Thursday, February 4, 2010

Research to Policy -MRC/UVRI 20 years celebrations

By Esther Nakkazi
On 2nd February we celebrated the Medical Research Council/ Uganda Virus Research Institute (MRC/UVRI) 20-year marriage anniversary on HIV research at Entebbe.
Medical research is not a sexy topic to cover by all means but it such an important topic especially when it translates into policy.

The search for government policy formulations from science research was not something I used to pay attention to, even as a science journalist, but as a freelancer you get privileges of tuning your pen and mind to whatever publication you are contributing to.

So in 06/07 while writing stories for a UK based editor, Robert Walgate, for a health magazine RealHeathNews the stories he was interested in were policies that accrue from research. There was one outstanding one, at the time, male circumcision as a result of the research done in Uganda, Kenya and South Africa. It is yet to become policy in Uganda.

Successfully the MRC/UVRI, a multi disciplinary, research unit on HIV has managed to lead to HIV policies, guidelines and treatment protocols in Uganda and beyond. For instance research conducted at the unit has produced such ground breaking results that is has helped change international guidelines for treating HIV.

A major trial conducted by the unit in the 1990’s showed that an antibiotic drug, cotrimoxazole (septrin) was able to cost effectively prevent many of the debilitating secondary infections that plague HIV patients because of the damage to their immune systems caused by the virus.

As a result, provision of these drugs for HIV has been introduced not only in Uganda, but also almost everywhere in Africa.
Dr. Paula Munduri manager HIV research programme at the Unit is currently planning a new study of cotrimoxazole in combination with ART to see if cotrimoxazole treatment is necessary once patients’ immune systems have sufficiently recovered.

If the results show that continued cotrimoxazole treatment is unnecessary then this could save money on giving people extra pills they do not need. But also importantly it will reduce on the number of pills that patients need to take when they are already on four to eight pills per day with ART, so this could improve patient compliance with treatment.

If funding is secured to go ahead, the trial will start in mid-2010. The funding has been secured, hopefully enough to carry more important research, as one of the speakers at the Entebbe celebrations announced. Mr. Martin Shearman, the British High Commissioner, announced 40 million pounds in support of the unit for the next ten years.

Some of the research underway as part of the unit’s basic science programme is to develop an HIV vaccine and exploring issues around the appearance of viral resistance to anti-retroviral drugs. The major focus is to pinpoint which host factors and which viral factors are actually responsible for providing protection against HIV.

One of the puzzles of HIV today is why a small group of individuals in this world have natural protection, that is even when exposed to the virus they do not seem to get the infection easily. It important to understand the special attributes of their immune systems, to design a vaccine, which could create such an immune response in other people.
Dr. Pietro Pala is leading this study a part the International Centre for HIV Vaccine Immunology (CHAVI) which is a large group of collaborating universities in the US and the UK linked up with samples from a very large cohort of sero-discordant couples in Kampala.

Samples have been collected since 2007; and enrollment of the patients in the study was recently completed.
MRC boasts of the most advanced basic research infrastructure, understanding the immune responses, people progression to HIV. It transcends all institutions because of the collaborations.

On 2nd Feb at the anniversary celebrations a regional reference laboratory at MRC/UVRI to monitor HIV drug resistance was commissioned by Dr. Gilbert Bukenya, the Vice president.
Hopefully we shall have more policies formulated from research at MRC/UVRI and I will have so much to write about the next time Walgate calls!

The lab commissioned at the MRC/UVRI 20th anniversary

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