It has been a sad commentary that Africa which is an endemic zone for malaria, for many years lacked the capacity to undertake clinical trials hence most trials on the continent were undertaken by foreign clinical research organizations. These research organizations were commercial entities that came to Africa to collect data and leave.
The second predicament is that when Africa got some sites that were collecting data, monitoring population and engaging in interventions and some clinical trials, scientists were unable to work with product developers to do clinical trials and contribute towards the registration of products.
This was the situation Africa found itself in prior to the birth of the Malaria Clinical Trials Alliance (MCTA). The continent had to make the fast move to form the alliance in line with the wise saying; “If you cannot beat them join them”. That alliance provided an opportunity to link up with product developers.
MCTA Management Team
According to Prof Fred Binka, Project Manager of MCTA and Dean of the School of Public Health, University of Ghana, the Malaria Vaccine Initiative (MVI) and the Medicines for Malaria Venture (MMV) opened their doors to forge the linkage with MCTA. With such great insight, the landscape has changed and MCTA moved on with its initial core business to improve infrastructure to ensure the successful in 10 countries across Africa. (Mozambique, Gabon, Tanzania, Nigeria, Malawi, Burkina Faso, Ghana, The Gambia, Kenya and Senegal).
In the long term, the objective is to identify, support, strengthen, mentor and network trial sites to facilitate their self-sustainability, ensuring that trial sites remain functional at the end of a trial and develop into a Centre, thus increasing the number of Centres in Africa which would be ready to conduct not only trials for malaria vaccine and drug interventions but research in other relevant infectious diseases.
MCTA would ensure that the trial sites are equipped with proper management tools to identify, hire and train staff, strengthen information technology and data management systems as well as ensure good and transparent financial systems.
One of the greatest impact of MCTA to Africa is the current research into the biggest malaria clinical trial in Africa involving 16,000 children with the RTS,S candidate malaria vaccine. Countries involved in the trial sponsored by the PATH MVI include Ghana, Kenya, Tanzania, Gabon, Burkina Faso, Mozambique and Malawi.
Early this year when the MCTA was winding down its phase one activities after four years of support to 16 sites in Africa, the researchers on the project met to take a stock on the lessons learned and to chart the way forward into the second phase. The meeting was held at Hotel Cardoso in Maputo, the Mozambican capital and attended by 26 site leaders from project sites in Africa who presented reports of progress made in their respective sites.
Ms Jessica Milman of the Bill and Melinda Gates Foundation, who spoke at the opening, lauded the work done so far by African scientists in building local capacity in the conduct of clinical trials that meet international standards.
She told the site leaders “We want to celebrate your accomplishment in terms of building the necessary scientific research capacity which we find extremely important”.
Ms Milman assured the site leaders that the Bill and Melinda Gates Foundation was pleased with the provision of infrastructure and equipment at the various clinical sites and was considering how to take the project further in the next phase.
Prof. Paulo Garrido, the Mozambican Health Minister, in a speech read on his behalf urged the private sector to forge partnership with African governments to undertake clinical trials to improve on the existing tools to eliminate and ultimately to eradicate malaria from the continentProf. Fred Binka said the project has enabled African scientists to demonstrate to product developers that they could equally undertake clinical trials as foreign commercial clinical research organizations. He said as a result of the collaboration between African research scientists and product developers, more drugs are being tested in Africa with positive outcomes.
He said there is the need for African governments to strengthen their collaboration with health research institutions on the continent to enable them to help find solutions to various diseases that affect the people. Universities on the continent must also collaborate with health research sites in a joint effort in generating reliable scientific data for development.
Though the first phase of the MCTA project in Africa has come to an end, Prof. Binka said the funders would be approached for resources to continue the project adding that MCTA would not only commit resources to malaria trials but also malaria control and elimination.
“We shall not only concentrate on the search for vaccines and drugs but also measures towards malaria elimination,” he disclosed.
Prof. Binka said malaria elimination would include studies into the epidemiology of the parasite transmission and also parasite surveillance.
He described the ongoing Phase III malaria vaccine trial as the biggest in Africa adding that the MCTA has been able to develop at least 10 sites with adequate capacity to successfully undertake the RTS,S phase III trial and make such sites credible research centres across Africa.
Prof. Binka said a major achievement of the MCTA was the building of the human resource capacity of the African scientists.
Dr. Pascoal Mucumbi, Chairman of the MCTA Board, was elated that Africans have been able to develop new research technologies to meet global challenges. He hoped that the health research effort on the continent would be sustained to ensure a better quality of life for the people.
Participants at MCTA meeting
Dr. Seth Owusu Agyei, Director of the Kintampo Health Research Centre and Chairman of the Board of INDEPTH Network, said the second phase of the project might go beyond malaria to include other equally deadly diseases such as tuberculosis and HIV.
This, he said would be done after INDEPTH Network had met the funding agencies to determine interests within the development of the people.