Africa Analysis: Benefits of the restarted R&D alliance

The reboot of the Europe-Africa clinical trials alliance could make Africa invest in health R&D, writes Linda Nordling.

In 2010 in Mali’s capital Bamako, representatives from over two dozen African health ministries signed a ‘call for action’ urging theirgovernments至少分配2％healthministry budgets to研究。[1]

The aim of the call was for African governments to take ownership of the research agenda, which at the time was viewed as too driven by international donor priorities.

Nearly a decade on, many people argue that donors’ influence over health research agendas in Africa remains too strong. And the two per cent goal is still a pipe dream.

There is no doubt that African countries have seen increased investment in health research. But with most of this increase coming from international donors, the question of who sets the research agenda remains.

Mechanisms matter

In 2008, after the Bamako meeting, critics condemned the lack of mechanisms in the call of action for its proposed implementation. [2]

But for countries looking for a way to fulfil their two per cent ambition, a reinvented Europe-Africa clinical trials programme offers a vehicle for doing so and for directing international funding towards national priorities.

“Many people argue that donors’ influence over health research agendas in Africa remains too strong.”

Linda Nordling

欧洲第一和发展中国家临床试验合作伙伴关系（EDCTP）于2003年成立，是欧洲对三个与贫困有关的健康危机的反应疾病：HIV/AIDS，，，，结核andmalaria。

Between its launch and 2014, when the programme ended, EDCTP funded 254 collaborative research projects between Africa and Europe to the tune of €378 million (about US$425 million, focusing on phase II and III clinical trials, according to the EDCTP.

A second programme — EDCTP2 — was launched in December 2014. So far the ten-year programme has secured almost US$115 million for calls for proposals launched in 2014 and 2015. Another round of calls for proposals are expected later this year.

欧盟已经批准了约767美元毫on for EDCTP2 provided that additional member country and private sector contributions materialise as expected.

重组合作伙伴关系

The need for clinical research能力发展and project funding remains immense despite the large investments made to date through EDCTP, says the programme’s executive director, Michael Makanga.

他说，非洲的疾病负担仍然很大。人群之间存在自然的差异 - 他们如何应对疾病和治疗方法，这些疾病和治疗方法仍然很少了解，耐药性是一种新兴的威胁。

EDCTP2具有扩展的范围。在疾病方面，除了第一个计划中的三巨头外，它都解决了被忽视的传染病 - 以及临床研究的类型funds。第一个EDCTP侧重于II期和III期临床试验（功效研究），EDCTP2资金I期（人类安全研究）和IV期（监测已经到达市场的监测干预措施）。

“There simply are no short cuts to taking back control of their continent’s health research agenda.”

Linda Nordling

其他创新在EDCTP2中，是非洲参与国家的更紧密参与和所有权。14个非洲成员国 - 布基纳法索，喀麦隆，刚果，加蓬，冈比亚，加纳，马里，莫桑比克，尼日尔，尼日尔，塞内加尔，南非，坦桑尼亚，乌干达和赞比亚 - 现在拥有统治和实施机制的代表权和平等投票权在该计划中，尽管在第一部分中，该项目是从欧洲驱动的。

Makanga说：“这反映了开发界普遍认为发展无法通过单方面行动或援助来完成的。” Makanga说。他补充说，尽管它使非洲国家有更多影响该计划的权力，但它也期望他们增加对其医疗保健系统和研究的投资。

非洲的机会

The EDCTP2 African member countries have already committed to pay €200,000 each as a membership investment in the programme. While this may be a small contribution compared to the entire project budget, it is nevertheless significant for the countries involved.

But in order to fully exploit the opportunity offered them by the programme, African countries should invest more. They should use their EDCTP2 projects as catalysts for strengthening domestic health research.

History shows that scientifically at least, EDCTP funding can bring a lot of bang for its buck. A bibliometric评估去年在欧洲和非洲发表的临床研究论文发表，发现与EDCTP相关的论文与HIV，结核病和HIV-TB共同感染有关，涉及来自非洲作者的作者的论文是世界平均水平的五倍。[3]

As with all other health research programmes targeting Africa, the challenge with EDCTP and its successor is making sure that investments are可持续的。In other words, that once the programme funding runs out, the gains made in terms of capacity building on the ground in Africa persist into the future.

发生这种情况的唯一方法是让非洲政府拥有对能力的所有权，并将其视为要维持的东西，而不是捐助者继续加油。根本没有任何捷径来控制其非洲大陆的健康研究议程。

Journalist Linda Nordling, based in Cape Town, South Africa, specialises in African science policy, education and development. She was the founding editor of Research Africa and writes for SciDev.Net, Nature and others.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.