Transcript Research on HIV, TB and malaria achievements

Knowledge gap
Program
implementation
Impact evaluation
Evaluate new tools
Translate new
knowledge into policy
and implementation
Research on HIV, TB and malaria
achievements
• Globally, remarkable progress in control of
HIV, TB and malaria in last two decades:
millions of lives have been saved
• Progress made possible by research
contributions to improved control:
– HIV: discovery of anti-retroviral drugs;
demonstrating their impact on transmission
– TB: multidrug regimens, outcome monitoring
– Malaria: ACT, insecticide-treated bed nets
KEMRI & CDC public health and research
collaboration since 35 years
1.
2.
3.
Insecticide-treated bed net trial informing global
malaria control policy
Kisumu breastfeeding study informing PMTCT
guidelines
HPTN 052: transmission impact of ARV:
treatment as prevention
1. Lindblade et al JAMA 2004 2. Thomas et al PLoS Med 2011 3. Cohen et al. N Engl J Med 2011
Major challenges
research response
• Despite progress, elimination of HIV, TB and
malaria as public health threats still far away
• Ambitious sustainable development goals
adopted (end epidemics…)
• Priority studies for KEMRI and CDC collaboration:
– Population based studies on maximum impact of
current tools
– Clinical studies to evaluate new tools
• Other research priorities:
– New tools development, operational research, social
science research
Population based studies
impact of current tools
• HIV: population impact of
combined interventions in
particular diagnosis and treatment
• TB: impact of improved case finding
plus improved TB prevention (ART,
LTBI treatment)
• Malaria: feasibility of preelimination in high transmission
area
• NTDs: optimum delivery of MDA
% Parasitemia
100
90
80
70
60
50
40
30
20
10
0
1982 1992 2003 2006 2007 2008 2009 2010 2011 2012 20
<5 yrs
5-14 yrs
>15 yrs
Clinical studies
evaluation of new tools
• HIV: PoC diagnostics; various drug
trials (ARVs) and prevention trials (e.g.
vaginal ring)
• TB: diagnostic platform; various drug
trials (e.g. short course preventive
therapy, new TB drugs, TB-HIV
treatment), vaccine trials
• Malaria: low dose primaquine among
children to reduce transmission
• NTDs: PoC diagnostics schistosomiasis
Often multicentre, e.g. ACTG, TBTC
Conclusions
• Research relatively easy to translate into
health programs, if this translation is
considered in formulating research questions
• Major role for research in accelerating the
control of communicable diseases in highburden, low-income settings