EACCR4

The challenge

Despite some progress, sub-Saharan Africa remains underrepresented as a location for clinical trials. This has multiple implications, including a lack of data on the efficacy and safety of new interventions in African populations and delays in introducing new medical innovations in African countries.

Strengthening of clinical trial capacity requires investment in multiple areas. Laboratory infrastructure may need to be upgraded to support the analyses integral to clinical studies. In particular, diagnostic capabilities may need to be strengthened. Clinical trial sites may need further development so patients can be recruited, cared for, and studied in safe settings. 

Above all, human capacity needs to be developed to ensure that trials are performed safely, efficiently and rigorously.  The Africa Centres for Disease Control and Prevention (Africa CDC) public health workforce strategy has identified serious staffing shortages and outlined priority development needs to enable the region to contribute its fair share to trials.

For the past 15 years, the East African Consortium for Clinical Research (EACCR) has built subregional capacity for clinical research thanks to funding through successive EDCTP programmes.  It has provided a framework for collaborative studies and baseline data collection, as well as a high-quality network that supports the training and career development of early-career researchers.

The project

The EACCR4 project is building on this foundation, with the network expanding to include 23 partner institutions from 13 countries, including seven from sub-Saharan Africa. Three countries with less well-developed health research systems – the Democratic Republic of the Congo (DRC), Somalia and Zambia – have joined the network, alongside additional European institutions. 

The network is also strengthening its connections with national public health institutes in participating countries and placing greater emphasis on clinical research during epidemics. 

The EACCR4 project incorporates a broad spectrum of capacity-building activities, with a focus on less well-developed institutions. At least two clinical research sites will be upgraded, and integrated support will be provided to strengthen laboratory capacities. Site capacities will be audited to inform site-specific development plans. Weaker sites will be paired with stronger sites and supported through training and mentorship, with the aim of certifying four additional laboratories during the project. The network’s statistics and data management platform will be strengthened and expanded to new sites. 

Through the project, nine PhD students and 18 master’s students will be supported. Training will also be provided to clinical and laboratory personnel, and 28 new clinical research associates will be trained in clinical trial monitoring.  Five emerging leaders will benefit from research leadership training, with priority being given to promising researchers from the three new countries with less well-developed clinical research systems. 

The network’s HIV/AIDS and TB research will focus on surveillance for drug resistance and application of digital, machine learning and models for predicting HIV and TB drug resistance. The malaria programme will address parasite drug resistance and insecticide resistance in mosquito vectors. Neglected tropical disease research will focus on epidemiology and diagnostics. 

Epidemics are a new priority area for the network. Key activities will include strengthening genomics surveillance, preparation for clinical trials in outbreak situations, and training for research during outbreaks. There will be a focus on strengthening laboratory diagnostic capacity, as well as introducing mobile laboratories in the DRC and Zambia and linking existing labs to national public health institutes in other countries.

Impact

The EACCR4 project will further strengthen clinical research capacity in East Africa. It will: 

• Provide a high-quality environment for training early-career researchers.
• Support the accelerated development of some of the most promising future research leaders.
• Equip more sites to carry out high-quality research, including during outbreaks.
• Generate new knowledge to support more effective treatment and control of priority infectious diseases.

The EACCR4 project will ensure that more clinical research is conducted in East Africa, including vital research during outbreaks and at additional sites in countries with less experience of hosting clinical research studies.