The welcoming session at a large conference is important in setting the pace for the remainder of the event. The Ninth Forum got off to a fine start on Monday evening, as it contained not only welcome messages from our Portuguese hosts, important updates on the progress of EDCTP and some inspiring keynote addresses, but also music and prizes!
Michael Makanga welcomed delegates and thanked both our hosts and the sponsoring organisations, before giving an outline of the scope of the presentations, discussions, workshops and plenary sessions that will be taking place. He announced that EDCTP´s fora will continue to be held every two years, but will in future alternate between African and European venues.
This is the first Forum to be held in Portugal and it was good to learn of the commitment of the government of Portugal to the EDCTP programme. It intends to support the plans for an EDCTP3. Portugal, where a growing number of African students are studying, believes that all sectors of society should participate in the gathering of knowledge and share in its benefits. An increased role for the private sector and a continued focus on ethical issues are also seen as crucial.
The Gulbenkian Foundation is a very important Portuguese philanthropic organisation, which only last week signed a memorandum for an extended partnership with EDCTP. It was encouraging to hear something about the Foundation´s priorities, and its desire to promote science and make knowledge available to all.
Mark Palmer, on behalf of EDCTP´s General Assembly, outlined the history of EDCTP, which he described as a ´unique programme´. He highlighted some of the key developments, notably the introduction of a legal structure for the EDCTP Association that allows African countries to be full and equal partners. He felt that this move, which came in with the launch of EDCTP2, convinced African nations that Europe was serious about supporting health research in Africa.
We heard EDCTP described as ´a wonderful success story´ by Dr Cornelius Schmaltz, Head of the Unit for ‘Fighting infectious diseases and advancing public health’ from the European Commission. He said a little about the EU´s forthcoming Horizon Europe programme, which would be responsible for supporting the hoped-for third phase of EDCTP.
The meeting watched also a video message by WHO Director General Dr Tedros Adhanom Ghebreyesus. He gave his best wishes for a successful Forum and also took the opportunity to stress WHO´s commitment to the open publication of all clinical trials.
Michael Makanga then returned to present some excelente slides that demonstrate just how much EDCTP has achieved in its 15 years. He also announced the publication of a new booklet focusing on some of EDCTP´s success stories.
A short but inspiring keynote address was given by AIDS activist, Flaviah Namuwaya. She was born with HIV and described the difficulties encountered by all those growing up with the infection. Completing schooling is a particular problem, many students are unable to take their medication properly while also studying. Getting regular blood tests also poses a challenge. Research has made it possible to introduce more effective and more easily adhered to drug regimens. It is research that has made it possible for Flaviah (and many others) to survive to become healthy, high-achieving adults.
Dr Sise Kityo Mutuluza (who is Flaviah´s physician) gave the second keynote address – a comprehensive account of research to develop improved drug regimens for babies and young children with HIV. Since the introduction of three-drug ART for pregnant women with HIV, mother-child transmission rates have fallen to less than 5%, but mothers are less likely to continue with treatment after birth and the dangers of transmission during breastfeeding are high. For HIV-positive babies, baby-size pills are easier to administer than syrups. The EDCTP-suported CHAPAS trials (plus other studies) have led to changes in the WHO recommendations on drug regimens for HIV-positive children. But many challenges still remain, care for adolescents living with HIV remains poor. Further simplification of regimens is still needed as ´Suboptimal adherence is still the rule, not the exception´. Other issues include: better monitoring of treatment, better HIV tests, finding out more about the long-term side-effects of ARVs, and addressing the issue of non-communicable diseases as people living with HIV have been shown to be particularly vulnerable to these conditions.
The four prizes of this Ninth Forum, described elsewhere in this blog, were then swiftly awarded before the meeting was privileged to hear four songs from Portugal´s wonderful Fado tradition. An inspiring start indeed to our meeting!