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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
Biomedical Conference - Kumasi, 2012
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)
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
•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
Biomedical Conference - Kumasi, 2012
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 Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
Clinical research28% (4.2%)
Preclinical Research
72% (10.8%)
Preclinical research
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
Observational Interventional0%
20%
40%
60%
80%
100%
Distribution of primary outcomes of clinical trial performed in Cameroon
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
* 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
Biomedical Conference - Kumasi, 2012
Malaria28%
HIV/AIDS40%TB
4%
Meta-bolic syn-
dromes11%
Helminths9%
Others8%
Distribution of sponsorship
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
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.
Biomedical Conference - Kumasi, 2012
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
Biomedical Conference - Kumasi, 2012
Areas of collaboration with University of Buea
Biomedical Conference - Kumasi, 2012
COLLABORATION
Biomedical and Fundam
ental researc
h
Social research
Epidemiological
research
Applied researc
h
Conclusion
Biomedical Conference - Kumasi, 2012
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)
Biomedical Conference - Kumasi, 2012
Biomedical Conference - Kumasi, 2012
ATTENTION
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YOU