emmanuel acha asongalem vice dean, research and cooperation, faculty of health sciences university...

THE STATE OF BIOMEDICAL RESEARCH IN CAMEROON

Emmanuel Acha ASONGALEM Vice Dean, Research and Cooperation, Faculty of Health SciencesUniversity of BueaEmail: [email protected], [email protected]: 237 7554 5718

Objectives Introduction Organisation of research in Cameroon Biomedical Research Centres National biomedical research priorities Percentage distribution of research conducted in

Cameroon Types of research Research funding Some ongoing clinical researches going on in

Cameroon Some biomedical researches going on in UB Unethical incidence of biomedical research Ethical issues in Cameroon Areas of collaboration

Biomedical Conference - Kumasi, 2012

Cameroon


Official Name: Republic of Cameroon

AREA: 457,439 Sq Km (183,568 Sq Mi)

Official Languages: English and French

July 2010 Population 19 406 100

Organisation of research in Cameroon

No single National organ is responsible for coordinating research in Cameroon.

Three Ministries are involve in biomedical research: Ministry Higher Education (MINESUP)

▪ Coordinated by Div. Operational Research Ministry of Health (MINSANTE)

▪ Coordinated by Division of Operational Health Research

Ministry of Scientific Research (MINRESI)▪ Coordinated by Div. of Research and Program Policy)


Centers of Biomedical Research

MINISTRY OF SCIENTIFIC RESEARCH Camdiagnostics Institute of Medical Research and Medicinal Plants Studies (IMPM) National Institute for Agricultural Research (IRAD)

MINISTRY OF HIGHER EDUCATION Universities (8 state and >10 private)

▪ University of Buea – Malaria, HIV/AIDS, Influenza virus and other emerging infectious diseases▪ University of Yaounde 1 – Malaria, HIV/AIDS, Metabolic syndrome▪ University of Douala – Malaria▪ University of Dschang – Malaria

MINISTRY OF HEALTH International Reference Center of Chantal Biya (IRCCB) Institute Pasteur – Medical Services Organization of Coordination for the fight against endemic diseases in Central Africa

(OCEAC) – Malaria, HIV/AIDS, infectious diseases PRESICA, Yaounde – HIV/AIDS Investigative Research – Cameroon (IRECAM) – HIV/AIDS Baptist Center, Mutengene – HIV/AIDS National Health Laboratory (Hygiene Mobile) – emerging diseases National Laboratory for quality control of drugs (CENAME) – National Medication

Distribution Center.Biomedical Conference - Kumasi, 2012

National Biomedical research priorities


•HIV/AIDS•Malaria•Tuberculosis•Emerging diseases – bird and swine flu, cholera•Onchocerciasis

Communicable diseases

•Cardiovascular diseases•Hypertension•Heart diseases•Diabetes•Cancer•Respiratory diseases•Asthma

Non Communicable disease

•Traditional medicine•Nutrition

Others

Percentage distribution of research conducted in Cameroon


Hyper

tens

ion

Cance

rs

Diabe

tes

Other

s

HIV/A

IDS

Malar

ia

Tube

rculos

is

Hepat

itis B

& C

Helm

inth

s

Filiaria

Other

s

8%5.7%

7.8%

78.5%

24.6%21.3%

6.3% 5.3% 4.8% 3.7%

34%Non-Communicable diseases Communicable diseases

Distribution of Health Research in Cameroon


Biomedical & Fun-damental

research 15%

Applied research

14%

Epidemio-logical

research 57%

Opera-tional & Health

Systems research

9%

Social research5%

Types of biomedical research in Cameroon


Clinical research28% (4.2%)

Preclinical Research

72% (10.8%)

Preclinical research


Natural products•Identification and isolation of new drug leads•Pharmacological screening•Toxicological screening•Pharmaceutical formulations

Others •Drug resistance studies•HIV, HVB variants•Development of diagnosing kits•Therapeutic strategies (traditional treatments of HIV/AIDS)

Study types of Clinical Trials


Observational Interventional0%

20%

40%

60%

80%

100%

Distribution of primary outcomes of clinical trial performed in Cameroon


Diagn

ostic

trials

Prev

entiv

e tri

als

Qualit

y-of

-life

trials

Scre

ening

trials

Trea

tmen

t tria

ls

Compa

ssiona

te u

se tr

ials

3%16%

10%18%

53%

0%

Sources of biomedical research sponsorship


Inter-na-

tional41%

Private3%

Gov-ern-ment56%

Budget estimates for research in Cameroon

Year National (USD) International (USD)(§)

Total (USD)MINESUP(*

)MPH (†) MINRESI

‡PRIVATE

2006

>18,200 000

400 000 600 000 NA 15 858 646 >35 million

2007

>18,200 000

460 000 615 000 NA 27 857 639 >47 million

2008

>18,200 000

450 000 600 000 NA 21 916 952 >41 million

2009

>18,200 000

470 000 710 000 NA 33 032 594 >52 million

2010

>18,700 000

430 000 686 000 NA 11 999 562 >31 million

2011

>19,100 000

441 000 605 500 NA 23 079 960 >43 million

2012

>20,400 000

420 000 599 600 NA 15 497 342 >37 million


* Not specifically for biomedical research† subsidises to public medical schools and research institution; excludes money in collaborative centers such CIRCB‡ allocated for health research . It is mainly given to IMPMNA: data not available§ Allocation from Global fund to fight HIV/AIDS, Malaria and TB

Areas of international-sponsored research


Malaria28%

HIV/AIDS40%TB

4%

Meta-bolic syn-

dromes11%

Helminths9%

Others8%

Distribution of sponsorship


Clinical Trials

Preclinical Clinical Trials

Preclinical

85

15

5

95

Internationally Sponsored Nationally Sponsored

Sponsors of Biomedical reseach in Cameroon

International sponsors & Institutions America

Centre for Disease Control John Hopkins School of Public Health National Institutes of Health US Army HIV Research project (LEID) USAID

France Institut de Recherche pour la Développement

(IRD) French National Agency for Research

on AIDS and Viral Hepatitis (ANRS, France)

Centre de Recherche pour la Santé des Armées (CRESAR)

Italy CIRCB

Canada Canadian International Development

Research Center (IDRC)Biomedical Conference - Kumasi, 2012

International organs WHO (TDR, UNAIDs, Global Fund) European Union (EDCTP project on HIV/AIDS,

Malaria, TB, CANTAM) United Nations Family Planning Agency

(UNFPA) UNICEF World Bank (Global Fund for the fight against

HIV/AIDS/TB/Malaria) GTZ

International NGOs Helen Keller International Gates & Melinda Foundation Médecins Sans Frontiére

Pharmaceutical companies▪ Pfizer▪ Sanofi Aventis▪ Gilead Science▪ Roche

National institutions Government (Universities, IMPM, CENAME,

Hygiene Mobile) Private (very little contributions)

Clinical trials going on in Cameroon


Prevalence of cardiovascular risk factors in patients attending general practice clinics in

selected countries in the Africa and the Middle East region (49 (6) locations) Yaounde, Deido-Douala, Bafoussam, Mbandjock, Njombe and Soa (Pfizer)

Evaluation of three strategies of second-line antiretroviral treatment in Africa (Dakar -

Bobo-Dioulasso - Yaoundé) (Gilead Sciences and

Janssen Pharmaceutical N.V., Belgium)

Some biomedical researches going on in UB


This project is part of the MalariaGEN (Malaria Genomics and Epidemiology Consortial 1

project involved recruitment of severe malaria in Buea and collecting blood for genomic

variations.

Central Africa Network on Tuberculosis, HIV/AIDS and Malaria

(CANTAM project) sponsored by European and Developing Countries Clinical Trials Partnership (EDCTP)

Work on Infectious diseases like influenza, cholera (LEID),

sponsored by John Hopkins - Army Institute.

Unethical incidence of biomedical research

Tenofovir (VIREAD) prophylactic or preventive properties against HIV infection Cambodia and West Africa (Cameroon, Ghana & Nigeria) (started July,

2004). Gates Foundation (USA) Family Health International (FHI –USA) Care

and Health Programme (CHP) – an NGO.400 uninfected sex workers (200 test drug + 200 placebo)

Visit by Act Up-Paris and REDS (Réseau Ethique Droit et Santé, to Cameroon, protest from sex workers, picked up by France-2 TV, magnified and trial suspended in February 2005.

Causes leading to failure Transport of USD3 Prevention package did not include female condoms 5 social workers to counsel 100 participants Infected HIV participants were not to treated with HIV drugs 6 (palcebo) 4 (Tenofovir) have seroconverted by August 2005. State-of –the-art treatment was ordered by FHI.


Ethical issues in Cameroon

• All health research projects must obtain permits from the Div. of Operational Research in MPH.– About 14 ERCs in Cameroon, but only 2 are recognized at the

MPH (the national ERC (1987), and the ethics committee of Centre International de Reference Chantal Biya (CIRCB) since 2006)

– To date, Administrative Authorization for clinical trials and protocols with international collaboration is only granted for protocols reviewed at the National Ethics Committee

– The MPH (in collaboration with the CNEC) is currently proposing a guide to regulate the creation of Institutional Review Boards in Cameroon

– Faculty of Health Sciences, University of Buea, has a functional ERB for both students and externally funded projects


Areas of collaboration with University of Buea


COLLABORATION

Biomedical and Fundam

ental researc

h

Social research

Epidemiological

research

Applied researc

h

Conclusion


Biomedical research in Cameroon constitutes only 15% of all health

researches conducted and depends mostly on external collaboration.

References & Information sources

National Ethical Committee of Cameroon, Yaounde. Ministry of Health

Division of operational Health research▪ http://dev.cdnss.dros-minsante-cameroun.org/

Ministry of Higher Education Division of Operational research

▪ http://www.citi.cm/minesup-recherche/ Ministry of Scientific Research & Innovation

Division of Rsearch and Program Policy▪ http://www.minresi.net/minresi/

Cadre de dépenses à Moyen Terme Santé by Ministry of Public Health, 2010 Situational Analysis of Health Research in Cameroon by Council on Health Research

for Development (COHRED), 1995. Libraries and interviews

University of Buea University of Yaounde1 University of Douala Univesity of Dschang

OCEAC library Global fund (www.theglobalfund.org)


http://www.minresi.net/minresi/


ATTENTION

FOR YOUR

THANK

YOU

emmanuel acha asongalem vice dean, research and cooperation, faculty of health sciences university...

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