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Research Relationships

This week I’ve been benchmarking Centers of Excellence for Research in HIV in Uganda and other African countries to understand the different business models and critical success factors for conducting clinical research.  All these centers share a common tripartite mission of patient care, research and training in HIV / AIDS.  “No man is an island” said English poet, John Donne, and this is very true in clinical research.  Clinical trials in both the US and in Africa can only succeed through organizations working together in multiple partnerships.  1)       International founding partners Most Research Institutes in Africa were first established in broad partnership with a US or European research organization; the Infectious Diseases Institute (IDI) with Pfizer, Uganda Vaccines Research Institute (UVRI) with UK Medical Research Council (MRC), the Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) focusing on reducing mother to child transmission of HIV with Johns Hopkins, and Center for the Program of AIDS Research in South Africa  (CAPRISA) with Columbia University.  Such partnerships enable academic exchange and access to research funding from NIH and other international sources.  2)       Partners for patient access and care While African Research Institutes have established their own specialist and rural clinics to provide patient care and have created patient cohorts for research studies, they also partner with national and regional hospitals like Mulago adjacent to IDI, and Gulu in Northern Uganda to recruit additional patients for clinical trials and to provide inpatient care if needed.  Several centers that pioneered African trials of HIV antiretroviral drugs including CAPRISA and the Joint Clinical Research Center (JCRC) are members of the AIDS Clinical Trial Group and participate in international multi-center trial networks.  3)       Partners for clinical and lab data management IDI and other Research Institutes have established internal capabilities to support clinical trials including laboratories for diagnostic and clinical biomarker testing, and data management units.  However some specialized tests are outsourced to partner laboratories, either in Africa or internationally; and technology can enable remote data management by local or international partners.  4)       Partners for Policy Change The ultimate goal of clinical research in Africa is to establish national health policies that are based on scientific evidence. Effective partnership with the Ministry of Health in planning studies, disseminating the results and effecting and implementing heath policy changes is key. IDI will need to extend and strengthen partnerships in these four key areas to ensure continuing success in the future.

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