Building sustainable clinical trial sites in Sub-Saharan Africa through networking, infrastructure improvement, training and conducting clinical studies: The PanACEA approach

Anna-Maria Mekota; Stephen H Gillespie; Michael Hoelscher; Andreas H Diacon; Rodney Dawson; Gavin Churchyard; Ian Sanne; Lilian Minja; Gibson Kibiki; Leonard Maboko; Shabir Lakhi; Moses Joloba; Abraham Alabi; Bruce Kirenga; Timothy D McHugh; Martin P Grobusch; Martin J Boeree; PanACEA consortium

doi:10.1016/j.actatropica.2022.106776

Building sustainable clinical trial sites in Sub-Saharan Africa through networking, infrastructure improvement, training and conducting clinical studies: The PanACEA approach

Acta Trop. 2023 Feb:238:106776. doi: 10.1016/j.actatropica.2022.106776. Epub 2022 Dec 8.

Authors

Anna-Maria Mekota¹, Stephen H Gillespie², Michael Hoelscher³, Andreas H Diacon⁴, Rodney Dawson⁵, Gavin Churchyard⁶, Ian Sanne⁷, Lilian Minja⁸, Gibson Kibiki⁹, Leonard Maboko¹⁰, Shabir Lakhi¹¹, Moses Joloba¹², Abraham Alabi¹³, Bruce Kirenga¹⁴, Timothy D McHugh¹⁵, Martin P Grobusch¹⁶, Martin J Boeree¹⁷; PanACEA consortium

Affiliations

¹ Division of Infectious Diseases and Tropical Medicine, University Hospital LMU Munich, Munich, Germany. Electronic address: [email protected].
² University of St. Andrews, Division of Infection and Global Health, School of Medicine, St. Andrews, United Kingdom.
³ Division of Infectious Diseases and Tropical Medicine, University Hospital LMU Munich, Munich, Germany.
⁴ Task Applied Science, Cape Town, South Africa.
⁵ University of Cape Town Lung Institute, Cape Town, South Africa.
⁶ The Aurum Institute for Health Research, Johannesburg, South Africa & School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
⁷ Clinical HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
⁸ Swiss Tropical and Public Health Institute, Basel, Switzerland.
⁹ Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
¹⁰ NIMR-Mbeya Medical Research Center, Mbeya, Tanzania.
¹¹ University Teaching Hospital, Lusaka, Zambia.
¹² Makerere University, Kampala, Uganda.
¹³ Centre de Recherche Médicale de Lambaréné (CERMEL), Lambaréné, Gabon; Institute for Tropical Medicine, Eberhard-Karls-University Tübingen, Germany.
¹⁴ Kenya Medical Research Institute, Nairobi, Kenya.
¹⁵ Centre for Clinical Microbiology, University College of London, London, UK.
¹⁶ Centre de Recherche Médicale de Lambaréné (CERMEL), Lambaréné, Gabon; Institute for Tropical Medicine, Eberhard-Karls-University Tübingen, Germany; Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.
¹⁷ Department of Lung Diseases, Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.

PMID: 36502888
DOI: 10.1016/j.actatropica.2022.106776

Abstract

Introduction: The Pan-African Consortium for the Evaluation of Anti-Tuberculosis Antibiotics (PanACEA) was designed to build tuberculosis (TB) trial capacity whilst conducting clinical trials on novel and existing agents to shorten and simplify TB treatment. PanACEA has now established a dynamic network of 11 sub-Saharan clinical trial sites and four European research institutions.

Objectives: In 2011, a capacity development program, funded by the European & Developing Countries Clinical Trials Partnership (EDCTP), was launched with four objectives, aiming at strengthening collaborating TB research sites to reach the ultimate goal of becoming self-sustainable institutions: networking; training; conducting clinical trials; and infrastructure scaling-up of sites.

Methods: Assessment in six sub-Saharan TB-endemic countries (Gabon, Kenya, South Africa, Tanzania, Uganda and Zambia) were performed through a structured questionnaire, site visits, discussion with the PanACEA consortium, setting of milestones and identification of priorities and followed-up with evaluations of each site. The results of this needs-based assessment was then translated into capacity development measures.

Results: In the initial phase, over a four-year period (March 2011 - June 2014), the programme scaled-up six sites; conducted a monitoring training program for 11 participants; funded five MSc and four PhD students, fostering gender balance; conducted four epidemiological studies; supported sites to conduct five Phase II studies and formed a sustainable platform for TB research (panacea-tb.net).

Conclusion: Our experience of conducting TB clinical trials within the PanACEA programme environment of mentoring, networking and training has provided a sound platform for establishing future sustainable research centres. Our goal of facilitating emergent clinical TB trial sites to better initiate and lead research activities has been mostly successful.

Keywords: Capacity development; Infrastructure upgrade; Networking; Sub-Saharan Africa; Sustainability; Training.

MeSH terms

Africa, Northern
Capacity Building
Clinical Trials as Topic*
Humans
International Cooperation*
Tanzania
Tuberculosis* / drug therapy
Zambia