We are shifting focus to clinical research, says RBC medical research director Musanabaganwa

Over the last 22 years, the health sector has garnered praise from both locals and development partners for its continuous reduction of maternal and infant death rates, malaria, new HIV infections and mother-to-child HIV transmissions, among others. But the success has come with a price. For instance, development partners continue to slash aid to the health sector, arguing that the funds should be channelled to countries that are still struggling with health issues. However, medical experts say that while the country has made commendable progress, there is need to channel the financial support to medical research to sustain the gains achieved. What is the way forward? The New Times’ Nasra Bishumba spoke to the Director of Medical Research Centre at Rwanda Biomedical Centre (RBC), Clarisse Musanabaganwa, about research and more. Excerpts: Tell us a little bit about the Medical Research Centre Musanabaganwa says RBC is in the process of setting up a conducive environment for clinical trials. / Courtesy The Medical Research Centre is a unit under the Director General’s Office in Rwanda Biomedical Centre. Our mission is to set up a conducive research environment that attracts external investment and collaboration in areas of medical research. Our focus is mostly in attracting biotechnology and pharmaceutical industries to come and do medical research in Rwanda. We also focus on building partnerships with clinical research organisations and academia; locally and globally. Why should one pick Rwanda as their medical research country of choice? There are several key strengths in the health sector that can help to boost research environment and research in general in Rwanda. First, there is a strong political will; even President Paul Kagame is excited to support a research environment friendly to researchers; whether local or international, and achieve a flexible world class and standards complying medical research, fostering quality research and safe community. This summarises in sound research with no or minimum research conduct challenges. Basic research infrastructure is in place; to name a few, we now have a medical research centre, which I consider a big step. We have the National Reference Laboratory in charge of nationwide diagnosis and confirmation of results from district level and the Epidemic Surveillance and Response (ESR) responsible for controlling and fighting against epidemics. RBC is a big institution with different programs and interventions of which each is important for the overall improvement of the health sector. In fact, each programme’s daily data help in operational research and subsequent analysis. What is the biggest challenge when it comes to doing medical research in Rwanda? Lack of a strong regulatory system is a universal centre-piece for quality and effective research in terms of compliance to scientific norms, ethics and international best research practices. There is a regulatory system for research in Rwanda, yet it still needs strong improvement to meet the adequate standards and become internationally competent. This leads to a challenging scenario for researchers when it comes to applying for approvals to conduct research activities. The process is still hard and ambiguous with no clear course of application, well-defined requirements, advisory guidance and so forth. There is limited source of funding for research within the health sector because HIV/AIDS and malaria diseases are still priorities according to Millennium Development Goals (MDGs) and get most of the funds. There is also a challenge of over-reliance on donor funding yet when the money comes it is ultimately programme directed. We still need to do advocacy to try and change the mindset of health sector professionals; to stop thinking only in terms of donors but to start looking for alternative ways to mobilise resources. Another challenge is the weak program for intellectual property rights, copyrights and patenting. We are now a model for Africa when it comes to achieving the Millenium Development Goals and we do have great practices. We are laying down the mechanisms to use for the protection of our practices and indigenous research ideas. There is also the issue of brain drain. We keep providing capacity building, however the retention of staff continues to be a challenge. Sometimes, research collaborators come with requirements such as having sites that respect international best practices and accordingly, we sustain the capacity building needed to make the program effective but after some time, when you go for assessment, everyone has left for greener pastures. The trained staff turnover is unacceptably higher with no promising solution in sight. While research work is time consuming and implies dedicated mind and sometimes private sacrifices, there are no clear research incentives. There should be incentives to encourage people who spend days and nights writing proposals. There has been talk of Rwanda trying to work toward attracting clinical researchers into the country. Could you tell us a little about that? We are in the process of setting up a conducive environment for clinical trials – Bio-pharmaceutical drug development research activities. So far, we have put in place guidelines and platforms to speed up the processes. We are doing this in anticipation of more clinical trial projects where research is done on investigational products that are not yet on the market. They may be drugs, medical devices, surgical procedures or other biological products like vaccines and others. This is a deal between pharma-biotech industries and health facilities where they test the products before they are officially approved to be marketed. Clinical trials are big projects and it has been hard to bring them here without a proper regulatory framework. We have conducted a situation analysis to see where we stand in terms of site readiness in health facilities that can be able to collaborate or host those big clinical trial projects. We have assessed 13 referral and provincial hospitals. We are also looking at laboratory infrastructure, and the good news is that some of them are being upgraded from diagnostic to research level. The issue of funding continues coming at the forefront of medical research issues in this country. What strategies have you put in place to deal with it? We have the National Health Research Agenda. It helps to control the funding that comes in research since it comes with clear priorities. This agenda aligns both the ongoing and upcoming research activities with the country’s research priorities. We are trying to promote local research making sure that the investigator-initiated projects get maximum priority. There has been the establishment of RBC Research Grant System, where we are trying to build the spirit of writing and competing for research grants. This is a strategy that even developed countries use for resource mobilization and to keep their health systems sustained. What new innovation should we expect to see soon? We are planning and advocating to make Rwanda the regional hub for computation medicine and bio-informatics. This is a research place where basic research and new innovations sit and flourish, where experts come explore and manage data and most important where a community burden tailored local medicine can be designed, processed and be used in future. We are also trying to secure collaboration with international research institutions fostering common goals of outstanding research, quality research products, safe and healthy community. editorial@newtimes.co.rw

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We are shifting focus to clinical research, says RBC medical research director Musanabaganwa