s Annette Kuesel, International Conference who is coordinating the moxidectin research effort Centre in Mali, scene of together with Fatorma Bolay of the Liberia Institute the Global Ministerial Forum on Research for of Biomedical Research, developed a plan to provide Elaine Ruth Fletcher Health, 17-19 November solar power-based electricity to the centre. Managing Editor, TDRnews 2008, which drew 1100 participants from around the world. (Olivier Asselin) Letter from TDR’s director No. 82 Optimizing global health research ‘architecture’ Research policy actors are examining critical ques- cation in activities and administration tions about how the global community can act on needs to be examined. Just as donors recent calls for massive new investment into a global are urged to “harmonize” activities, we R&D effort targeting neglected diseases. need to examine ourselves and see how we are collaborating with our partners. The Global Strategy and Plan of Action on Public Health, However, any proposed reorganization Innovation and Intellectual Property (GSPA), approved must consider that the ultimate goal is by the World Health Assembly in May 2008, has led to improve efficiency, responsiveness to to the creation of a major WHO task force on sustain- scientific opportunity and the needs of able financing of research. This highlights the need to developing countries – and not merely spend much more on such research. superimpose another layer of bureau- cracy. Right now, only 3% of the US$ 160 billion spent glob- ally on health research is invested in neglected dis- TDR is in a pivotal position in this de- eases. Some argue this should quadruple to 12% over bate. TDR’s special programme model the next six years. of governance equally involves both developed and developing country gov- If funds of such an order of magnitude are to be lever- ernments. As TDR’s Joint Coordinating aged then investors, whether private or public donors, Board chairman has remarked, the co-sponsorship of 3 need to be assured that the international organiza- TDR by several UN agencies makes the Programme re- tions and NGOs engaged in research have coordinat- sponsive not to only WHO, but to the UN system more ed mandates for action that optimize their efficient broadly. We believe that the maintenance of this gov- use of funds and can appropriately support regional ernance model is crucial if developing countries are to and national efforts. play a pivotal role in global research for health, and WHO-associated and other health research agencies if research is to remain accountable to high disease have thus been called upon to improve coherence of burden countries. programmes, or even consider a merger of certain in- There will be furthered discussion of TDR’s position ternational research efforts.1 and role in research coordination and alignment at This need to review global health ‘architecture’ was the next Joint Coordinating Board session, 15-17 June. noted in the Bamako call for action at the close of the It is important to bear in mind the good news inher- Global Ministerial Forum on Research for Health in ent to this debate: that is the wave of interest in re- November 2008. search for health, both at the global policy level and from developing countries. At the Bamako Forum, In direct response to the Bamako call, WHO’s Execu- I spoke with the minister of health from Sierra Leone, tive Board, meeting in January, asked actors to “better a country recovering from civil war. He was adamant align and coordinate the global health research archi- that development of research capacity was critical to tecture and its governance through the rationaliza- health and development. tion of existing global health research partnerships, to improve coherence and impact, and to increase ef- TDR is building such capacity on the ground. In this ficiencies and equity.” 2 TDRnews issue, we feature efforts in Liberia and Ugan- da, where research investments are greeted with en- The matter is sure to also arise as the World Health thusiasm and involvement by policy leaders as well Assembly considers approval of a new WHO research as local communities. Engaging and responding to strategy in May. No single programme or agency can country needs has to be kept in the forefront of our remain aloof to the questions being asked and the thinking. It is these efforts that will lay a good founda- challenges posed. There are indeed multiple inter- tion for a research ‘architecture’ that is strong, stable national research initiatives operating from WHO, and durable. involving other partners. And there are multiple NGO initiatives promoting research. Potential dupli- 1 Røttingen JA, Marchiori Buss P, Davies S, Touré O. Global-health research architecture—time for mergers? The Lancet 373: 9659, pp 193-195 Dr Robert Ridley 2 WHO Executive Board resolution: EB124.R12 (http://www.who.int/gb/ ebwha/pdf_files/EB124/B124_R12-en.pdf) TDR Director No.
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