TDR Results 2014 Report
Measuring for improvement
For research on diseases of poverty UNICEF • UNDP • World Bank • WHO TDR/STRA/15.2
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TDR Results
2014 Report
1. Summary ...... 4
2. Introduction ...... 5
3. Achieving TDR’s scientific and technical objectives ...... 9
3.1 Outcome: Infectious disease knowledge, solutions and implementation strategies translated into policy and practice in disease endemic countries ...... 9 3.2 Main output: New and improved solutions and implementation strategies that respond to health needs of disease endemic countries developed ...... 10 3.3 Feeder output: High quality intervention and implementation research evidence produced ...... 12 3.4 Feeder output: Enhanced research and knowledge transfer capacity within disease endemic countries ...... 15 3.5 Feeder output: Key stakeholders in disease endemic countries engaged in setting the research agenda and ensuring research reflects their needs ...... 17 4. Applying TDR core values to our work ...... 18
4.1 Socio‐economic and gender equity ...... 18 4.2 Effective partnerships ...... 24 4.3 Sustainability of outcomes ...... 24 4.4 Quality of work ...... 24 5. Management performance ...... 25
5.1 Effective resource mobilization ...... 25 5.2 Effective management ...... 25 6. Continuous performance improvement: learning from success and failure ...... 27
7. Annexes ...... 28
Annex 1. List of TDR‐supported peer‐reviewed publications 2014 ...... 28 Annex 2. Progress on the TDR’s current portfolio of expected results – Status as at 31 December 2014 ...... 45 Annex 3. Tools and strategies developed or contributed by TDR and that have been in use for at least 2 years ...... 46 Annex 4. Estimate leverage in 2014 ...... 50 Annex 5. 2014 contributions to the 2014‐15 biennium ...... 51
4 TDR RESULTS | 2014 REPORT
1. Summary
The year 2014 represented a solid step forward towards achieving TDR’s goals and delivering new tools, solutions and strategies against infectious diseases of poverty. The vast majority of the expected results are on track despite a challenging environment that led to a number of TDR’s staff dedicating time and effort to fighting the Ebola outbreak.
This report shows progress made on various performance indicators related to three overarching categories: technical expected results, application of organizational core values, and managerial performance.
Projects in research capacity strengthening made significant progress. The number of individual training grants increased greatly in 2014 compared to previous years, with 103 new grants awarded addressing global and regional priorities. The School of Public Health at the University of Ghana in Accra was selected as the TDR Regional Training Centre in the African region and will develop training programmes based on both the Implementation Research Toolkit developed by TDR and the School’s own courses in implementation research. TDR’s network of Regional Training Centres is now disseminating training courses in a geographical area expanded to include the Western Pacific, South‐East Asia and European WHO regions, in addition to the Americas, its inception point.
TDR trainees’ career tracking showed that 88% of respondents still worked in health research, they returned to their regions (and countries) of origin following completion of their education, they were twice more likely to manage teams and three times more likely to be in permanent posts than their European counterparts. This information came from a European Science Foundation survey of grantees from several institutions, including TDR. TDR trainees rated the importance of support by their sponsor much higher, indicating a higher level of appreciation.
The number of peer‐reviewed publications supported by TDR in 2014 increased significantly from 120 to 227compared to the previous year. The proportion published in open or free access was 88%, a significant increase compared to previous years, and a reflection of recent policies of both TDR and WHO on open‐access publications. First authors came from 54 DEC (disease endemic country) and 18 non‐DEC countries from all WHO regions.
The proportion of women as first author reached an all‐time peak of 47% of TDR‐supported publications. The proportion of contracts awarded to women in 2014 was 43%, the highest in recent years. Reflecting the Programme’s focus on gender equity as a core value, TDR initiated a project to identify and gather solutions to roadblocks that affect the careers of women researchers.
New research evidence, summarized in this report, contributed to innovative tools, strategies and solutions likely leading to improved prevention, diagnosis and treatment, with a positive impact on beneficiaries in disease endemic countries. Projects benefited from partnerships with control programmes, academia and communities, and for each dollar invested in TDR direct operations in 2014, we estimate another three dollars were leveraged from partners.
To improve the development of products for diseases that disproportionately affect developing countries, the World Health Assembly (WHA) adopted a resolution to establish a new mechanism for funding health R&D through a voluntary, pooled fund, and identified TDR as the best existing mechanism to develop the proposed R&D fund.
A new business model is being tested to enhance TDR’s efficiency through collaboration with institutions in low and middle income countries (e.g. administration of postgraduate training grants by universities and implementation through partnerships of the initiative on social innovation in health). This business model, the Programme’s strategy and performance will be assessed in 2015 and 2016, with the goal of continuing to achieve the best value for money in the fight against infectious diseases of poverty. TDR RESULTS | 2014 REPORT 5
2. Introduction
The 2014 Results Report measures the set of performance indicators against targets and in line with the 2012‐2017 strategic plan and the current Performance Assessment Framework approved by the JCB in June 2013.
The report shows progress made on various performance indicators related to three overarching categories: technical expected results, application of organizational core values and managerial performance.
Aside from the work on its strategic areas (intervention and implementation research and research capacity strengthening), TDR has responded to the call of the World Health Assembly and is incubating the global mechanism for funding health R&D for diseases that disproportionately affect developing countries.
As shown in the diagram below, TDR aims for a global impact to reduce the burden of infectious diseases of poverty. TDR’s contribution is made possible by the overall outcome of the Programme, which is the translation of new knowledge, solutions and tools into policy and practice in disease endemic countries. These in turn are the result of three feeder outputs that support and complete each other, with the sustainability of research outputs being enhanced by the engagement of stakeholders and by the capacity built in countries.
Figure 1 ‐ TDR results chain
An overview of the progress made on each of TDR’s key performance indicators is presented in the monitoring and evaluation matrix (see Table 1), with further detail being provided in the body of the report. 6 TDR RESULTS | 2014 REPORT
Table 1‐ TDR's monitoring and evaluation matrix 2012‐2017 Expected results Key performance indicators Baseline Target Progress Frequency of (2011) (2017) (contribution 2014) measurement
Technical expected results Outcome: 1. Number and proportion of innovative knowledge, new/improved 0 30 17 Measured annually, solutions or implementation strategies successfully applied in ≥75% (+4) cumulative over 6 Infectious disease knowledge, years solutions and implementation developing countries 70% strategies translated into 2. Number of tools and reports that have been used to inform policy 0 7 3 Measured annually, policy and practice in disease and/or practice of global/regional stakeholders or major funding (0) cumulative over 6 endemic countries agencies years Main output: 3. Number and proportion of innovative knowledge, new/improved 0 35 16 Measured annually, solutions or implementation strategies developed in response to ≥87% (+6) cumulative over 6 New and improved solutions years and implementation requests from WHO control programmes and/or diseases endemic 100% strategies that respond to countries health needs of disease 4. Number of peer‐reviewed publications supported by TDR and 233 ≥150/year 554 (2012‐2014) Measured annually endemic countries developed percentage published in open access journals Not 100% (+227 in 2014) measured 88% open access (2014) Feeder outputs: 5. Number and evidence of new/improved tools, case‐management, 0 40 16 Measured annually, control or implementation strategies generated through TDR (+6) cumulative over 6 High quality intervention and years implementation research facilitation with systematic quality review by external committees evidence produced 6. Proportion of peer‐reviewed publications supported by TDR with 61% ≥70% 67% Measured annually first author from Disease Endemic Country (DEC) institutions
Enhanced research and 7. Number of DEC institutions and/or networks demonstrating 0 5 3 Measured annually, knowledge transfer capacity expanded scope of activities and/or increased funding from (+3) cumulative over 6 within disease endemic alternative sources thanks to TDR support years countries 8. Number of TDR grantees/trainees and proportion demonstrating 0 150 58/68 Measured on career progression and/or increased scientific productivity ≥80% 85% cohorts 3‐5 years 140 new trainees after training ended (+103 in 2014) TDR RESULTS | 2014 REPORT 7
Expected results Key performance indicators Baseline Target Progress Frequency of (2011) (2017) (contribution 2014) measurement Key stakeholders in disease 9. Number and evidence of research‐related agendas, 0 9 8 Measured annually, endemic countries engaged in recommendations and practices agreed by stakeholders at global, (0) cumulative over 6 years setting the research agenda regional or country level and ensuring research reflects 10. Proportion of TDR outputs produced with key DEC stakeholder Not 100% 100% Measured annually their needs active involvement measured
Application of core values Equity 11. Proportion of TDR grants/contracts awarded to institutions or 59% DEC 75% DEC 70% DEC (amount) Measured annually Social and economic: individuals in DECs (total count and total dollar amount) 62% DEC (count)
12. Proportion of experts from DECs on TDR advisory committees 58% 60% 71% Measured annually
Gender: 13. Proportion of women among grantees/contract recipients (total 35% (n) 50% 43% (% count) Measured annually count and total amount) 17% ($) 28% (% amount)
14. Proportion of women on TDR advisory committees 32% 50% 43% Measured annually
15. Proportion of women as first author of peer‐reviewed publications Not 50% 47% Measured annually supported by TDR (within a calendar year) measured
Effective partnerships 16. Resources leveraged as direct contributions (co‐funding, services or Not tbd 1:3 (provisional data) Measured annually in‐kind) to TDR projects (examples) measured ($ TDR : $ partners)
Sustainability of outcomes 17. Number of effective public health tools and strategies developed 51 67 72 Measured annually, which have been in use for at least two years two years after adoption Quality of work 18. Proportion of project final reports found satisfactory by peer‐ Not >80% 100% Measured annually review committees measured 8 TDR RESULTS | 2014 REPORT
Expected results Key performance indicators Baseline Target Progress Frequency of (2011) (2017) (contribution 2014) measurement
Management performance Effective resource mobilization 19. Percentage of approved biennial budget successfully funded 78% ≥100% To be measured in Measured in the 2015 second year of each biennium 20. Percentage of income received from multi‐year agreements Not tbd To be measured in Measured in the measured 2015 second year of each biennium Effective management 21. Percentage of staff workplans and performance reviews (including Not ≥90% 90.4% Measured annually personal development plan) completed on time measured
22. Proportion of expected results on track 60% ≥80% 69% Measured annually
23. Proportion of significant risk management action plans that are on Not ≥80% 100% Measured annually track measured
TDR RESULTS | 2014 REPORT 9
3. Achieving TDR’s scientific and technical objectives
The indicators covering TDR’s achievement of expected results measure the outcome level as well as the outputs generated which, once translated into policy and practice, will have an impact on the burden of disease in countries.
3.1 Outcome: Infectious disease knowledge, solutions and implementation strategies translated into policy and practice in disease endemic countries
TDR works with partners in disease endemic countries (DECs) to generate essential knowledge and evidence for the prevention and control of infectious diseases of poverty, and to facilitate translation of the solutions into policy and improved healthcare. TDR’s approach leads to strengthening health systems operations in these countries, ultimately reducing the burden of infectious diseases of poverty.
This is done through three key mechanisms – the generation of new evidence and knowledge products, capacity building in disease endemic countries, and the formation of close working relationships with key policy makers and programme staff to ensure the translation of new knowledge into effective disease control efforts on the ground.
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014)
1. Number and proportion of innovative knowledge, 0 30 17 new/improved solutions or implementation strategies ≥75% (+4) successfully applied in developing countries 70% 2. Number of tools and reports that have been used to inform 0 7 3 policy and/or practice of global/regional stakeholders or (0) major funding agencies
Indicator 1 ‐ Number and proportion of innovative knowledge, new/improved solutions or implementation strategies successfully applied in developing countries Several new tools, solutions and strategies generated between 2012 and 2014 started being used by countries. Other tools, especially some of those developed in 2013, have not yet reached this stage; their utilization will be accounted for in future reports. Below is a list of tools utilized by countries. The eco‐health approach was instrumental to improve and innovate the routine Chagas disease interventions in Bolivia, Guatemala and Mexico, e.g. through routine indoor residual spraying of insecticides against domestic vectors of Chagas disease by national control services. Preliminary results from the eco‐system interventions in five study sites indicate a significant reduction in the density of dengue vectors compared to routine programmes, notably in Brazil, Colombia and Mexico, but also in Ecuador and Uruguay. Policy‐makers and practitioners were an active part of the research initiative and committed to scaling up the interventions at city level. Moxidectin was included in the list of 'alternative treatment strategies' to accelerate the elimination of onchocerciasis in Africa where feasible.
10 TDR RESULTS | 2014 REPORT
In 2014 TDR launched the Implementation Research Toolkit to help strengthen capacity to conduct implementation research embedded in disease control programmes. This is a tutorial to be used by a broad range of stakeholders such as researchers, policy‐makers and disease control programme officers to identify system bottlenecks, formulate appropriate research questions and conduct research to address the bottlenecks. Soon after it was published, the TDR secretariat received requests from institutions and research teams in DECs starting to use the toolkit. In addition, several new IMPACT grant projects have been designed to apply the concepts in the toolkit.
Indicator 2 ‐ Number of tools and reports that have been used to inform policy and/or practice of global/regional stakeholders or major funding agencies No change to this indicator occurred in 2014.
3.2 Main output: New and improved solutions and implementation strategies that respond to health needs of disease endemic countries developed
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014)
3. Number and proportion of: innovative knowledge, 0 35 16 new/improved solutions or implementation strategies ≥87% (+6) developed in response to requests from WHO control 100% programmes and/or diseases endemic countries
4. Number of peer‐reviewed publications supported by TDR 233 ≥150/year 554 (2012‐2014) and percentage published in open access journals Not 100% (+227 in 2014) measured 88% open access (2014)
Indicator 3 ‐ Number and proportion of: innovative knowledge, new/improved solutions or implementation strategies developed in response to requests from WHO control programmes and/or diseases endemic countries The totality of the outputs generated in 2014 (six, see indicator 5) were done in response to needs identified by countries, disease‐control programmes or international groups of experts with heavy representation from disease endemic countries researchers.
Indicator 4 ‐ Number of peer‐reviewed publications supported by TDR and percentage published in open access journals The number of peer‐reviewed publications supported by TDR in 2014 increased significantly compared to the previous year, from 120 to 227. The proportion published in open or free access was 88%, a significant increase compared to previous years, and a reflection of recent policies of both TDR and WHO on open‐access publications.
In order to promote and enhance the translation of research into practice, free access to research publications is key. To measure the extent to which TDR‐supported publications responded to the open‐ access concept, the percentage of publications electronically accessible (full text) on PubMed/MEDLINE were counted. In general, users can access articles free of charge either because they are published in an TDR RESULTS | 2014 REPORT 11
open access journal (such as PLoS or BioMed Central journals) or they are stored in a free access repository (such as PubMed Central) at the request of one of the research funders. Other scenarios that guarantee free access are TDR‐funded journal supplements or special agreements between authors and publishers to make the access to a specific article free of charge for the reader.
Of the 227 peer‐reviewed publications in 2014, 88% (n=201) complied with the concept of open / free access. This represents a significant increase from the previous year (from 50% to 88%), and is mainly due to application of the new open‐access policies.
Of the 227 publications, 84 come from the SORT IT programme, reflecting outputs from operational research done by disease control programmes in DECs to address bottlenecks and issues in the implementation of their work. The SORT IT programme leverages significant resources from the countries involved, as well as from other organizations that are part of the initiative and their publications are entirely open access.
Figure 2. ‐ TDR‐SUPPORTED PUBLICATIONS: Proportion in open/free access, 2014
Open/free access 88%
Not open 12%
The complete list of publications supported by TDR in 2014 is attached in Annex 1. It provides the names of the authors, the publication title, name of the peer‐reviewed journal where it appeared and the institution as well as the country of the first author. 12 TDR RESULTS | 2014 REPORT
3.3 Feeder output: High quality intervention and implementation research evidence produced
The generation of new research evidence comes as a result of research projects and grants that TDR funds.
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014)
5. Number and evidence of new/improved tools, case‐ 0 40 16 management, control or implementation strategies (+6) generated through TDR facilitation with systematic quality review by external committees
6. Proportion of peer‐reviewed publications supported by TDR 61% ≥70% 67% with first author from DEC institutions
Indicator 5 ‐ Number and evidence of new/improved tools, case management, control or implementation strategies generated through TDR facilitation with systematic quality review by external committees Evidence on incentives for community health workers. Incentivising community health workers to make a valuable contribution to the health outcomes of communities involves building and sustaining a meaningful, responsive, well‐resourced and well‐managed role for community health workers as part of both the health system and the broader communities in which they work. A revised version of the realistic review on incentives for community health workers entitled “Incentivize Community Health Worker Performance and Retention” was published in an online reference guide with case studies for programme managers and policy‐makers. In addition, during 2014 a multi‐country research initiative was completed to explore the current use of strategies for attraction, retention and performance management of community health workers in five African countries (DR Congo, Ghana, Senegal, Uganda and Zimbabwe). Further to earlier work on dengue surveillance in 10 countries and its ability to detect outbreaks, a systematic literature review on dengue surveillance and contingency planning has been completed and published, identifying shortcomings of current dengue contingency plans and making evidence‐based recommendations for improvement. The retrospective study on the validity of alarm signals for dengue outbreaks in five countries (Brazil, Dominican Republic, Malaysia, Mexico and Viet Nam) has been completed. The third international TDR stakeholder conference highlighted the need for analysing prospectively the predictive value of alarm signals for dengue outbreaks and to establish cost‐effective response activities. This has now been taken up by the next phase of the dengue outbreak research programme. Establishing a new global mechanism for funding health R&D. There has been a long‐running debate through the World Health Assembly (WHA) about how to improve the development of products for those diseases that disproportionately affect developing countries which culminated in a resolution at the WHA in 2013 to establish a new mechanism for funding health R&D through a pooled fund. The priorities for this fund would be identified by the establishment of a WHO observatory to track and monitor funding flows and other activities supporting R&D for neglected diseases. Following comparison with a number of other organizations, WHO identified TDR as the best existing mechanism to develop the proposed R&D fund. TDR RESULTS | 2014 REPORT 13
Summarizing evidence for policy drafting. Six systematic reviews conducted and published: 3 Cochrane (schistosomiasis treatment, malaria treatment and malaria diagnostics) and 3 non‐ Cochrane systematic reviews (malaria, schistosomiasis treatment and dengue surveillance and outbreak response). An additional review of how the strength of a recommendation in WHO’s guidelines (GRADE) affects uptake of the recommendation in national guidelines was conducted with other WHO departments and published in 2014. The School of Public Health at the University of Ghana in Accra was selected in 2014 as the TDR Regional Training Centre in the African Region. The Regional Training Centre will develop training programmes based on both the contents of the Implementation Research Toolkit developed by TDR and the School’s own courses in implementation research. New knowledge in the approaches to diagnosing and preventing visceral leishmaniasis. Initial findings related to identifying cases of visceral leishmaniasis indicate that the combined camp approach in the three countries (Bangladesh, India and Nepal) can identify cases not only of VL and PKDL but also tuberculosis and leprosy. Additionally, community‐based bednet impregnation with slow‐release insecticide reduced VL incidence by 65% in VL‐endemic areas in a large intervention study conducted in 72 VL‐endemic villages in Bangladesh (over 25 000 inhabitants).
Indicator 6 ‐ Proportion of peer‐reviewed publications supported by TDR with first author from DEC institutions The percentage of publications with first authors from a DEC was 67%, relatively stable over the last 3 years.
Figure 3. ‐ TDR‐SUPPORTED PUBLICATIONS: first authors from DEC, 2008‐2014
250 100% with
90 DEC 200 78% 80% publications 70% 73 74 from
of 68%
publications 62% 61% 65% 67% of 63 author 150 60%
Number 37 first 66 Percentage 100 40% 38 153
149 132 109 143 134 82 50 20%
0 0% 2008 2009 2010 2011 2012 2013 2014 DEC non‐DEC % DEC
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The distribution by country of the first authors of 2014 publications is presented in Table 2. First authors come from 54 DEC and 18 non‐DEC countries from all six WHO regions, reflecting TDR’s global reach. The geographical coverage has increased significantly from previous years thanks to the SORT IT programme, which trains personnel from DEC disease control programmes in conducting operational research in their field.
Table 2 ‐ TDR‐SUPPORTED PUBLICATIONS: country of first author, 2014
DEC countries Non‐DEC countries Afghanistan 1 Fiji 11 Pakistan 9 Australia 6 Argentina 6 Gambia 2 Papua New Guinea 1 Belgium 5 Armenia 1 Georgia 2 Philippines 1 Canada 2 Azerbaijan 1 Ghana 6 Rwanda 2 Denmark 2 Bangladesh 2 Guatemala 1 Solomon Islands 1 Estonia 1 Belarus 3 India 11 South Africa 4 France 7 Benin 2 Kenya 7 Sri Lanka 1 Germany 2 Bhutan 1 Madagascar 1 Sudan 3 Greece 1 Brazil 7 Mali 1 Swaziland 1 Japan 1 Burkina Faso 2 Marshall Islands 1 Tanzania 2 Latvia 2 Cameroon 6 Mexico 3 Thailand 1 Luxembourg 3 China 7 Micronesia 1 Togo 1 Netherlands 1 Colombia 4 Moldova 2 Tonga 2 New Caledonia 1 Congo, DR 2 Mozambique 1 Tunisia 2 New Zealand 1 Cook Islands 1 Myanmar 1 Uganda 2 Sweden 1 Côte d'Ivoire 2 Nepal 1 Ukraine 3 Switzerland 14 Egypt 3 Nicaragua 1 Vanuatu 2 United Kingdom 11 Ethiopia 5 Nigeria 5 Zambia 1 United States 13
Figure 4. – TDR‐SUPPORTED PUBLICATIONS: first authors from a DEC, 2014
DEC 67% n=153
non‐DEC 33% n=74
TDR RESULTS | 2014 REPORT 15
3.4 Feeder output: Enhanced research and knowledge transfer capacity within disease endemic countries
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014)
7. Number of DEC institutions and/or networks demonstrating 0 5 3 expanded scope of activities and/or increased funding from (+3) alternative sources thanks to TDR support
8. Number of TDR grantees/trainees and proportion 0 150 58/68 demonstrating career progression and/or increased ≥80% 85% scientific productivity 140 new trainees (+103 in 2014)
Indicator 7 ‐ Number of DEC institutions and/or networks demonstrating expanded scope of activities and/or increased funding from alternative sources thanks to TDR support
TDR’s network of Regional Training Centres is now disseminating the training courses in a geographical area initially covering south and central America (Brazil, Colombia, Cuba, Ecuador, Guatemala, Jamaica and Peru), which has recently expanded to include Regional Training Centres in the Western Pacific (RITM, Philippines), South‐East Asia (GMU, Indonesia) and European (AMS, Kazakhstan) Regions. Regional Training Centres are appropriate vehicles for implementing and disseminating the training tools that TDR is developing within its expanding portfolio. Skill‐ building and train‐the‐trainer courses on effective project planning and evaluation (EPPE), Good Clinical Practices (GCP) and Good Clinical Laboratory Practices (GCLP) are now available in four RTCs, and some of the courses have been integrated in university curricula. A workshop involving representatives of these training centres was recently held to implement GCP/GCLP train‐the‐ trainer courses.
The Regional Training Centre in Latin America (CIDEIM, Cali, Colombia) established a network of institutions to further disseminate training skills and courses. In 2014, the Latin American network expanded coverage of the project management training programme through a skill‐ building course and a train‐the‐trainer course at the Universidad Nacional Autónoma de Honduras, Tegucigalpa; Instituto National de Salud, San Salvador, El Salvador; and Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, San José, Costa Rica. In addition, this training programme has been developed as new e‐learning modules on budget planning, data analysis and data management.
The Regional Training Centre at Gadjah Mada University, Indonesia is now functioning and expanded the scope of its training courses by introducing a new course on Good Health Research Practice. To broaden the scope of research covered by the GCP guidelines (namely ethics and quality), the RTC network has collaborated with the London School of Hygiene and Tropical Medicine and the Secretariat of the WHO Ethics Review Committee in developing a training programme on Good Health Research Practice (GHRP). This training programme adapts the existing GCP guidelines to a wide range of health research, including implementation research, with a focus on low‐ and middle‐income countries. In 2014 this training course was piloted at the University of Heidelberg in Germany, and at the Regional Training Centre at Gadjah Mada University in Indonesia. The other regional training centres will use and disseminate the programme in 2015. 16 TDR RESULTS | 2014 REPORT
Indicator 8 ‐ Number of TDR grantees/trainees and proportion demonstrating career progression and/or increased scientific productivity Career progression survey In 2014 TDR took part in the European Science Foundation career tracking survey pilot testing, conducted in collaboration with other funders of educational and training programmes. A TDR cohort of 150 grantees was selected and the survey was completed at the end of 2014 with a focus group discussion on the preliminary results held in December which involved TDR grantees. The survey results will be available in April 2015 and a report and manual on how to conduct such a survey will be published by mid‐2015. This survey will then be improved as needed before being implemented on a regular basis (every 2‐3 years). Preliminary survey data highlights regarding TDR grantees (77 respondents): 88% (68/77 respondents) still work in health research A much higher proportion of WHO/TDR respondents are involved in staff management (58/68 respondents) compared to their peers in the combined survey group (85% TDR compared to 40% others respectively) WHO/TDR respondents’ utilisation of their doctorate level skills is very high (92% use regularly) and higher than the combined group (85%) WHO/TDR respondents are much more heavily involved in research supervision of PhD and other students and colleagues than the combined group. They are also much more likely to be managing a research team and setting up a laboratory than the combined group. WHO/TDR respondents were nearly three times as likely as their European (mainly researcher) peers to be in permanent (mainly medical and educational) posts – but with a research component. A similarly high proportion of WHO/TDR respondents in comparison to the combined group respondents described themselves as Frascati referenced researchers (over 80%). Unlike respondents funded by other participant organizations, a significant proportion of the WHO/TDR respondents moved to Europe to complete their doctorates but returned to their regions (and countries) of origin following completion of their education WHO/TDR respondents rated the importance of support by their sponsor (WHO/TDR) much higher than the combined group average (x ̄ = 1.33 vs 2.01), indicating a higher level of appreciation WHO/TDR respondents’ reported outputs were broadly in line with the combined group apart from a higher level of awards and patents reported by WHO/TDR respondents Another survey will likely take place in 2016 involving research grantees in addition to training grantees. Progress – new grants in 2014 The number of grants awarded in 2014 increased greatly compared to previous years, with 103 new grants being awarded.
In 2014, 34 new impact grants were awarded, 8 that had been recommended from the first call for proposals (2013) and 26 from the second call (2014). In the second round, TDR received 460 applications from applicants in 74 LMICs. The main topics proposed were in epidemiology, vector control, diagnosis and treatment of infectious diseases of poverty. Other areas of interest were cross‐cutting and mainly related to health system strengthening, including health education, health systems analysis, ethics, knowledge management, research methodology and social science. The external reviewers research recommended 26 proposals for funding. The gender distribution (women/men) was 42%/58% among applicants and among those recommended for funding. The grants were awarded to investigators from 23 LMICs (Argentina, Bangladesh, Bolivia, TDR RESULTS | 2014 REPORT 17
Cameroon, Colombia, Congo, Ethiopia, Gambia, Georgia, Ghana, India, Kenya, Liberia, Mongolia, Mozambique, Nigeria, Papua New Guinea, Peru, Solomon Islands, Somalia, Tanzania, Thailand and Viet Nam).
The international postgraduate training scheme awarded 22 grants to nationals from LMICs to acquire postgraduate qualifications (MSc, PhD) and for other training towards careers in health research. The huge demand for training support is shown by the large number of applications (328) received.
Four WHO regional offices issued calls for proposals for small grants jointly with TDR. Following the selection process, 38 small grants were awarded in 2014 through this scheme.
In 2014 TDR awarded 9 highly competitive postdoctoral grants designed to facilitate mentorship and “re‐entry” of LMIC researchers in their home countries/institutions and to enable them to initiate independent research careers.
Career development fellowships ongoing. The European and Developing Countries Clinical Trials Partnership (EDCTP) and TDR signed an agreement in 2014 to join forces in developing clinical trials capacity. Following a joint TDR‐EDCTP call for applications (deadline 31 January 2015) and a joint review and selection process, TDR will offer ten positions and EDCTP seven to eight positions per year, with placement of the fellows to start in the second semester of 2015. Twenty host organizations have agreed to participate in the first round of this new joint scheme. No new grants were awarded under this scheme in 2014.
3.5 Feeder output: Key stakeholders in disease endemic countries engaged in setting the research agenda and ensuring research reflects their needs
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014)
9. Number and evidence of research‐related agendas, 0 9 8 recommendations and practices agreed by stakeholders at (0) global, regional or country level 10. Proportion of TDR outputs produced with key DEC Not 100% 100% stakeholder active involvement measured
Indicator 9 ‐ Number and evidence of research‐related agendas, recommendations and practices agreed by stakeholders at global, regional or country level No change in 2014.
Indicator 10 ‐ Proportion of TDR outputs produced with key DEC stakeholder active involvement All outputs generated in 2014 involved disease endemic countries in multiple ways: consultation to determine priorities; engagement of experts to design, review and oversee projects; awarding capacity‐ strengthening grants; working with the WHO regional offices; collaborating with vector control programmes or disease control programmes; or conducting and monitoring research in the field. Numerous project sites from DECs contributed financial or in kind resources. 18 TDR RESULTS | 2014 REPORT
4. Applying TDR core values to our work
4.1 Socio‐economic and gender equity
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014) 11. Proportion of TDR grants/contracts awarded to 59% DEC 75% DEC 70% DEC (amount) institutions or individuals in DECs (total count and 62% DEC (count) total dollar amount)
12. Proportion of experts from DECs on TDR advisory 58% 60% 71% committees
13. Proportion of women among grantees/contract 35% (n) 50% 43% (% count) recipients (total count and total amount) 17% ($) 28% (% amount)
14. Proportion of women on TDR advisory committees 32% 50% 43%
15. Proportion of women as first author of peer‐ Not 50% 47% reviewed publications supported by TDR (within a measured calendar year)
Indicator 11 ‐ Proportion of TDR grants/contracts awarded to institutions or individuals in DECs and low income countries (total count and total dollar amount) In 2014, the proportion of grants and contracts awarded to institutions and researchers in DECs (US$ 5.4 million) was 70%, which is a decrease from 2013 (75%). However this represents a significant year‐to‐year increase in the absolute amount awarded to DECs (US$ 5.4 million 2014 compared to US$ 3.7 million in 2013).
Figure 5 ‐ GRANTS/CONTRACTS: proportion awarded to disease endemic countries (% count) in 2014
non‐DEC n=68 38%
DEC n=109 62%
TDR RESULTS | 2014 REPORT 19
Figure 6 ‐ GRANTS/CONTRACTS: proportion awarded to disease endemic countries (% amount) in 2014
non‐DEC US$2.3M 30% DEC US$ 5.4M 70%
Figure 7 ‐ GRANTS/CONTRACTS: Yearly progress in amounts awarded to DECs
$10,000,000 100%
$8,000,000 80% 75% 68% 70% 64% $6,000,000 60%
$4,000,000 40%
$2,000,000 20%
$‐ 0% 2011 2012 2013 2014
DEC non‐DEC %DEC
Indicator 12 ‐ Proportion of experts from DECs on TDR advisory committees The proportion of experts from DECs in advisory roles to TDR remains beyond the desired target of 60%, reflecting TDR’s efforts to give disease endemic countries a central role in priority setting and oversight of research and capacity strengthening initiatives. These figures are provisional until all data from committees has been compiled.
Figure 8 – COMMITTEES: proportion of experts from disease endemic countries in TDR advisory roles
non‐DEC 29% n=12
DEC 71% n=30
20 TDR RESULTS | 2014 REPORT
Figure 9 ‐ COMMITTEES: yearly progress, proportion of experts from DECs in TDR advisory roles
70 100%
60 80% 50 69% 71% 40 60%
30 40% 20 20% 10
0 0% 2013 2014
DEC non‐DEC %DEC
Indicator 13 ‐ Proportion of women among grantees/contract recipients (total count and total amount) The proportion of grants and contracts awarded to women in 2014 was 43% (number of contracts) and 28% (amount).
TDR has initiated a call for proposals to identify and gather solutions to roadblocks that affect the careers of women researchers. The call was issued in 2014 and gathered attention from a vast geographical region, with most applications coming from Africa. Following internal screening and review by three STAC members, ten proposals were selected and contracts are being drafted with funding from TDR’s Strategic Development Fund. It is envisaged that the solutions provided by the grantees will be scalable so that they could encourage women researchers to pursue their careers and contribute at a higher percentage to the critical mass of scientists and scientific work in disease endemic countries.
Figure 10 ‐ GENDER: Proportion of contracts awarded to women (% count)
Women 43% Men 57%
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Figure 11 ‐ GENDER: Progress in proportion of contracts awarded to women (% count)
60% 50% TARGET 50% 43%
40% 35% 34% 33% 32%
30%
20%
10%
0% 2009 2010 2011 2012 2013 2014 2015
No data available in 2013.
Figure 12 ‐ GENDER: Proportion of contracts awarded to women (% amount)
Women 28% US$ 2.1M
Men 72% US$ 5.6M
22 TDR RESULTS | 2014 REPORT
Indicator 14 ‐ Proportion of women on TDR advisory committees The proportion of women on advisory committees in 2014 was 43%, slightly up from 42% in 2013.
Figure 13 – COMMITTEES: proportion of women in TDR advisory roles
Women 43%
Men 57%
Figure 14 ‐ COMMITTEES: progress in proportion of women in TDR advisory roles
60%
TARGET 50% 43% 50% 42%
40% 34% 33% 32% 28% 30%
20%
10%
0% 2009 2010 2011 2012 2013 2014 2015
TDR RESULTS | 2014 REPORT 23
Indicator 15 ‐ Proportion of women as first author of peer‐reviewed publications supported by TDR (within a calendar year) In 2014, 47% of first authors of TDR‐supported publications were women. Compared to 2013, the results show marked improvement (47% vs. 41%). This is largely due to a higher proportion of women first authors of publications resulting from SORT‐IT projects in disease‐endemic countries.
Figure 15 – TDR‐SUPPORTED PUBLICATIONS: gender distribution of first authors (n=226), 2014
Women Men 47% 53%
Figure 16 ‐ TDR‐SUPPORTED PUBLICATIONS: gender distribution of first authors year‐to‐year
100%
80%
60% 53% Men proportion 59% 40% 47% Women 41% Gender
20%
0% 2013 2014
24 TDR RESULTS | 2014 REPORT
4.2 Effective partnerships
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014) 16. Resources leveraged as direct contributions (co‐funding, Not tbd 1:3 (provisional data) services or in‐kind) to TDR projects (examples) measured ($ TDR : $ partners)
Indicator 16 ‐ Resources leveraged as direct contributions (co‐funding, services or in‐kind) to TDR projects (examples) Based on the assumptions used to make the estimation, in 2014 TDR projects leveraged approximately US$ 25 million in contributions by implementers, communities, control programmes, or additional grants. Annex 4 provides a detailed list as well as the assumptions used in each case. This means that for each dollar invested in TDR direct operations in 2014, another three dollars were leveraged from partners and communities.
4.3 Sustainability of outcomes
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014) 17. Number of effective public health tools and strategies 51 67 72 developed which have been in use for at least two years
Indicator 17 ‐ Number of effective public health tools and strategies developed which have been in use for at least two years Eight new tools and strategies have been added to the list. They have been in use since 2012 and they include improved tools and interventions, guidelines and good practices as well as research evidence that contributed to innovative approaches.
4.4 Quality of work
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014) 18. Proportion of project final reports found satisfactory by Not >80% 100% peer‐review committees measured
Indicator 18 ‐ Proportion of project final reports found satisfactory by peer‐review committees On the sample measured, all project final reports successfully passed the review, therefore, the percentage in 2014 was 100%.
TDR RESULTS | 2014 REPORT 25
5. Management performance
5.1 Effective resource mobilization
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014) 19. Percentage of approved biennial budget successfully 78% ≥100% To be measured in funded 2015
20. Percentage of income received from multi‐year agreements Not tbd To be measured in measured 2015
Indicator 19 ‐ Percentage of approved biennial budget successfully funded This indicator is measured at the end of the biennium.
Indicator 20 ‐ Percentage of income received from multi‐year agreements This indicator is measured at the end of the biennium.
5.2 Effective management
Key performance indicators Baseline Target Progress (2011) (2017) (contribution 2014) 21. Percentage of staff workplans and performance reviews Not ≥90% 90.4% (including personal development plan) completed on time measured
22. Proportion of expected results on track or achieved 60% ≥80% 69%
23. Proportion of significant risk management action plans that Not ≥80% 100% are on track measured
Indicator 21 ‐ Percentage of staff workplans and performance reviews (including personal development plan) completed on time The vast majority of staff workplans and performance reviews were done on time in 2014 (90.4%). TDR secretariat have engaged in the TDR Staff Development initiative by joining professional courses, pursuing higher education and acquiring new skills. WHO is now implementing a similar initiative.
Indicator 22 ‐ Proportion of expected results on track At 31 December 2014, the status of the expected results was as follows: 17 were advancing on schedule; financial implementation seems low in some cases due to calls for proposals that will only lead to contracts in 2015 1 successfully completed during the year 4 were being closely monitored due to some delays in activities implementation 3 encountered delays that likely will delay their outputs 1 was cancelled at the recommendation of the Scientific Working Group 2 were merged with other existing expected results for better alignment of activities, at the recommendation of the Scientific Working Group. 26 TDR RESULTS | 2014 REPORT
Figure 17 ‐ Status of expected results as at 31 Dec 2014
Outputs Cancelled delayed 4% 12%
Activities delayed 15% On schedule or completed 69%
Indicator 23 ‐ Proportion of significant risk management action plans that are on track There were no notable delays in implementing the risk management actions in 2014.
At the TDR progress review in 2014, three additional risks were identified: Risk 14 ‐ WHO budget ceiling is set low for TDR 2014‐2015 biennium budget approved by JCB Action: Discuss with ADG/HTM the possibility of increasing TDR’s budget ceiling in order to match implementation as relevant
Risk 15‐ World Health Assembly requested TDR to consider hosting a pooled funding mechanism for R&D for neglected diseases to be operational by 2016 Actions: Ensure TDR has a role in the implementation of the WHO Member State selected demonstration projects to ensure learning from this process informs future R&D pooled funding Ensure planning includes TDR governing bodies and other stakeholders, to have a clear understanding of how it fits and complements the TDR Strategy Ensure TDR core funders continue to provide undesignated funding to the Programme while supporting the R&D pooled fund and to ensure WHA continues to be in charge of raising and replenishing funds for the R&D pooled fund Risk 16 – Impact of WHO staff mobility policy on TDR. Action: Liaise with WHO Management, follow the development of this policy and, if appropriate, develop scenarios and their implications
TDR RESULTS | 2014 REPORT 27
6. Continuous performance improvement: learning from success and failure
The 2014‐2015 biennium signals the beginning of a new portfolio of innovative projects and a change in the working model to enhance the emphasis on collaboration and working through partners. In a way, this represents a proof of concept for a reorganized and slimmed down TDR that can implement in an effective and efficient manner and provide a leadership role for research and capacity strengthening in infectious diseases of poverty. New partnership approaches and business models are being piloted through novel initiatives such as: partnerships with leading instituions promoting and supporting research for social innovation in healthcare delivery; long‐term partnerships with seven universities in awarding individual grants in a coordinated manner, increasing efficiency by having the universities manage grants administration and contracts; establishing a joint call for applications with EDCTP (inspired by the recent Ebola outbreak) to award grants for strengthening regional and country capacity to conduct high quality research during emergencies and/or epidemic outbreaks. Two budget scenarios were developed for 2014‐2015, in accordance with recommendations of the JCB. Implementation started at the lower budget scenario of US$ 50 million. As additional funds above this were confirmed, implementation was scaled up gradually in line with available funding. This required detailed and flexible plans to allow for scaling up the workplan on short notice. The same approach, successfully tested during the current biennium, will be applied to the 2016‐2017 budget and workplan. The two rounds of restructuring in 2011 and 2012 resulted in a leaner and more cost‐effective TDR, with staff costs in 2014‐2015 reduced by 40% compared to 2012‐2013 and by 60% compared to 2010‐2011. TDR’s sound financial situation, with new systems that improve efficiency (online grant application process, a streamlined way of monitoring the portfolio) or assure quality and accountability (working through Scientific Working Groups, a formal prioritization system, a system for financial audits of project sites, systematic project evaluations), and a nurturing framework for staff development, are likely to facilitate successful implementation in the coming years. TDR continues to closely manage identified risks for the Programme and the projects it funds. New risks have been added to the register in order to best mitigate implications of: (i) the coming WHO policy on staff mobility; and (ii) establishment of the pooled health R&D fund. The year 2014 represented the take‐off phase for many new projects as well as the forming of Scientific Working Groups that play a key advisory and guiding role for TDR teams and projects. Although the vast majority of outputs are on track for timely delivery, some projects encountered delays, reflected in a relatively low financial implementation in 2014. A new system to closely monitor and speed up the pace of slow‐implementing projects has been put in place which has also fostered cross‐TDR collaborations as “One TDR”. TDR’s new staff development policy, which was introduced in August 2013, has now been successfully piloted and has enhanced staff motivation and skills ‐ 2 staff have completed respectively an MBA and an MPH, 4 staff are enrolled in academic studies (2 BA business studies, 1 MPH, 1 PhD) and 1 staff received a short course certificate. This initiative has run ahead of the new WHO policy for staff development, which is similar and was launched in 2014. Moving forward, in 2015 the Programme will implement new systems to promote organizational learning and to assure quality and accountability. The two evaluations of TDR’s grant schemes and of the approach to regional training centres for good practice dissemination will further enhance the research capacity strengthening area and will feed into the Programme external review of 2016. Financial implementation audits of project sites will contribute to strengthening their capacity to manage research grants and will provide assurance that the best value for money is obtained from TDR grants. 28 TDR RESULTS | 2014 REPORT
7. Annexes
Annex 1. List of TDR‐supported peer‐reviewed publications 2014 (Retrieved from Web of Science and PubMed)
1. Abba, K., Kirkham, A. J., Olliaro, P. L., Deeks, J. J., Donegan, S., Garner, P., and Takwoingi, Y. Rapid diagnostic tests for diagnosing uncomplicated non‐falciparum or Plasmodium vivax malaria in endemic countries. Cochrane.Database.Syst.Rev. 12, CD011431. 2014. Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, Merseyside, United Kingdom, L3 5QA. PubMed 2. Abbey, M., Bartholomew, L. K., Nonvignon, J., Chinbuah, M. A., Pappoe, M., Gyapong, M., Gyapong, J. O., Bart‐Plange, C., and van den Borne, B. Factors related to retention of community health workers in a trial on community‐based management of fever in children under 5 years in the Dangme West District of Ghana. International Health 6[2], 99‐105. 2014. Ghana Hlth Serv, Res & Dev Div, PM Bag 190, Accra, Ghana. PubMed 3. Abdalla, H., Wilding, C. S., Nardini, L., Pignatelli, P., Koekemoer, L. L., Ranson, H., and Coetzee, M. Insecticide resistance in Anopheles arabiensis in Sudan: temporal trends and underlying mechanisms. Parasites & Vectors 7. 2014. Wits Research Institute for Malaria, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. PubMed 4. Abeygunawardena, S. C., Sharath, B. N., Van den Bergh, R., Naik, B., Pallewatte, N., Masaima, M. N. N. Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring? Pub. Health Action 4(2): 105– 109, 2014. District Chest Clinic Kaltura 150, Sri Lanka. PHA 5. Acosta, C. D., Dadu, A., Ramsay, A., Dara, M. Drug‐resistant tuberculosis in Eastern Europe: challenges and ways forward Pub. Health Action 4(3): S3–S12, 2014. WHO Regional Offi ce for Europe, Tuberculosis and Multidrugresistant,Tuberculosis Programme, UN City, 2100 Copenhagen, Denmark. PHA 6. Acosta, C. D., Rusovich, V. Harries, A. D., Ahmedov, S., van den Boom, M., Dara M. A new roadmap for childhood tuberculosis. Lancet Glob Health. 2(1):e15‐7, 2014. WHO Regional Offi ce for Europe, Tuberculosis and Multidrugresistant, Tuberculosis Programme, UN City, 2100 Copenhagen, Denmark. PubMed 7. Adam, O., Ali, A. K. M., Hubschen, J. M., and Muller, C. P. Identification of congenital rubella syndrome in Sudan. Bmc Infectious Diseases 14. 2014. Natl Res Ctr, Commiss Biotechnol & Genet Engn, Dept Med Biotechnol, Khartoum, Sudan. PubMed 8. Adebamowo, C., Bah‐Sow, O., Binka, F., Bruzzone, R., Caplan, A., Delfraissy, J. F., Heymann, D., Horby, P., Kaleebu, P., Tamfum, J. J., Olliaro, P., Piot, P., Tejan‐Cole, A., Tomori, O., Toure, A., Torreele, E., and Whitehead, J. Randomised controlled trials for Ebola: practical and ethical issues. Lancet 384[9952], 1423‐1424. 18‐10‐2014. National Health Research Ethics Committee, Abuja, Nigeria. PubMed 9. Adie, H., Igbang, T., Otu, A., Braide, E., Okon, O., Ikpi, E., Joseph, C., Desousa, A., and Sommerfeld, J. Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study. Pan Afr.Med.J. 17, 221. 2014. Ministry of Health, Calabar, Nigeria. PubMed 10. Aksoy, S., Attardo, G., Berriman, M., Christoffels, A., Lehane, M., Masiga, D., and Toure, Y. Human African trypanosomiasis research gets a boost: unraveling the tsetse genome. PLoS.Negl.Trop.Dis. 8[4], e2624. 2014. Yale School of Public Health, Department of Epidemiology and Public Health, New Haven, Connecticut, United States of America. PubMed 11. Alikhanova, N., Akhundova, I., Seyfaddinova, M., Mammadbayov, E., Mirtskulava, V., Rüsch‐Gerdes, S., Bayramov, R., Suleymanova, J., Kremer, K., Dadu, A., Acosta, C. D., Harries, A. D., Dara M. First national survey of anti‐tuberculosis drug resistance in Azerbaijan and risk factors analysis. Pub. Health Action 4(3): S17–S23, 2014. Scientific Research Institute of Lung Disease, 25/14 E Suleymanov Street, Baku, Azerbaijan. PHA 12. Alley, C. and Sommerfeld, J. Infectious disease in times of social and ecological change. Med.Anthropol. 33[2], 85‐91. 2014. Department of Sociomedical Sciences , Mailman School of Public Health, Columbia University , New York , New York , United States of America. PubMed
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13. Alo, A., Gounder, S., Graham, S. M. Clinical characteristics and treatment outcomes of tuberculosis cases hospitalised in the intensive phase in Fiji, Pub. Health Action 4(3): 164–168, 2014. National Tuberculosis Programme, Ministry of Health Fiji, Suva, Fiji. PHA 14. Anchang‐Kimbi, J. K., Achidi, E. A., Apinjoh, T. O., Mugri, R. N., Chi, H. F., Tata, R. B., Nkegoum, B., Mendimi, J. M. N., Sverremark‐Ekstrom, E., and Troye‐Blomberg, M. Antenatal care visit attendance, intermittent preventive treatment during pregnancy (IPTp) and malaria parasitaemia at delivery. Malaria Journal 13. 2014. University of Buea, Dept Zool & Anim Physiol, Buea 63, Cameroon. PubMed 15. Andrade, J. M. and Murta, S. M. F. Functional analysis of cytosolic tryparedoxin peroxidase in antimony‐resistant and ‐ susceptible Leishmania braziliensis and Leishmania infantum lines. Parasites & Vectors 7. 2014. Fiocruz MS, Ctr Pesquisas Rene Rachou, BR‐30190002 Belo Horizonte, MG, Brazil. PubMed 16. Arnold, B. F., Priest, J. W., Hamlin, K. L., Moss, D. M., Colford, J. M., and Lammie, P. J. Serological Measures of Malaria Transmission in Haiti: Comparison of Longitudinal and Cross‐Sectional Methods. Plos One 9[4]. 2014. University of California Berkeley, School of Public Health, Dept. Epidemiology, Berkeley, CA 94720 United States of America. PubMed 17. Arnott, A., Wapling, J., Mueller, I., Ramsland, P. A., Siba, P. M., Reeder, J. C., and Barry, A. E. Distinct patterns of diversity, population structure and evolution in the AMA1 genes of sympatric Plasmodium falciparum and Plasmodium vivax populations of Papua New Guinea from an area of similarly high transmission. Malar.J. 13, 233. 2014. Division of Infection and Immunity, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia. PubMed 18. Arshad, A., Salam, R. A., Lassi, Z. S., Das, J. K., Naqvi, I., and Bhutta, Z. A. Community based interventions for the prevention and control of tuberculosis. Infect.Dis.Poverty. 3, 27. 2014. Division of Women and Child Health, The Aga Khan University, 74800 Karachi, Pakistan. PubMed 19. Asante‐Poku, A., Aning, K. G., Boi‐Kikimoto, B., and Yeboah‐Manu, D. Prevalence of bovine tuberculosis in a dairy cattle farm and a research farm in Ghana. Onderstepoort Journal of Veterinary Research 81[2]. 2014. Noguchi Memorial Institute of Medical Research, Dept. Bacteriology, Accra, Ghana. PubMed 20. Asante‐Poku, A., Nyaho, M. S., Borrell, S., Comas, I., Gagneux, S., and Yeboah‐Manu, D. Evaluation of Customised Lineage‐Specific Sets of MIRU‐VNTR Loci for Genotyping Mycobacterium tuberculosis Complex Isolates in Ghana. Plos One 9[3]. 2014. University of Ghana, Noguchi Memorial Institute of Medical Research, Dept. Bacteriology, Legon, Ghana. PubMed 21. Assogba, B. S., Djogbenou, L., Saizonou, J., Diabate, A., Dabire, R. K., Moiroux, N., Gilles, J. R. L., Makoutode, M., and Baldet, T. Characterization of swarming and mating behaviour between Anopheles coluzzii and Anopheles melas in a sympatry area of Benin. Acta Tropica 132, S53‐S63. 2014. University of Abomey Calavi, Inst Reg Sante Publ, Cotonou, Benin. PubMed 22. Atta, H. and Reeder, J. World Malaria Day 2014: invest in the future. Defeat malaria. East Mediterr.Health J. 20[4], 219‐ 220. 2014. Regional Adviser, Malaria Control and Elimination, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt. PubMed 23. Awadzi, K., Opoku, N. O., Attah, S. K., Lazdins‐Helds, J., and Kuesel, A. C. A Randomized, Single‐Ascending‐Dose, Ivermectin‐Controlled, Double‐Blind Study of Moxidectin in Onchocerca volvulus Infection. Plos Neglected Tropical Diseases 8[6]. 2014. Onchocerciasis Chemotherapy Research Center, Hohoe, Ghana. PubMed 24. Badejo, J. A., Abiodun, O. O., Akinola, O., Happi, C. T., Sowunmi, A., and Gbotosho, G. O. Interaction between rifampicin, amodiaquine and artemether in mice infected with chloroquine resistant Plasmodium berghei. Malaria Journal 13. 2014. University of Ibadan, College of Medicine, Dept. Pharmacology & Therapeut, Ibadan, Nigeria. PubMed 25. Bajis, S., Van den Bergh, R., De Bruycker. M., Mahama, G., Van Overloop, C., Satyanarayana, S., Bernardo, R. S., Esmati, S., Reid, A. J. Antibiotic use in a district hospital in Kabul, Afghanistan: are we overprescribing? Pub. Health Action 4(4): 259–264, 2014. Operational Centre Brussels, Médecins Sans Frontières, Rue Dupre 94, 1090 Jette, Brussels, Belgium. PHA 26. Bakajika, D. K., Nigo, M. M., Lotsima, J. P., Masikini, G. A., Fischer, K., Lloyd, M. M., Weil, G. J., and Fischer, P. U. Filarial Antigenemia and Loa loa Night Blood Microfilaremia in an Area Without Bancroftian Filariasis in the Democratic Republic of Congo. American Journal of Tropical Medicine and Hygiene 91[6], 1142‐1148. 2014. Programme Natl Lutte Onchocercose, Kinshasa, Dem. Rep. Congo. PubMed 27. Balak, D. A., Bissell, K., Roseveare, C., Ram, S., Devi, R. R., Graham S. M. Absolute Lymphocyte Count Is Not a Suitable Alternative to CD4 Count for Determining Initiation of Antiretroviral Therapy in Fiji. J. Trop. Med. 2014:715363, 2014. Reproductive Health Clinic, Ministry of Health, P.O. Box 30, Suva, Fiji. PubMed 30 TDR RESULTS | 2014 REPORT
28. Banla, M., Tchalim, S., Karabou, P. K., Gantin, R. G., Agba, A. I., Kere‐Banla, A., Helling‐Giese, G., Heuschkel, C., Schulz‐ Key, H., and Soboslay, P. T. Sustainable Control of Onchocerciasis: Ocular Pathology in Onchocerciasis Patients Treated Annually with Ivermectin for 23 Years: A Cohort Study. Plos One 9[6]. 2014. Natl Inst Hyg, Onchocerciasis Reference Lab, Sokode, Togo. PubMed 29. Barnadas, C., Senn, N., Iga, J., Timinao, L., Javati, S., Malau, E., Rarau, P., Reeder, J. C., Siba, P., Karunajeewa, H., Zimmerman, P. A., Davis, T. M., and Mueller, I. Plasmodium falciparum and Plasmodium vivax genotypes and efficacy of intermittent preventive treatment in Papua New Guinea. Antimicrob.Agents Chemother. 58[11], 6958‐6961. 2014. Vector Borne Diseases Unit, Papua New Guinea Institute of Medical Research (PNGIMR), Goroka, Papua New Guinea PubMed 30. Bates, I., Boyd, A., Aslanyan, G., and Cole, D. C. Tackling the tensions in evaluating capacity strengthening for health research in low‐ and middle‐income countries. Health Policy Plan. 8‐4‐2014. Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Manchester Business School, Booth St W, Manchester, Greater Manchester M15 6PB, United Kingdom. PubMed 31. Benzaken, A. S., Bazzo, M. L., Galban, E., Pinto, I. C. P., Nogueira, C. L., Golfetto, L., Benzaken, N. S., Sollis, K. A., Mabey, D., and Peeling, R. W. External quality assurance with dried tube specimens (DTS) for point‐of‐care syphilis and HIV tests: experience in an indigenous populations screening programme in the Brazilian Amazon. Sexually Transmitted Infections 90[1], 14‐18. 2014. UNAIDS, Brasilia, DF, Brazil. PubMed 32. Bezerra, C. M., Cavalcanti, L. P. D., de Souza, R. D. M., Barbosa, S. E., Xavier, S. C. D., Jansen, A. M., Ramalho, R. D., and Diotaiuti, L. Domestic, peridomestic and wild hosts in the transmission of Trypanosoma cruzi in the Caatinga area colonised by Triatoma brasiliensis. Memorias do Instituto Oswaldo Cruz 109[7], 887‐898. 2014. Univ Fed Ceara, Programa Posgrad Saude Comunitaria, Fortaleza, Ceara, Brazil. PubMed 33. Bhutta, Z. A., Salam, R. A., Das, J. K., and Lassi, Z. S. Tackling the existing burden of infectious diseases in the developing world: existing gaps and the way forward. Infect.Dis.Poverty. 3, 28. 2014. Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan. PubMed 34. Bhutta, Z. A., Sommerfeld, J., Lassi, Z. S., Salam, R. A., and Das, J. K. Global burden, distribution, and interventions for infectious diseases of poverty. Infect.Dis.Poverty. 3, 21. 2014. Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan. PubMed 35. Bissell, K., Viney, K., Brostrom, R., Gounder, S., Khogali, M., Kishore, K., Kool, B., Kumar, A. M. V., Manzi, M., Marais, B., Marks, G., Linh, N. N., Ram, S., Reid, S., Roseveare, C., Tayler‐Smith, K., Van den Bergh, R., Harries, A. D. Building operational research capacity in the Pacific. Pub. Health Action 4(2): S2–S13, 2014. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; School of Population Health, the University of Auckland, Auckland PO Box 28862, Remuera, Auckland 1541, New Zealand. PHA 36. Bobosha, K., Fat, E. M. T. K., van den Eeden, S. J. F., Bekele, Y., van der Ploeg‐van Schip, JJ, de Dood, C. J., Dijkman, K., Franken, K. L. M. C., Wilson, L., Aseffa, A., Spencer, J. S., Ottenhoff, T. H. M., Corstjens, P. L. A. M., and Geluk, A. Field‐ Evaluation of a New Lateral Flow Assay for Detection of Cellular and Humoral Immunity against Mycobacterium leprae. Plos Neglected Tropical Diseases 8[5]. 2014. Armauer Hansen Res Inst, Addis Ababa, Ethiopia. PubMed 37. Bobosha, K., Wilson, L., van Meijgaarden, K. E., Bekele, Y., Zewdie, M., van der Ploeg‐van Schip, JJ, Abebe, M., Hussein, J., Khadge, S., Neupane, K. D., Hagge, D. A., Jordanova, E. S., Aseffa, A., Ottenhoff, T. H. M., and Geluk, A. T‐Cell Regulation in Lepromatous Leprosy. Plos Neglected Tropical Diseases 8[4]. 2014. Armauer Hansen Res Inst, Addis Ababa, Ethiopia. PubMed 38. Bowman, L. R., Runge‐Ranzinger, S., and Mccall, P. J. Assessing the relationship between vector indices and dengue transmission: a systematic review of the evidence. PLoS.Negl.Trop.Dis. 8[5], e2848. 2014. Liverpool School of Tropical Medicine, Liverpool, United Kingdom. PubMed 39. Brelsfoard, C., Tsiamis, G., Falchetto, M., Gomulski, L. M., Telleria, E., Alam, U., Doudoumis, V., Scolari, F., Benoit, J. B., Swain, M., Takac, P., Malacrida, A. R., Bourtzis, K., and Aksoy, S. Presence of Extensive Wolbachia Symbiont Insertions Discovered in the Genome of Its Host Glossina morsitans morsitans. Plos Neglected Tropical Diseases 8[4]. 2014. St Catharine Coll, Dept Nat Sci, St Catharine, KY, United States of America. PubMed 40. Bucardo, F., Reyes, Y., Svensson, L., and Nordgren, J. Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination. Plos One 9[5]. 2014. University of Leon UNAN Leon, Dept Microbiol, Leon, Nicaragua. PubMed 41. Bullen, C., van Griensven, J. Operational research in the South Pacific. Pub. Health Action 4(2): S1, 2014. National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand. PHA
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42. Bustamante, D. M., De Urioste‐Stone, S. M., Juarez, J. G., and Pennington, P. M. Ecological, Social and Biological Risk Factors for Continued Trypanosoma cruzi Transmission by Triatoma dimidiata in Guatemala. Plos One 9[8]. 2014. San Carlos University, Dept Biol, Guatemala City, Guatemala. PubMed 43. Buys, L., Aird, R., van, Megen K., Miller, E., and Sommerfeld, J. Perceptions of climate change and trust in information providers in rural Australia. Public Underst.Sci. 23[2], 170‐188. 2014. Queensland University of Technology, Australia. PubMed 44. Cardinal, M. V., Orozco, M. M., Enriquez, G. F., Ceballos, L. A., Gaspe, M. S., varado‐Otegui, J. A., Gurevitz, J. M., Kitron, U., and Gurtler, R. E. Heterogeneities in the Ecoepidemiology of Trypanosoma cruzi Infection in Rural Communities of the Argentinean Chaco. American Journal of Tropical Medicine and Hygiene 90[6], 1063‐1073. 2014. 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56. Das, M., Isaakidis, P., Armstrong, E., Gundipudi, N. R., Babu, R. B., Qureshi, I. A., Claes, A., Mudimanchi, A. K., Prasad, N., Mansoor, H., Abraham, S. Directly‐Observed and Self‐Administered Tuberculosis Treatment in a Chronic, Low‐Intensity Conflict Setting in India. PLoS One. 20;9(3):e92131, 2014. Operational Research, Médecins Sans Frontières, New Delhi, Delhi, India. PubMed 57. Das, M., Isaakidis, P., Van den Bergh, R., Kumar, A. M. V., Nagaraja, S. B., Valikayath, A., Jha, S., Jadhav, B., and Ladomirska, J. HIV, multidrug‐resistant TB and depressive symptoms: when three conditions collide. Global Health Action 7, 1‐5. 2014. Médecins Sans Frontières, O, A‐131, New Delhi 110024, India. PubMed 58. Davtyan, K., Zachariah, R., Davtyan, H., Ramsay, A., Denisiuk, O., Manzi, M., Khogali, M., Van den Bergh, R., Hayrapetyan, A., Dara, M. Performance of decentralised facilities in tuberculosis case notification and treatment success in Armenia. Pub. Health Action 4(3): S13–S16, 2014. 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70. Enriquez, G. F., Bua, J., Orozco, M. M., Wirth, S., Schijman, A. G., Gurtler, R. E., and Cardinal, M. V. High levels of Trypanosoma cruzi DNA determined by qPCR and infectiousness to Triatoma infestans support dogs and cats are major sources of parasites for domestic transmission. Infection Genetics and Evolution 25, 36‐43. 2014. University of Buenos Aires, Fac Exact & Nat Sci, Lab Ecoepidemiol, RA‐1428 Buenos Aires, DF, Argentina. PubMed 71. Fanai, S., Viney, K., Tarivonda, L., Roseveare, C., Tagaro, M., Marais, B. J. Profile of tuberculosis patients with delayed sputum smear conversion in the Pacific island of Vanuatu. Pub. Health Action 4(2): S19–S24, 2014. National Tuberculosis Programme, Department of Public Health, Ministry of Health, PMB 9009, Port Vila, Vanuatu. PHA 72. Fonua, L., Bissell, K., Vivili, P., Gounder, S., Hill, P. C. Sputum smear microscopy referral rates and turnaround time in the Tonga Islands. Pub. Health Action 4(2): S29–S33, 2014. 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83. Gounder, A., Gounder S, Reid, S. A. Evaluation of the implementation of the Xpert® MTB/RIF assay in Fiji. Pub. Health Action 4(3): 179–183, 2014. P J Twomey Hospital, Ministry of HealthSuva, Fiji. PHA 84. Guelbeogo, W. M., Sagnon, N., Liu, F., Besansky, N. J., and Costantini, C. Behavioural divergence of sympatric Anopheles funestus populations in Burkina Faso. Malaria Journal 13. 2014. Ctr Natl Rech & Format Paludisme, Ouagadougou 01 BP 2208, Ouagadougou, Burkina Faso. PubMed 85. Guillerm, N., Tayler‐Smith, K., Berger, S. D., Bissell, K., Kumar, A. M. V., Ramsay, A., Reid, A. J., Zachariah, R., Harries, A. D. What happens after participants complete a Union‐MSF structured operational research training course? Pub. Health Action 4(2): 89‐95, 2014. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France. PHA 86. Haoues, M., Refai, A., Mallavialle, A., Barbouche, M. R., Laabidi, N., Deckert, M., and Essafi, M. Forkhead box O3 (FOXO3) transcription factor mediates apoptosis in BCG‐infected macrophages. Cellular Microbiology 16[9], 1378‐1390. 2014. University of Tunis El Manar, Tunis, Tunisia. PubMed 87. Harries, A. D., Bianchi, L., Jensen , P. M., Pantages, M., Bissell, K., Kumar, A. M. V., Hinderaker, S. G., Tayler‐Smith, K., Van den Bergh, R., van den Boogaard, W., Manzi, M., Isaakidis, P., Reid, A. J., Zachariah, R. Public Health Action for public health action. Pub. Health Action 4(3): 139–140, 2014. International Union Against Tuberculosis and Lung Disease Old Inn Cottage, Vears Lane, Colden Common Winchester SO21 1TQ, United Kingdom. PHA 88. Harries, A. D., Marais, B., Kool, B., Ram, S., Kumar, A. M. V., Gounder, S., Viney, K., Brostrom, R., Roseveare, C., Bissell, K., Reid, A. J., Zachariah, R., Hill, P. C. Mentorship for operational research capacity building: hands‐on or hands‐off? Pub. Health Action 4(2): S56–S58, 2014. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; London School of Hygiene & Tropical Medicine, London, United Kingdom. PHA 89. Hunsperger, E. A., Yoksan, S., Buchy, P., Nguyen, V. C., Sekaran, S. D., Enria, D. A., Vazquez, S., Cartozian, E., Pelegrino, J. L., Artsob, H., Guzman, M. G., Olliaro, P., Zwang, J., Guillerm, M., Kliks, S., Halstead, S., Peeling, R. W., and Margolis, H. S. Evaluation of commercially available diagnostic tests for the detection of dengue virus NS1 antigen and anti‐dengue virus IgM antibody. PLoS.Negl.Trop.Dis. 8[10], e3171. 2014. Dengue Branch, Centers for Diseases Control and Prevention, San Juan, Puerto Rico, United States of America. PubMed 90. Iribagiza, M. K., Manikuzwe, A., Aquino, T., Amoroso, C., Zachariah, R., van Griensven ,J., Schneider, S., Finnegan, K., Cortas, C., Kamanzi, E., Hamon, J. K., Hedt‐Gauthier, B. L. Fostering interest in research: evaluation of an introductory research seminar at hospitals in rural Rwanda. Pub. Health Action 4(4): 271–275, 2014. Partners In Health–Inshuti, Mu Buzima, PO Box 3432, Kigali, Burera District, Northern Province, Rwanda. PHA 91. Irungu, B. N., Orwa, J. A., Gruhonjic, A., Fitzpatrick, P. A., Landberg, G., Kimani, F., Midiwo, J., Erdelyi, M., and Yenesew, A. Constituents of the Roots and Leaves of Ekebergia capensis and Their Potential Antiplasmodial and Cytotoxic Activities. Molecules 19[9], 14235‐14246. 2014. University of Nairobi, Dept Chem, Nairobi 00100, Kenya. PubMed 92. Ismail, H. A., Tijani, M. K., Langer, C., Reiling, L., White, M. T., Beeson, J. G., Wahlgren, M., Nwuba, R., and Persson, K. E. M. Subclass responses and their half‐lives for antibodies against EBA175 and PfRh2 in naturally acquired immunity against Plasmodium falciparum malaria. Malaria Journal 13. 2014. Karolinska Inst, Dept Microbiol Tumor & Cell Biol MTC, S‐17177 Stockholm, Sweden. PubMed 93. Itogo, N., Hill, P. C., Bissell, K., Harries, A. D., Viney, K., Gounder, S. Tuberculosis notifications, characteristics and treatment outcomes: urban vs. rural Solomon Islands, 2000–201. Pub. Health Action 4(2): S25–S28, 2014. Ministry of Health and Medical Services, PO Box 349 Honiara, Solomon Islands. PHA 94. Ives, A., Masina, S., Castiglioni, P., Prevel, F., Revaz‐Breton, M., Hartley, M. A., Launois, P., Fasel, N., and Ronet, C. MyD88 and TLR9 dependent immune responses mediate resistance to Leishmania guyanensis infections, irrespective of Leishmania RNA virus burden. PLoS.One. 9[5], e96766. 2014. Department of Biochemistry, University of Lausanne, Epalinges, Switzerland. PubMed 95. Jobanputra, K., Parker, L. A., Azih C., Okello, V., Maphalala, G., Jouquet, G., Kerschberger, B., Mekeidje, C., Cyr, J., Mafikudze, A., Han, W., Lujan, J., Teck, R., Antierens, A., van Griensven, J., Reid, T. Impact and Programmatic Implications of Routine Viral Load Monitoring in Swaziland. J Acquir Immune Defic Syndr. 67(1):45‐51, 2014. Médecins Sans Frontières (Operational Centre Geneva), Mbabane, Swaziland. PubMed
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96. Jones, C. H., itez‐Valladares, D., Guillermo‐May, G., Dzul‐Manzanilla, F., Che‐Mendoza, A., Barrera‐Perez, M., Selem‐ Salas, C., Chable‐Santos, J., Sommerfeld, J., Kroeger, A., O'Dempsey, T., Medina‐Barreiro, A., and Manrique‐Saide, P. Use and acceptance of long lasting insecticidal net screens for dengue prevention in Acapulco, Guerrero, Mexico. BMC.Public Health 14, 846. 2014. Universidad Autonoma de Yucatan, Carretera Merida‐Xmatkuil Km, 15,5, Merida C,P, 97315, Mexico.PubMed 97. Joseph, S. J., Li, B., Ghonasgi, T., Haase, C. P., Qin, Z. H. S., Dean, D., and Read, T. D. Direct Amplification, Sequencing and Profiling of Chlamydia trachomatis Strains in Single and Mixed Infection Clinical Samples. Plos One 9[6]. 2014. Emory University, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 United States of America. PubMed 98. Kaba, D., Zacarie, T., M'Pondi, A. M., Njiokou, F., Bosson‐Vanga, H., Krober, T., McMullin, A., Mihok, S., and Guerin, P. M. 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Annex 2. Progress on the TDR’s current portfolio of expected results – Status as at 31 December 2014
Expected Result Status Support adequate country response to epidemic challenges: evidence‐based guidance for dengue On schedule outbreak detection & response Integrated capacity building and research for lab‐to‐field translation of putative resistance markers Cancelled Vulnerability to emerging drug resistance and its consequences for control programmes On schedule Facilitate innovation to generate tools to achieve control programme objectives On schedule Strengthen evidence base for policy decisions and programme implementation by maximizing utility Activities of available data delayed Safety data for policy decisions On schedule Intervention & Implementation research to inform policies for the elimination of Visceral Activities leishmaniasis (VL) delayed Community‐based scheduled screening and treatment of malaria in pregnancy for improved On schedule maternal and infant health: a cluster‐randomized trial (COSMIC) Activities Improved management of febrile illnesses delayed Outputs Structured Operational Research and Training Initiative (SORT IT) delayed Strategic support to WHO regional activities : the regional training centers On schedule WHO Regional Office collaboration and small grants On schedule Targeted research training grants in low‐and middle‐income countries On schedule Research Capacity Strenghtening and Knowledge Management impact grants to improve disease On schedule control Advanced training in Clinical Product Development (Career Development Fellowship grants) On schedule TDR alumni network: piloting the concept and supporting system On schedule Knowledge management priorities and gaps in implementation research, research capacity On schedule strengthening and and research & development Activities Capacity strengthening to bring research evidence into policy delayed Collaborative networks for harmonization of policies and practices On schedule Strategic engagement in global health initiatives On schedule Outputs Promoting research for improved community access to health interventions in Africa delayed Improved chagas and dengue disease control through innovative ecosystem management and Completed community‐directed interventions Population health vulnerabilities to VBDs: increasing resilience under climate change conditions in On schedule Africa Implementation research in support of the WHO Global Strategy for dengue prevention and control On schedule Application of social entrepreneurship for the prevention and control of infectious diseases of On schedule poverty Assessment of insecticide resistance mechanisms in malaria vectors and their impact on control Outputs failure in Africa delayed 46 TDR RESULTS | 2014 REPORT
Annex 3. Tools and strategies developed or contributed by TDR and that have been in use for at least 2 years
# Year Tools / strategies
1. 1981 Leprosy ‐ WHO recommendation for use of multidrug therapy (MDT) for leprosy following its registration in 1980 by Ciba‐Geigy. 2. 1983 Schistosomiasis ‐ Diagnostic urine‐filtration technique in disease control use 3. 1983 African trypanosomiasis ‐ Card agglutination diagnostic test for trypanosomiasis (CATT) in disease control use. 4. 1987 Onchocerciasis ‐ Ivermectin registered by Merck, and donation programme begins 5. 1989 Chagas disease ‐ Improved agglutination blood test for rapid screening of transfusion blood in disease control use. 6. 1990 African trypanosomiasis ‐ Eflornithine® registered by Marion Merrell Dow. 7. 1993 Onchocerciasis ‐ Rapid epidemiological mapping of onchocerciasis (REMO) in disease control use. 8. 1994 Filariasis ‐ Single‐dose treatment with DEC or ivermectin is shown to be an appropriate treatment regimen, providing the basis for a new global control strategy based on mass drug administration. 9. 1994 Leishmaniasis ‐ Direct agglutination diagnostic test (DAT) and standard leishmania skin test antigen in disease control use. 10. 1994 Chagas disease, sleeping sickness and leishmaniasis ‐ Parasite genome sequencing project launched in meeting in Brazil, co‐sponsored by TDR and FIOCRUZ. Sequences published in 2005. 11. 1994 Onchocerciasis ‐ Effectiveness of mass drug administration with ivermectin in preventing posterior segment eye disease, visual impairment and blindness demonstrated in longitudinal studies in Africa. 12. 1994 Visceral leishmaniasis ‐ Liposomal amphotericin B registered by NeXstar. 13. 1995 Schistosomiasis ‐ Method for rapid identification of urinary schistosomiasis in highly endemic communities validated and in control use. 14. 1995 Onchocerciasis ‐ Importance of onchocercal skin disease determined, providing the basis for extending onchocerciasis control to forest areas in Africa. 15. 1996 Lymphatic filariasis ‐ Drug delivery strategies developed for lymphatic filariasis elimination in Africa. 16. 1996 Schistosomiasis ‐ Guidelines for diagnosis of female genital schistosomiasis completed. 17. 1996 Malaria ‐ Final results of large field trials of insecticide‐treated bednets involving 400 000 people in Ghana, Burkina Faso, Kenya and The Gambia demonstrate that insecticide‐ treated bednets could reduce overall childhood mortality by around 20%. 18. 1996 Onchocerciasis ‐ Community‐directed treatment (ComDT) of onchocerciasis with ivermectin becomes the mainstay of APOC mass drug administration delivery strategies following multi‐country field studies testing the model’s efficacy. 19. 1997 Leprosy ‐ Improved multidrug therapy based on rifampicin, oflaxacin and minocycline (ROM) used for leprosy control.
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# Year Tools / strategies
20. 1997 Malaria ‐ A TDR‐supported pan‐African conference on research in Dakar, Senegal decides to create the Multilateral Initiative on Malaria. 21. 1998 Malaria ‐ Home management of malaria approach adopted as a strategy by WHO. 22. 1998 Lymphatic filariasis ‐ Safety demonstrated for albendazole as treatment. 23. 2000 Lymphatic filariasis ‐ Rapid mapping of filariasis in control use. 24. 2000 HINARI, a partnership for Health InterNetwork Access to Research Initiative, is launched with TDR as part of the partnership in the area of research capacity building. 25. 2000 Malaria ‐ Germline transformation of Anopheles mosquitoes. 26. 2000 WHO published the Operational guidelines for ethics committees that review biomedical research 27. 2001 TDR initiates several partnerships for developing capacity in bioinformatics. 28. 2001 Malaria ‐ Evidence for policy – Reducing potential for artemisinins resistance via use of artemisinins combination therapy (ACT) in uncomplicated malaria 29. 2001 Good laboratory practice:Quality practices for regulated non‐clinical research and development 30. 2002 Malaria ‐ Genome sequencing of Anopheles gambiae completed by TDR‐fostered consortium. 31. 2002 Visceral leishmaniasis – Miltefosine registration as first oral therapy against VL 32. 2002 The Strategic Initiative for Developing Capacity in Ethical Review (SIDCER) is inaugurated. 33. 2002 Workbook for Investigators 34. 2003 Malaria – Unit‐dose packaging of Coartem® to ensure adherence and suitability for home management of malaria in collaboration with Novartis. 35. 2003 Lymphatic filariasis ‐ Longitudinal studies produce evidence that mass drug administration would be required for more than 4–6 years in most places to eliminate lymphatic filariasis. 36. 2003 Sexually transmitted diseases ‐ TDR‐led evaluation of rapid syphilis diagnostic tests led to those with acceptable performance being placed on the WHO procurement list at negotiated pricing for member states. 37. 2004 African trypanosomiasis ‐ International Glossina Genomics Initiative (IGGI) to fully sequence the tsetse fly genome launched. 38. 2004 Malaria ‐ Regulatory label extension is obtained for the use of Coartem® (oral treatment of artemether + lumefantrine) in infants and young children above 5 kg in weight. 39. 2005 Visceral leishmaniasis ‐ The health ministers of India, Nepal and Bangladesh sign a Memorandum of Understanding pledging to eliminate kala azar (visceral leishmaniasis) from their countries by 2015. 40. 2005 Visceral leishmaniasis ‐ Validation of RK39 as a diagnostic for use in India but not in Africa, incorporated into visceral leishmaniasis elimination programme. 41. 2005 Onchocerciasis ‐ RAPLOA (rapid assessment procedure for determining areas of Loa loa endemicity) developed, validated and incorporated into disease control use. 48 TDR RESULTS | 2014 REPORT
# Year Tools / strategies
42. 2005 Malaria ‐ Results from studies in Ghana indicate that the proportion of caregivers using ACTs correctly in terms of promptness, dosage and number of days is more than 90%, leading to reduced delay in seeking treatment. 43. 2005 WHO published the Operational Guidelines for the Establishment and Functioning of Data and Safety Monitoring Boards 44. 2005 Effective project planning and evaluation for biomedical and health research 45. 2006 Malaria ‐ Evidence for pre‐referral treatment use provided in WHO Malaria Treatment Guidelines 46. 2006 Dengue ‐ Multi‐country studies validating pupal productivity survey methods for dengue vector control are published, demonstrating method effectiveness. 47. 2006 Initial results from multi‐country studies demonstrate potential for expanding the community‐directed treatment strategy for ivermectin, established under APOC, to deliver a broader, integrated set of interventions, including insecticide‐treated bednets 48. 2007 Leishmaniasis ‐ Paromomycin is registered for use in India through the Institute for One World Health. 49. 2007 Tuberculosis ‐ WHO Policy recommending reduction of the number of smears for the diagnosis of tuberculosis and defining a new sputum smear‐positive case 50. 2008 Community‐directed interventions (CDI), an integrated approach for improved access to vital drugs and preventive measures, including for malaria, in remote African communities. 51. 2008 Schistosomiasis ‐ Evidence for dosage of Praziquantel for the control of schistosomiasis 52. 2008 Malaria ‐ Mefloquine‐artesunate combination drug has been developed for malaria treatment and introduced in Brazil. 53. 2008 Dengue ‐ Dengue diagnostics test available at negotiated price (new ones in evaluation) 54. 2008 Tuberculosis ‐ WHO Policy on line probe assays and second‐line drug susceptibility testing 55. 2010 African trypanosomiasis ‐ the tsetse fly genome sequenced, assembled and annotated by the International Glossina Genomics Initiative (IGGI) Consortium 56. 2010 WHO guidelines recommend rectal artesunate in paediatric populations with severe malaria living in remote locations in rural Africa and Asia 57. 2010 WHO recommendation against the use of immunodiagnostics tests for active or latent TB infection 58. 2010 TB fluorescence microscopy. Research results informed the introduction of LED‐FM in high burden countries in Nov 2010 59. 2010 A simplified, revised and evidence‐based disease classification system for dengue adopted in Latin‐American and Asian countries 60. 2010 Visceral Leishmaniasis (VL) active case detection methods applied at large scale by control programmes in the Indian subcontinent 61. 2011 Malaria rapid diagnostics tests evaluation rounds have led to quality improvements and the RDTs have become part of the overall strategy for malaria: Test, Treat, Track. 62. 2011 An evidence‐based strategy to support the elimination of visceral leishmaniasis is being used in the Indian subcontinent
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# Year Tools / strategies
63. 2011 New synthetic routes for enantiomerically‐pure L‐praziquantel identified in collaboration with the Australian Research Council; used to develop a new pediatric formulation. 64. 2011 Planning, Monitoring and Evaluation Framework for Capacity Strengthening in Health Research. ESSENCE Good Practice document series 65. 2012 Five keys to improving research costing in low‐ and middle‐income countries, ESSENCE Good Practice document series 66. 2012 Optimized and standardized trapping and bait technology for relevant vectors of HAT 67. 2012 Community‐based ecosystem management interventions for better disease prevention of dengue in Asia and of dengue and Chagas disease in Latin America 68. 2012 HAT‐Trick, a decision support system for improved vector control intervention methods of human African trypanosomiasis (HAT) 69. 2012 Framework for the introduction of rapid tests on sexually transmitted infections into country programmes 70. 2012 Dengue vector control methods and strategies, combining targeted breeding containers and insecticide‐treated materials 71. 2012 Evidence contributing to the WHO and UNICEF Integrated Community Case Management (iCCM) strategy to reduce childhood mortality through community case management of malaria, pneumonia and diarrhoea 72. 2012 T3: Test. Treat. Track. Evidence on feasibility and costs of universal coverage diagnostic, testing and antimalarial treatment.
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Annex 4. Estimate leverage in 2014
TDR Expected Result Partners' contribution Partner organization's name 2014 Contribution type contribution TOTAL 24 750 000 Vectors, environment and society 9 650 000 Evidence basis for the improvement of University of Bamako; Cameroon, Kenya, 2 000 000 Personnel, facilities, ongoing control integrated malaria vector control strategies in Mali, USA programmes East, Central and West Africa Evidence for community and eco‐based vector Sites / institutions in Bolivia, Brazil, 3 000 000 Partners’ contribution over a period control in Latin‐America for Dengue fever and Colombia, Ecuador, Guatemala, Mexico of 3 years Chagas disease and Uruguay Evidence on impact of climate change on Sites / institutions in Botswana, Côte 700 000 Technical support, facilities, vector‐borne diseases in Africa d’Ivoire, Kenya, Mauritania, South Africa, laboratory work Tanzania and Zimbabwe Evidence on community‐based strategies to Sites / institutions in Burkina‐Faso, DR 500 000 Community support, control enhance access to control interventions in Congo, Ghana, Malawi, Nigeria, Senegal, programmes efficiencies, third party Africa Uganda and Zimbabwe site funding Social innovation in healthcare delivery Oxford University, University of Cape 700 000 Technical support, joint calls for Town proposals Scale‐up of community‐based dengue vector Government and communities in Brazil, 2 250 000 Governments and third party site control in Latin America and the Caribbean Colombia, Mexico, Uruguay funding for interventions Assessment of insecticide resistance Control programmes in Benin, Mali, 500 000 Contribution of control programs, mechanisms in malaria vectors Nigeria community health workers and laboratory technicians Intervention and implementation research 5 900 000 Visceral leishmaniasis (VL) elimination in VL control programmes and other 500 000 Site co‐funding, technical support, Southeast Asia: case management, vector partners in India, Nepal, Bangladesh, bednets control and diagnostic policies Canada Grand Challenges, Structured Operational Research and Training TB Union, MSF, country control 4 600 000 Technical support, staff time, support Initiative (SORT IT) programmes, The Royal Netherlands for research, data management, Tuberculosis Federation, the US CDC, meetings, co‐funding of projects, Estonia, Kazakhstan, Panama publications Community‐based scheduled screening and EC, academic institutions, country sites 800 000 Project co‐funding, technical support, treatment of malaria in pregnancy (Cosmic) meetings Research capacity strengthening/knowledge 9 200 000 management Short‐term training (impact) grants Nairobi University, Kenya 260 000 Management support, infrastructure Regional Training Centres WHO regions, training centres supported 370 000 Development of courses, course fees, by TDR (Colombia, Kazakhstan, additional grants leveraged Philippines and Indonesia) Small regional grants WHO African Regional Office, Eastern‐ 150 000 Technical support, staff time of Mediterranean Regional Office regional office focal points, reviewers from regions and meetings ESSENCE for Health Research Wellcome Trust, ESSENCE members 250 000 Technical expertise, consultant support, document development fees, consultation meetings Harmonized stakeholder‐endorsed research Creation of the Global Health R&D Fund 8 000 000 Technical support, meetings agenda administered by TDR Career Development Fellowships Astellas, Eisai, GS UK GSK Bio, Novartis 170 000 Contributions by host institutions Basel, Novartis Sienna, Roche , Merck, Pfizer Sanofi‐Aventis, Sanofi Pasteur, Sigma‐Tau, MMV, DNDi, FIND, CRP‐ Santé, AIBST
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Annex 5. 2014 contributions to the 2014‐15 biennium
TDR is able to conduct its work thanks to the commitment and support from a variety of funders. These include our long‐term core contributors from national governments and international institutions, as well as designated funding for specific projects within our current priorities.
Total for the CONTRIBUTOR biennium 2014‐15 (US$) Member States Belgium 4,076,087 China 110,000 Cuba 5,000 Germany 814,111 India 55,000 Japan 270,000 Luxembourg 1,336,898 Malaysia 25,000 Mexico 10,000 Norway 2,200,381 Panama 7,000 Portugal 63,532 Spain 61,958 Sweden 10,401,755 Switzerland 1,829,268 Thailand 46,026 Turkey 5,000 United Kingdom of Great Britain and Northern Ireland 7,633,588 World Bank 1,250,000 World Health Organization 900,000
Total Member States 31,100,605
Bill & Melinda Gates Foundation 2,905,385 Drugs for Neglected Diseases initiative (DNDi) 829,969 European Commission 1,250,137 Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, 89,673 Germany International Development Research Centre (IDRC), Canada 4,352,301 Royal Tropical Institute (KIT) 112,403 United Nations Development Programme (UNDP) 932,368 U.S. Agency for International Development (USAID) 608,076
Total Revenue 42,180,916 52 TDR RESULTS | 2014 REPORT
Thank you to our core contributors who provided overall Programme support in 2014
Thanks also to the contributors who provided support to specific projects in 2014
* Listed in order of level of contribution.
TDR/STRA/15.2
TDR/World Health Organization 20, Avenue Appia 1211 Geneva 27 Switzerland
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The Special Programme for Research and Training in Tropical Diseases (TDR) is a global programme of scientific collaboration established in 1975. Its focus is research into neglected diseases of the poor, with the goal of improving existing approaches and developing new ways to prevent, diagnose, treat and control these diseases. TDR is sponsored by the following organizations:
World Bank