Impact evaluationEvaluate new tools

Translate new knowledge into policy and implementation

Knowledge gap

Program implementation

Research on HIV, TB and malariaachievements

• 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. Insecticide-treated bed net trial informing global malaria control policy

2. Kisumu breastfeeding study informing PMTCT guidelines3. 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 challengesresearch 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 studiesimpact 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 pre-elimination in high transmission area

• NTDs: optimum delivery of MDA

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Clinical studiesevaluation 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 high-burden, low-income settings