African Research Leader scheme
The African Research Leader (ARL) scheme is a prestigious award, jointly funded under the MRC/DFID concordat agreement. The scheme aims to strengthen research leadership across sub-Saharan Africa by attracting and retaining exceptionally talented individuals who will undertake high-quality programmes of research on key global health issues pertinent to the region.
A further call for MRC/DFID African Research Leaders is now launched.
ARL Case Studies:
Health and wellbeing of female adolescents and young adults, and their infants: limiting the inter-generational risk of metabolic disease in South Africa
ARL – Professor Shane Norris, University of Witwatersrand, South Africa
UK Principal Investigator – Professor David Dunger, University of Cambridge
A growing challenge in sub-Saharan Africa is the complex relationship between poor maternal nutrition and postnatal stunting on the one hand; and poor diet and the increased risk of adolescent and adult obesity on the other, leading to an increased risk of type-2 diabetes and metabolic risk in future generations.
Since obtaining his ARL award Professor Norris has become Director of MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), a new unit within the Department of Paediatrics aimed at researching health and wellbeing across generations. DPHRU addresses the South African national priorities of increasing life expectancy, decreasing maternal and child mortality, and strengthening health system effectiveness, all by drawing on unique longitudinal cohort data.
Professor Norris proposes to tackle this complex area of research in two key ways:
- A comparative study of urban-rural adolescents and young adults for obesity and metabolic disease risk. This study draws upon two well-established longitudinal research platforms, the urban Birth to Twenty cohort (Bt20) and the rural Agincourt Health and Socio-Demographic Surveillance System (HDSS). Studies of contemporary adolescent and young adults (generation 1) and their offspring (generation 2) provide a unique opportunity to evaluate outcomes relating to risk factors for type-2 diabetes and metabolic disease that are transmitted across generations.
- Exploring the intergenerational risk of metabolic disease, with a focus on how pre-pregnancy body composition impacts on weight gain and carbohydrate metabolism during pregnancy; and the association of these factors with delivery (birth) outcome and infant body composition at age one year.
Having Professor Dunger as his UK partner has brought Professor Norris in closer contact with multiple nutrition, epidemiology and metabolism groups in Cambridge and this has created a strong collaboration for preparing further targeted intervention studies.
Filariasis elimination in Africa: refining the strategies through research
ARL – Professor John Gyapong, University of Ghana
UK Principal Investigator – Professor Moses Bockarie, Liverpool School of Tropical Medicine
Lymphatic filariasis (elephantiasis) in Ghana is caused by the parasitic worm Wucheria bancrofti transmitted by mosquito vectors. As part of a WHO global programme, the Ghana Filariasis Elimination Programme has been in operation since 2000.
The programme has completed several rounds of mass drug administration with rollout in different districts to attain total national coverage. Reduction to less than 1% prevalence in some sites has been demonstrated, while in others prevalence is much higher and has remained incompatible with elimination of transmission.
Since obtaining his ARL award, Professor Gyapong has received a significant rise in seniority and responsibility with his promotion to Pro-Vice Chancellor for Research Innovation and Development at the university. He has therefore recruited four junior investigators who will complete PhDs with the University of Ghana while also taking forward the four key research questions:
- How to improve treatment coverage and compliance, particularly in urban populations?
- Can the use of mobile telephony platforms improve reporting and strengthen the health system?
- When to stop mass drug administration and how to effectively monitor recrudescence?
- How will integrated control with other neglected tropical diseases affect lymphatic filariasis elimination and the health system?
Building on his own School of Public Health position, combined with the essential partnering with the national elimination programme in Ghana and the nearby Noguchi Memorial Institute of Medical Research (with access to wet lab facilities) has provided a strong cross-institutional platform for his research.
Targeting male mosquito behaviour for vector control
ARL – Dr Abddoulaye Diabaté, Institut de Recherche en Sciences de la Santé (IRSS)/Centre Muraz, Burkina Faso
UK Principal Investigator – Dr Frederic Tripet, Keele University
Malaria remains a major cause of mortality in many parts of Africa. The control of mosquito populations remains one of the most efficient ways of decreasing the incidence of the disease. This is commonly done by using insecticide-treated bednets and Indoor Residual Spraying (IRS). In many areas of Africa, however, mosquito populations are becoming resistant to commonly used pesticides.
Dr Diabaté’s research is to develop alternative approaches and strategies to curtail malaria and focuses on the male reproductive behaviour of Anopheles gambiae, the main vector of malaria in Africa. A. gambaie mates in flying swarms, and hence swarms constitute an ideal target for mosquito population control.
Dr Diabaté is the Head of the medical entomology laboratory at the IRSS, which is situated in a malaria endemic region of Burkina Faso. As a result of his award Dr Diabaté has been promoted to a ’Maître de Recherche’, a major step in his career progression to ’Directeur de Recherche’.
There are two main objectives of Dr Diabaté’s research programme:
- To explore the feasibility of predicting and manipulating swarm locations for mass swarm killing. The impact of swarm control will be measured in combination with IRS on local mosquito densities.
- To improve the mating performance of sterile laboratory-produced male mosquitoes which are released in the wild and can induce their sterility on further populations.
As part of his research he is building a unique malaria sphere which will hopefully attract researchers from across Africa and beyond.
The strong onsite mentorship of the Institute Director is extremely valuable and there is a clear vision to integrate disciplines from basic science discoveries to clinical and health benefits. His UK partner, Dr Tripet at Keele University, and broader partnering with Liverpool provide collaborative opportunities to access cutting-edge technologies not available in Burkina Faso.
Pathogenesis and management of M. ulcerans disease, Buruli ulcer
ARL – Dr Richard Phillips, Kwame Nkrumah University of Science & Technology (KNUST), Ghana
UK Principal Investigator – Dr Mark Wansbrough-Jones, St George’s University, London
Buruli ulcer is a neglected tropical disease caused by infection with M. ulcerans, a bacteria common in rural parts of West Africa including Ghana. It causes large, disfiguring skin ulcers mainly in children aged 5 to 15 years old, although people of any age can be affected. How a person becomes infected remains unknown but there have been major advances in understanding the mechanisms of disease since the establishment of the WHO Global Buruli Ulcer Initiative (http://www.who.int/buruli/en/), together with improved diagnosis and management. Antibiotic treatment for eight weeks is now standard, although some people may need only four weeks of antibiotic treatment.
The ARL award has helped Dr Phillips with his academic career and he has recently progressed from being a Research Fellow to a post as Senior Lecturer in Medicine at KNUST and he is looking forward to further promotion.
The main aims of Dr Phillips research programme are:
- To investigate markers for patients with early infection to identify patients who may respond rapidly to antibiotic treatment and for which a shortened course of antibiotic treatment will be adequate.
- To investigate the immune response to M. ulcerans during antibiotic treatment and when patients develop a paradoxical reaction, seen in 10 per cent of cases.
Dr Phillips will spend one year (out of his five-year award) in his UK partner institution, St George’s University, to work on improving technical assays and analysis including microarrays and proteomics work. This will also enable him to develop broader European collaborations and to consolidate aspects of the proteomics work before returning to Ghana.
Mental health among HIV infected CHildren and Adolescents in KAmpala, Uganda (CHAKA)
ARL - Dr Eugene Kinyanda, MRC/UVRI Uganda Research Unit on AIDS
UK Principal Investigator – Professor Vikram Patel, London School of Hygiene and Tropical Medicine
Although sub-Saharan Africa shoulders the greatest burden of youth HIV, little research has been conducted to better understand psychiatric problems (e.g. depression, anxiety and behaviour disorders) among HIV-infected children and adolescents in the region. The aim of this study is to investigate the impact of psychiatric disorders on HIV-infected children in Uganda and the implications for service provision.
Dr Kinyanda plans to investigate the prevalence, incidence and risk factors of psychiatric disorder among HIV-infected children and adolescents in urban Kampala and more rural Masaka, Uganda. He will also examine the help-seeking behaviour of these adolescents to identify service delivery gaps in Ugandan HIV services. The results of this study will provide invaluable information to policymakers and service providers about how to strengthen the provision of appropriate and effective mental health care for this vulnerable group.
Since obtaining an ARL award Dr Kinyanda has been promoted to Senior Investigator Scientist at the MRC/UVRI Unit; appointed Associate Professor in the Department of Psychiatry at Makerere University; and made an honorary Professor in the Faculty of Epidemiology & Population Health at the London School of Hygiene and Tropical Medicine (LSHTM). These appointments have increased Dr Kinyanda’s collaborative opportunities and his own scientific profile both in Africa and beyond.
Professor Patel, UK partner and mentor to Dr Kinyanda, has fostered greater contact between the ARL and scientists and health professionals at the LSHTM and other UK institutions through a three month visit to the UK including an attachment with the adolescent HIV clinic at Mortimer Market Centre.
Defining the merozoite targets of protective immunity against Plasmodium falciparum malaria through multi-centre cohort studies
ARL - Dr Faith Osier, Kenya Medical Research Institute-Centre for Geographic Medicine Research, Coast
UK Principal Investigator – Professor Kevin Marsh, University of Oxford
In malaria endemic regions, young children under the age of five are susceptible to severe and complicated forms of malaria, while older children and young adults experience only milder forms of the illness, and gradually appear to remain symptom-free despite being infected. How this immunity is acquired remains unknown, but it is thought to arise through the development of protective antibodies triggered against specific malaria antigens. It is only as a result of advances in technology that it is becoming possible to identify which of the many thousands of proteins that make up a malaria parasite are the triggers/targets of the protective antibodies.
Before obtaining her ARL award Dr Osier held an intermediate level fellowship from the Wellcome Trust. Since securing the ARL award she has been appointed to various prestigious positions significantly boosting her CV. She is now Visiting Professor of Immunology at Oxford University, Chair of the Bioscience Department at KEMRI-CGMRC, Adjunct Associate Professor in the Biomedical Sciences Department of nearby Pwani University and Secretary General to the Federation of African Immunological Societies (FAIS). She has also been nominated to AcademiaNet, an Expert Database for Outstanding Female Academics.
Dr Osier aims to use immuno-epidemiological analyses of multi-centre African cohorts, combined with bioinformatics and proteomic approaches, to identify and prioritise the best immune targets on the merozoite stage of malaria-causing Plasmodium falciparum. It is her hope that building on this new knowledge it will in the longer term be possible to develop an effective malaria vaccine. She is already in discussions with scientists at the Jenner Institute for optimising her research to be on the right trajectory towards vaccine development.
Dr Osier’s benefits from the long standing expertise of her UK mentor, Professor Marsh, but increasingly her own profile and leadership is being recognised with the establishment of new independent collaborations with Southern partners.
Pathogenic lineages of enteric bacteria in Nigeria
ARL - Dr Iruka Okeke, University of Ibadan, Nigeria
UK Principal Investigator – Professor Gordon Dougan, The Wellcome Trust Sanger Institute, Cambridge
Childhood diarrhoea and bacterial bloodstream infections account for a very high number of illnesses and deaths among children under-five in Nigeria and other parts of Africa. Enteric pathogens, such as Escherichia coli and Salmonella enterica, are major causes of these infections, however very little is known about the epidemiology of these bacteria in Nigeria, including which lineages account for the burden of disease.
With her ARL award Dr Okeke has relocated from her faculty position at Haverford College in the United States to pursue her career as a Professor at the University of Ibadan.
Dr Okeke will use a case-control study design to determine the contributions of specific E. coli and Salmonella lineages to childhood diarrhoea in Western Nigeria. She will use molecular methods to characterize the different strains of bacteria, their evolution and antimicrobial resistance.
Dr Okeke will build on collaborative links with other regional laboratories and extend some of the expertise built at Ibadan to those labs. The research will therefore build capacity in the area of molecular bacteriology and provide a collaborative link between West African scientists and the Wellcome Trust Sanger Institute, where the principal investigator is located.
Improving detection of depression in primary care in Sub-Saharan Africa (IDEAS Study)
ARL - Dr Abebaw Fekadu, Addis Ababa University, Ethiopia
UK Principal Investigator – Professor Martin Prince, King's College London
The detection of depression in primary care in Africa, including Ethiopia, is disappointingly low and poses a serious threat to the plans for scaling up mental healthcare in low income countries. Although detection does not guarantee good quality clinical care, accurate identification and engagement with a care pathway is the first critical step. There are interventions with promise in high income countries in improving detection however these cannot be transferred to other low income settings as they are.
Dr Fekadu holds the position of Associate Professor at his university and since receiving his ARL award he has applied for promotion to full professor. His career is progressing well and he is now elected as a fellow of the Ethiopian Academy of Sciences and is successfully leading a research consortium to establish a regional African Centre of Excellence supported by the World Bank.
Dr Fekadu aims to develop and pilot an intervention that improves detection of depression in primary care in Ethiopia and other low income settings. He aims to do this in three phases. Phase 1 (inception): Evidence will be collected about the nature of depression and its detection in primary care, specifically in the local context. Phase 2 (Development): An intervention package for improving detection will be put together. Phase 3: The intervention package will be tested to see if it is locally acceptable, feasible to deliver, that it improves detection affordably and can be replicated widely.
Dr Fekadu benefits from the expertise provided by his UK mentor, Professor Prince, which has allowed him to raise his own profile and take advantage of new collaborative opportunities. He has also benefitted personally from the mentorship in terms of improving his research and leadership skills and receiving pertinent career advice.
Adolescent Executive Functioning Association with Scholastic Outcomes, Risk Taking Behaviour and Medical Adherence in the Context of HIV
ARL - Dr Amina Ali Abubakar, Pwani University, Kenya
UK Principal Investigator – Professor Charles Newton, University of Oxford
Children born HIV positive are now living longer due to the availability of Antiretrovirals. However, to realize their full potential these children need to receive interventions that reduce the negative impact of HIV. In Africa, there is limited research evidence to guide the development of these much needed intervention programmes. This study will investigate the impact of HIV exposure on the functioning of adolescents aged 10-14 years at the Kenyan Coast.
Dr Abubakar is an Associate Professor of Psychology and Public Health at Pwani University, Kenya. She also holds the position of a research scientist at KEMRI/WTRP and an honorary fellow at the department of Psychiatry at University of Oxford. Prior to her ARL award she was a research fellow at Lancaster University.
In Africa there is a growing concern about the outcomes of HIV positive adolescents, particularly in the following key areas: poor educational outcomes, lack adherence to prescribed medication and involvement in risky sexual and drug related behaviour. Little is known of the impact of HIV on neuropsychological function of infected and exposed but uninfected adolescents in Africa. This study focuses on executive functioning (EF) which influences social, emotional and behavioural outcomes. Using a longitudinal study design Dr Abubakar plans to investigate the impact of HIV on executive functioning of adolescents and its association to scholastic outcomes, medical adherence and risk taking behaviour, by comparing adolescents who are HIV infected or exposed uninfected with those unexposed to HIV.
The specific objectives of Dr Abubakar’s research programme are to:
a) Examine the magnitude and pattern of EF deficits among HIV infected and HIV exposed uninfected adolescents;
b) Describe changes in EF over a critical time period during adolescence in the context of HIV;
c) Identify protective factors for EF outcomes in the context of HIV;
d) Describe the relationship between EF and Scholastic Outcomes, Risk Taking Behaviour and Medical Adherence in the Context of HIV.
Professor Newton, UK partner and mentor to Dr Abubakar, has provided greater insight into the biomedical and neurological aspects of the study and fostered contact between the new ARL and colleagues in Oxford and other UK institutions.
The pathogenesis and treatment of nodding syndrome
ARL - Dr Richard Idro, Makerere University, Uganda
UK Principal Investigator – Professor Kevin Marsh, University of Oxford
Nodding syndrome (NS) is a devastating but poorly understood brain disorder that is affecting thousands of children in Africa. It is characterised by head nodding and complicated by seizures, psychiatric difficulties, malnutrition, cognitive and physical decline. Studies suggest that this is a distinct type of epilepsy. The cause and mechanisms of disease are unknown. There is no specific treatment with available treatments only reducing symptoms in some patients.
Prior to his ARL award, Dr Idro was a consultant paediatrician in Mulago National Referral hospital in Kampala, Uganda. Since receiving the award, he has transitioned to Makerere University School of Medicine as Senior Lecturer in Paediatrics and Child Health. Dr Idro is also a visiting Professor on the International Brain Research Organization Neuroscience Schools and the European Academy of Neurology Regional Neurology Courses across Africa as well as visiting Fellow in Tropical Medicine at University of Oxford.
Dr Idro has set up a research unit in Kitgum General Hospital in northern Uganda where he is testing the hypothesis that NS is a neuro-inflammatory disorder induced by antibodies against the parasitic worm Onchocerca volvulus or its symbiotic bacteria, Wolbachia, cross reacting with and damaging the hosts neuron surface proteins and to determine whether these organisms may be targeted in treatment. He plans to do this by i) determining the relationship between NS, antibodies to host neuron surface proteins and infection by O.volvulus and by ii) conducting a pilot study targeting Wolbachia to explore the role of O.volvulus in the pathogenesis of NS. A definitive association between nodding syndrome and O.volvulus will allow escalation of treatments and prevention. If data from the pilot study is positive, doxycycline (a drug that attacks the adult worm by killing Wolbachia bacteria it contains) offers a cheap intervention that will be tested in a larger study.
Dr Idro has benefited from Professor Marsh’s expertise and direction and has established new collaborations allowing him access to different labs in the UK (neurosciences at Oxford, parasite genetics at Sanger and host genetics at UCL) as well as enormous facilities at the university Oxford. He has further taken advantage of training and skills building in genetics.
A further 4 ARLs were awarded in 2017:
Investigating the Human Malaria Reservoir of Transmission during Pregnancy
ARL – Dr Alfred Tiono, Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Burkina Faso
UK Principal Investigator – Professor Chris Drakeley, London School of Hygiene and Tropical Medicine
Dr Tiono plans to evaluate to what extent pregnant women contribute to malaria transmission. This will then inform malaria control and elimination programmes which need to effectively prevent transmission to mosquitoes to be successful.
Immune responses in malaria-exposed children immunised with a new generation blood-stage malaria vaccine
ARL - Dr Ally Olotu, Ifakara Health Institute, Tanzania
UK Principal Investigator – Professor Simon Draper, University of Oxford
Dr Olotu plans to use standard laboratory techniques to determine if a new malaria vaccine is safe and well-tolerated in adults, young children and infants. He will determine if the vaccine can produce antibodies capable of killing parasites growing in red blood cells in laboratory tests.
Characterisation of the breakdown in immune competence of the lung that favours development of tuberculosis in HIV-infected individuals
ARL - Dr Henry Mwandumba, College of Medicine, University of Malawi
UK Principal Investigator – Professor Stephen Squire, Liverpool School of Tropical Medicine
Dr Mwandumba aims to probe the mechanistic basis underlying the successful control of Mycobacterium tuberculosis (Mtb) in the lung to increase understanding of the pulmonary protective immune response against Mtb infections in humans. He will also explore the impact of HIV co-infection and ART on immune competence of the lung in general. This project will improve current understanding of immune control of TB in the lung and may contribute important knowledge to ongoing efforts to develop new drugs and vaccines for TB.
Determining Cellular Correlates of Immunity to Malaria in an Experimental Human Challenge Model of Exposed Adults
ARL - Dr Francis Ndungu Pwani University, Kenya
UK Principal Investigator – Professor Philip Bejon, University of Oxford
Dr Ndungu plans to test which cellular responses are connected with the ability to control malaria infection. He will do this by identifying patterns of immune responses that can be used as predictive markers of an individual’s ability to control inflammation, produce protective levels of antibodies and to control parasite growth.