The Global Health Network Annual Report 2019
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Better<br />
Research<br />
for Better<br />
<strong>Health</strong><br />
<strong>Annual</strong> <strong>Report</strong><br />
<strong>2019</strong>
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong><br />
enables easier, faster, and<br />
better research in the world’s<br />
most challenging settings.<br />
Contents<br />
04 Introduction and Executive Summary<br />
06 A Digital Platform for Knowledge Mobilisation in <strong>Global</strong> <strong>Health</strong><br />
11 Building Communities of Practice in <strong>Global</strong> <strong>Health</strong> Research<br />
16 <strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre<br />
22 Leadership from the Regions to Drive Capacity for Research<br />
28 Developing Careers and Fostering Team Capabilities<br />
30 Assessing Barriers and Enablers to Research, and Measuring the Impact of the Platform<br />
32 What next? <strong>The</strong> Strategic Development Plan<br />
THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Chairman’s View<br />
Professor Pontiano Kaleebu, Chair, <strong>The</strong> Steering Committee<br />
Almost ten years have passed since this idea was first brought to me<br />
whilst we were sitting under some trees outside a capacity development<br />
meeting we were holding in Entebbe. I’m so delighted to see how this<br />
straightforward idea for health researchers to share what they have<br />
learnt and what they do has flourished in this remarkable way!<br />
We need more research to be led from Africa and the other regions,<br />
and to make this fundamental shift our researchers need to access<br />
information, training, resources AND each other! I am very happy to see<br />
that <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> is now really the place our teams can<br />
go to and find all they need for running excellent world-class studies.<br />
This platform is filling the gaps and joining up everyone working on<br />
different diseases, in different places and allowing for the sharing of<br />
‘how to’ between them.<br />
I think we need to look forward now and see how we can use this<br />
platform to take research findings into practice and policy, to see how we<br />
can improve, how we do studies and really make evidence generation<br />
part of how we work better to manage, treat and prevent the worst<br />
diseases that cause such devastating mortality in our communities.<br />
I am proud and delighted to chair the steering committee of <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> <strong>Network</strong>, and I hope you enjoy reading this annual report –<br />
more importantly I hope it encourages YOU to get involved with this,<br />
if you are not already. Please use this platform to share your methods,<br />
tools and knowledge and help make health research faster, easier and<br />
better across the globe.<br />
Yours<br />
Professor Pontiano Kaleebu,<br />
Director MRC/UVRI Uganda Unit<br />
Head - Basic Sciences Programme
Introduction and Executive Summary<br />
Professor Trudie Lang, Director, <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong><br />
Research is critical to solving<br />
the world’s biggest health<br />
challenges.<br />
Research is critical to solving the world’s<br />
biggest health challenges. <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> facilitates the sharing of knowledge,<br />
methods and tools between disease areas,<br />
regions and organisations to amplify research<br />
outputs. Research teams and professionals<br />
are being trained and supported to lead and<br />
undertake health research in the world’s<br />
most challenging settings. This is achieved<br />
by applying the best digital technology and<br />
harnessing the sharing phenomena to enable<br />
the capture of life-saving data. Here we set<br />
out the achievements of the past year to<br />
highlight the impactful work being delivered<br />
by the research groups who are using this<br />
platform for knowledge sharing between<br />
their partners and wider networks.<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> has two highly<br />
integrated elements; facilitating Communities<br />
of Practice through <strong>The</strong> <strong>Network</strong> Member<br />
Hubs for research consortia to enable<br />
knowledge exchange, and alongside this,<br />
delivering research capacity development<br />
through training, career development and by<br />
providing guidelines, tools and resources. This<br />
is all about tacit learning; sharing the ‘knowhow’<br />
between organisations, roles, diseases<br />
and regions.<br />
This report provides an overview of<br />
the range of knowledge that is being<br />
shared between research teams all<br />
with the aim of driving faster and<br />
better research for better health<br />
across the globe.<br />
<strong>The</strong> <strong>Network</strong> Member Hubs are highly<br />
connected open hubs where research consortia<br />
are sharing data, knowledge, methods<br />
and know-how within their programmes<br />
and networks, and also with many others.<br />
<strong>The</strong>se are vibrant, multi-functioned and<br />
personalised spaces where research teams<br />
can work together whilst also sharing what<br />
works to benefit their groups and others.<br />
Groups are disseminating evidence, policies,<br />
guidelines and methods for implementation<br />
of research. This sharing of best practice,<br />
and the tools to implement them, removes<br />
duplication whilst raising standards and<br />
quality. This is achieved because this is crosscutting<br />
and ground-up and so is minimising<br />
bottlenecks and delivering meaningful data<br />
efficiently and to a high quality.<br />
Integrated with these Member Hubs are<br />
numerous mechanisms for delivering<br />
research skills to build sustainable research<br />
capacity. Some of these tools and training<br />
courses guide research consortia on specific<br />
topics within their programmes, to ensure<br />
standardization and quality. <strong>The</strong> others are<br />
not focusing on any one disease but instead<br />
provide the general skills and knowledge<br />
needed to set up high quality research<br />
studies. Previous capacity building efforts<br />
have focused on one disease or one protocol.<br />
However, the elements researchers find<br />
difficult do not differ between disease or even<br />
the type of study. <strong>The</strong>refore, solving the gaps<br />
in skills and information to address this leaves<br />
sustainable and adaptable capacity that can<br />
last beyond a single study. <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
Training Centre provides specifically designed<br />
training courses delivering research skills and<br />
know-how to healthcare workers.<br />
4 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Summary of <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong>’s impact:<br />
15 million<br />
visits to www.theglobalhealthnetwork.org<br />
600,000<br />
free online training courses taken by healthcare<br />
workers across the globe<br />
Another key barrier to research leadership in<br />
low- and middle-income countries (LMICs)<br />
is the ability for the whole research team<br />
to develop careers and to be recognized<br />
for their contribution to studies. To address<br />
this, the WHO/TDR partnership Professional<br />
Development Scheme for all roles of<br />
research staff was set-up. Here, this scheme<br />
is measuring research competencies to<br />
show and track capacity development, and<br />
this is working for individuals and also for<br />
organisations and research platforms.<br />
Working from, within and between global<br />
regions is fundamental to <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> and there are numerous countryled<br />
initiatives that are increasing research<br />
engagement, and providing practical support<br />
and training. This local leadership and regional<br />
ownership is aiming to empower healthcare<br />
professionals in the world’s most vulnerable<br />
regions to undertake locally led research.<br />
Making Research Easier,<br />
Faster and Better<br />
Tens of thousands of research methods, protocols<br />
and template documents downloaded, adapted<br />
and used – making research vastly easier, faster<br />
and better in the world’s poorest areas.<br />
Disseminating Methods,<br />
Tools and Know-How<br />
Large research consortia and organisations such<br />
as the World <strong>Health</strong> Organization (WHO) are using<br />
<strong>The</strong> <strong>Network</strong> to disseminate their research outputs,<br />
methods, tools and know-how.<br />
5
A Digital Platform for Knowledge<br />
Mobilisation in <strong>Global</strong> <strong>Health</strong><br />
<strong>The</strong> Platform Overview<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> as a platform<br />
has evolved since its<br />
conception, through<br />
to the flourishing<br />
community space it is<br />
today, by providing a<br />
number of useful tools<br />
and resources tailored<br />
to support community<br />
interaction. Each<br />
Member Hub is set up<br />
for each partner to give<br />
them their own highly<br />
specific online working<br />
space. Thus providing<br />
high specification web<br />
technology that gives<br />
research consortia<br />
highly affordable<br />
and attainable<br />
access to their own<br />
bespoke mechanism<br />
for sharing their<br />
documents, processes<br />
and repositories of<br />
information. <strong>The</strong> aim<br />
is to make information<br />
discoverable through<br />
tagging and linking<br />
which gives prominence<br />
to information that is<br />
needed by researchers<br />
in each specific field.<br />
Some of the features<br />
available include:<br />
●●Dynamic homepages of curated and<br />
automated content, social media feeds<br />
and image reels<br />
●●Standard pages of web content including<br />
formatted text, images, video and maps<br />
●●Community building tools including<br />
member profiles, blogs, articles, social<br />
bookmarking, and closed and open<br />
discussion working group spaces<br />
Member Hubs can also take advantage of<br />
a number of cross-cutting tools, to provide<br />
essential capacity development and support<br />
for health researchers including:<br />
●●SiteFinder – matching service for research<br />
platforms to find suitable study partners<br />
●●Process Map – step-by-step guidance<br />
for planning a successful health research<br />
project<br />
●●<strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre –<br />
encompassing high quality eLearning<br />
and online training and a Professional<br />
Development Scheme to build a<br />
professional CV and track professional skills<br />
training over a researcher’s career.<br />
“<strong>The</strong> downloadable tools and templates are<br />
very resourceful. Also eLearning short-courses<br />
are vital in getting knowledge and updates.<br />
This should be encouraged to enable my entire<br />
medical team to benefit”<br />
Laboratory Staff Member, Kenya<br />
SURVEY QUOTE<br />
A typical user’s journey<br />
through <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> and the tools<br />
available, free to all health<br />
researchers anywhere<br />
IMPROVE RESEARCH<br />
By sharing resources, training teams,<br />
and developing careers to drive more<br />
and better evidence and translating<br />
this into changes in practice that<br />
improve health<br />
SITEFINDER<br />
Connect your study<br />
or research site with<br />
potential collaborators<br />
6 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Digital Platform for Knowledge Mobilisation<br />
“I downloaded some microbiology standard<br />
operating procedures which I found useful<br />
indeed, furthermore I completed GCP,<br />
GCLP, Introduction to Clinical Research and<br />
Reviewing Genomic Data from <strong>Global</strong> <strong>Health</strong>”<br />
Field Worker, Uganda<br />
SURVEY QUOTE<br />
CREATE A PROFILE<br />
Join <strong>The</strong> <strong>Network</strong> to create<br />
a profile and connect with<br />
other health researchers<br />
JOIN A COMMUNITY<br />
Join a number of Member Hubs and find<br />
out more about specialty research areas,<br />
take part in discussions, post blogs and<br />
submit articles<br />
uExchanging methods,<br />
tools, know-how and<br />
outputs between<br />
diseases, regions,<br />
research areas and<br />
organisations<br />
TRAINING<br />
Take part in eLearning and gain<br />
certificates on successful completion<br />
PROFESSIONAL DEVELOPMENT<br />
SCHEME<br />
Sign up to the Professional Development Scheme -<br />
build your research profile and track your professional<br />
development over time<br />
PROCESS MAP<br />
Use the <strong>Global</strong> <strong>Health</strong> Research Process<br />
Map to plan your study<br />
7
Platform Usage and Access<br />
60,00<br />
New members in 2018<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> platform<br />
continues to experience<br />
strong growth with<br />
its user base and<br />
readership year on<br />
year. During this review<br />
period almost 60,000<br />
new memberships<br />
were registered, adding<br />
just fewer than 5,000<br />
new members per<br />
month. This drives<br />
capacity development<br />
in research and also<br />
enriches the platform<br />
with members’ input<br />
from discussions and<br />
article submissions<br />
through to queries and<br />
feedback concerning<br />
the platform and tools<br />
provided.<br />
From the platform’s feedback survey for this<br />
review period, more than 68% of visitors<br />
specified that they come to the platform from<br />
real-world recommendations – either by a<br />
friend, colleague or at an organisational level.<br />
Just under 25% reported hearing about the<br />
platform via referrals, search or article links. This<br />
shows very well how resources are passed on<br />
to physical networks by word of mouth and<br />
also highlights a useful area to focus on – better<br />
use of search engine optimisation and digital<br />
marketing.<br />
Search<br />
engine<br />
37<br />
Link from<br />
another<br />
website<br />
22<br />
<strong>Global</strong><br />
<strong>Health</strong><br />
Trials<br />
Workshop<br />
21<br />
Other 12<br />
Recommended by a<br />
friend, colleague or<br />
organisation<br />
193<br />
8 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Digital Platform for Knowledge Mobilisation<br />
0<br />
Digital Development<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> platform uses<br />
cutting-edge, digital technology to drive<br />
dissemination, visibility and engagement.<br />
<strong>The</strong> digital platform is built on an open source<br />
development framework called Django, which<br />
is a high-level Python Web framework that<br />
encourages rapid development and clean,<br />
pragmatic design. This allows <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> <strong>Network</strong> to benefit from Django’s many<br />
advantages including high levels of security<br />
and scalability, as well as leveraging a large<br />
community of developers from across the<br />
globe investing time in continuous long-term<br />
development and support. It is used by many<br />
global organisations and industry leaders in<br />
business including some of the most widely<br />
used social media networking platforms.<br />
<strong>The</strong> platform also benefits from a number of<br />
popular widely used plugins and third-party<br />
software that enrich our users’ experience and<br />
provide better access to great quality global<br />
health research information.<br />
Looking forward, <strong>The</strong> <strong>Network</strong> continues to grow and with that<br />
growth comes new opportunities to expand on the proven concept<br />
of the platform. <strong>The</strong> up-coming development roadmap will look to<br />
cover some key items such as:<br />
●●Developing a new look and feel for the platform to allow easier<br />
navigation of content<br />
●●Enhance the eLearning platform with new course structures, navigation<br />
and dashboards providing a richer learning environment<br />
●●Further develop the Professional Development Scheme to allow more<br />
access to research groups from low- and middle-income countries (LMICs)<br />
and implement better team reporting to research consortia wishing to track<br />
their team’s development through projects and their research cycle<br />
●●Continue to expand the number and breadth of Member Hubs and<br />
collaborations<br />
●●Develop the existing Process Map tool and create custom maps<br />
applicable for different research areas<br />
Furthermore, <strong>The</strong> <strong>Network</strong> has set out to<br />
make finding resources on the platform easier,<br />
smarter and faster. <strong>The</strong> implementation of<br />
a smart search and suggestion functionality<br />
within the platform will be investigated so<br />
that each user, from the moment they first<br />
visit and complete their profile through to<br />
active engagement on <strong>The</strong> <strong>Network</strong>, is able<br />
to see the most relevant content that meets<br />
their training and development needs. This<br />
will create a smarter learning and capacity<br />
development environment that successfully<br />
meets the needs of healthcare workers across<br />
the world to conduct high quality research. <strong>The</strong><br />
potential to utilise cloud services and associated<br />
tooling, such as the intelligent search feature,<br />
will also strengthen <strong>The</strong> <strong>Network</strong>’s capabilities<br />
and future-proof the scaling-up of the platform,<br />
providing an exciting prospect of collaboration<br />
with technology partners in industry.<br />
Finding new and novel ways to reach ‘nobandwidth’<br />
areas or areas of extremely poor<br />
connectivity is an area of great potential<br />
for solutions such as implementing offline<br />
apps and the production of a ‘platform on a<br />
stick’ offline version of <strong>The</strong> <strong>Network</strong>. Piloting<br />
such approaches in the field will provide an<br />
opportunity to road test these concepts and<br />
build tools that will better assist individuals<br />
and teams in remote locations to conduct high<br />
quality research.<br />
In order to help broaden and strengthen<br />
ownership of <strong>The</strong> <strong>Network</strong> and encourage<br />
local champions, more multilingual content via<br />
online tools and downloadable resources will<br />
be made available through the platform. This<br />
will improve accessibility of content to local<br />
healthcare workers and researchers, widening<br />
<strong>The</strong> <strong>Network</strong>’s reach.<br />
9
10 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong><br />
Jan – Feb<br />
9.4M
Building Communities of Practice<br />
Building Communities of Practice<br />
in <strong>Global</strong> <strong>Health</strong> Research<br />
A Community of Practice is a group of<br />
practitioners (thus specialists in their fields)<br />
who come together to share experiences and<br />
knowledge, solve a shared problem, promote<br />
best practice and develop professional skills. 1<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> has been<br />
conceptualized and<br />
implemented based<br />
on the concept of<br />
Communities of<br />
Practice 1 , aiming at<br />
creating an open,<br />
trusted and neutral<br />
platform to help<br />
facilitate and promote<br />
interactions and<br />
knowledge sharing<br />
between healthcare<br />
professionals,<br />
researchers and<br />
research consortia.<br />
<strong>The</strong> innovative application of the Communities<br />
of Practice concept to the field of global health<br />
research and the use of cutting-edge digital<br />
technology to build and link these online<br />
communities has made <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> platform a unique and valuable portal<br />
for knowledge exchange. This highly interactive<br />
digital ecosystem, with its many discussion<br />
forums, blog posts and groups, has facilitated<br />
the interaction between a multi-disciplinary<br />
audience of users – coming from 195 countries<br />
– and leveraged the sharing of practical<br />
experience between healthcare professionals,<br />
creating a self-sustaining platform whereby<br />
each user contribution has helped to increase<br />
the platform’s knowledge capital, and advance<br />
the research processes across the regions.<br />
Over the past 12 months, <strong>The</strong> <strong>Network</strong> has<br />
become the “science park” for 36 research<br />
consortia who have set up a Community of<br />
Practice and has grown by 34% in comparison<br />
to previous years. <strong>The</strong> <strong>Network</strong> received 5<br />
million visits, adding to an historical 15 million<br />
visits since its implementation in 2011.<br />
Jun – Jul<br />
11.8M<br />
Nov – Dec<br />
15 Million<br />
Frequency of visits to the<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> – 2018<br />
1 Wenger, E.C. and W.M. Snyder, Communities of Practice: <strong>The</strong> Organizational Frontier. Harvard Business Review, 2000. 78(1): p. 139-145.<br />
11
Linking the<br />
Member Hubs<br />
into Functional<br />
Knowledge<br />
Hubs<br />
In membership terms, <strong>The</strong> <strong>Network</strong> has<br />
experienced a soaring 44% increase in registered<br />
members to its many Member Hubs with 60,000<br />
members joining the platform in 2018, and adding<br />
to a pool of 135,000 registered members. <strong>The</strong> most<br />
popular communities were those where users<br />
could have rapid and facilitated access to training<br />
materials, and other downloadable resources such<br />
as guidelines and protocols for health research<br />
implementation (see table below).<br />
<strong>The</strong> interconnected structure of the platform<br />
has contributed to the development of fully<br />
functional, independent and self-organising<br />
Communities of Practice around seven<br />
complimentary thematic areas, namely: social<br />
sciences, ethics and community engagement;<br />
maternal health/mother and child research;<br />
laboratory, vectors and diagnostics; research<br />
consortia and networks; non-communicable<br />
diseases; research planning and methods; and<br />
infection, immunity and resistance (see panel far<br />
right). <strong>The</strong>se thematic areas are non-exclusive<br />
and borrow knowledge from each other and from<br />
other hubs. This is beneficial to each Member Hub<br />
as they will always host additional content from<br />
other scientific areas, as well as beneficial to the<br />
members that can access a very complete suite<br />
of resources from within a single Member Hub.<br />
Top-10 Member Hubs hosted on <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> in 2018.<br />
*Cumulative non-exclusive memberships until December 2018.<br />
Member Hub Historical Historical Memberships Webplatform<br />
Views Sessions Ranking<br />
<strong>Global</strong> <strong>Health</strong> Training Centre 10,414,330 774,225 104,507 1<br />
<strong>Global</strong> <strong>Health</strong> Trials 1,969,404 535,855 24,855 2<br />
INTERGROWTH-21 st 398,529 130,343 1,981 3<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> 298,527 154,420 - 4<br />
(landing page)<br />
Research Nurses 129,343 38,790 2,905 5<br />
SiteFinder 115,975 35,215 2,418 6<br />
ISARIC 105,809 36,027 1,266 7<br />
Bioethics Research Review 85,956 32,509 11,203 8<br />
Laboratories 81,226 33,449 3,906 9<br />
Mesh 77,041 26,850 1,277 10<br />
12 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Building Communities of Practice<br />
Member Hubs Hosted<br />
on <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> in 2018<br />
Member Hub Name<br />
<strong>The</strong>matic Area<br />
A good example here is the Mesh Member<br />
Hub, where a user can access various resources<br />
around community engagement on health<br />
research in low- and middle- income countries<br />
(LMICs), whilst learning about the application<br />
of ethics on health research implementation,<br />
taking training on fundraising in ethics and<br />
social sciences research, and furthering<br />
their understanding on engagement around<br />
epidemic response and preparedness. <strong>The</strong><br />
interconnectivity and complementary nature<br />
of these hubs expose the members to a<br />
much richer and multidisciplinary knowledge<br />
environment, and contribute to more complete<br />
capacity development in health research.<br />
ALERRT<br />
Research Consortia and <strong>Network</strong>s<br />
Bioethics Research Review Social Science, Ethics and Communities<br />
Brain Infections <strong>Global</strong> Research Consortia and <strong>Network</strong>s<br />
Childhood Acute Illness and Research Consortia and <strong>Network</strong>s<br />
Nutrition <strong>Network</strong> (CHAIN)<br />
CONSISE<br />
Research Consortia and <strong>Network</strong>s<br />
Coordinators<br />
Research Consortia and <strong>Network</strong>s<br />
Data management Research Planning and Methods<br />
Dengue<br />
Laboratory, Vectors and Diagnostics<br />
Diagnostics<br />
Laboratory, Vectors and Diagnostics<br />
EDCTP Knowledge Hub Research Planning and Methods<br />
Elsi 2.0<br />
Research Consortia and <strong>Network</strong>s<br />
Ergo<br />
Research Consortia and <strong>Network</strong>s<br />
GRAND<br />
Non-Communicable Disease<br />
<strong>Global</strong> Birth Defects Mother and Child<br />
Human Infection Studies Infection, Immunity and Resistance<br />
INTERGROWTH-21 st Mother and Child<br />
ISARIC<br />
Research Consortia and <strong>Network</strong>s<br />
Laboratories<br />
Laboratory, Vectors and Diagnostics<br />
Mesh<br />
Research Consortia and <strong>Network</strong>s<br />
Mother Child Research Mother and Child<br />
Musculoskeletal<br />
Non-Communicable Disease<br />
Research Nurses<br />
Research Consortia and <strong>Network</strong>s<br />
Pharmacovigilance Laboratory, Vectors and Diagnostics<br />
PRECISE<br />
Mother and Child<br />
Pregnancy CoLab<br />
Mother and Child<br />
REDe<br />
Research Consortia and <strong>Network</strong>s<br />
Research Methods Research Planning and Methods<br />
Social Science<br />
Social Science, Ethics and Communities<br />
TDR Fellows<br />
Research Consortia and <strong>Network</strong>s<br />
TREAD<br />
Social Science, Ethics and Communities<br />
<strong>Global</strong> <strong>Health</strong> Trials Laboratory, Vectors and Diagnostics<br />
WEPHREN<br />
Research Consortia and <strong>Network</strong>s<br />
WWARN/IDDO<br />
Research Consortia and <strong>Network</strong>s<br />
Zika Infection<br />
Infection, Immunity and Resistance<br />
ZiKAlliance<br />
Research Consortia and <strong>Network</strong>s<br />
ZikaPlan<br />
Research Consortia and <strong>Network</strong>s<br />
13
Harnessing Online Resources<br />
and Interactions to Promote<br />
Change in <strong>Health</strong> Research<br />
<strong>The</strong>re have been<br />
some extraordinary<br />
examples of how the<br />
interactive nature<br />
of <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> platform<br />
has contributed<br />
to advancing and<br />
developing health<br />
research capacity across<br />
the regions.<br />
A remarkable example came from Nigeria<br />
during the latest Lassa fever outbreak in<br />
early 2018. Dr Glory Ogunfowokan, Regional<br />
Faculty Lead, used the blog post facility on the<br />
<strong>Global</strong> <strong>Health</strong> Trials Member Hub to identify,<br />
organise and coordinate a response team of<br />
Nigerian healthcare professionals to fight the<br />
outbreak. His initiative triggered an interesting<br />
discussion session with the participation of<br />
many healthcare professionals, including<br />
a major funder contribution and offer to<br />
support research capacity and work. Such<br />
an example illustrates the power of these<br />
forums to harness local leadership and<br />
promote change-making collaborations that<br />
otherwise would be challenging to manifest.<br />
Another example is the use of <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> Training Centre to support training<br />
and knowledge standardisation prior to<br />
the implementation of a study led by the<br />
“Pregnancy Care Integrating translational<br />
Science, Everywhere” (PRECISE) team on<br />
pre-eclampsia and placenta displacement.<br />
“Working with <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> has been a fantastic<br />
opportunity to increase opportunities for developing the skills<br />
and capacity of staff across <strong>The</strong> PRECISE <strong>Network</strong> through the<br />
Professional Development Scheme and eLearning. We have had<br />
fantastic feedback from our teams in Africa about these aspects<br />
of <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> as well as using the private area<br />
for uploading study protocols and operating procedures that can<br />
be quickly and easily accessed by those working in the field. We<br />
have only been members since October 2018 and are excited to<br />
work with <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> to continue maximising the<br />
potential of this brilliant platform for our network.”<br />
Dr Meriel Flint-O’Kane<br />
PRECISE Community Programme Manager<br />
14 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Building Communities of Practice<br />
“Mesh now reaches an average of two or three thousand visits each month. This<br />
is in large part due to its position embedded within the larger community of <strong>The</strong><br />
<strong>Global</strong> <strong>Health</strong> <strong>Network</strong>, enabling us to share resources with thousands of researchers<br />
we would not otherwise reach, and the support of <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> team<br />
in enhancing our social media presence and platform traffic. Being part of a greater<br />
whole also enables us to collaborate with other disciplines and provide tools to enhance<br />
research, for example, developing a specialist area on engagement and epidemics<br />
to support <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> member hubs that focus on epidemic<br />
preparedness and response.<br />
A key example of where <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> team has added value to Mesh this<br />
year is during a consultation we ran on a working document being produced by UNICEF.<br />
<strong>The</strong> communications and operations teams at <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> advised us on<br />
how to get this out to a wide audience and facilitated its sharing on other Member Hubs.<br />
We also received personalised advice and feedback on how best to present and share a<br />
new area of the platform making it more user friendly; an example of the value of their<br />
web communications expertise. <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> team also provide support<br />
on how we and our partners can develop high quality and widely used eLearning in the<br />
future. Taken together, all this support means we can run Mesh effectively and enable<br />
it to continually develop, building on the learning that <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> team<br />
are uniquely situated to gather and share due to their helicopter view of the Member<br />
Hubs, and building on their challenges and successes.”<br />
Natalie Hunter<br />
Mesh Coordinator, Wellcome<br />
15
<strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
Training Centre<br />
<strong>The</strong> Training Centre is extremely popular and is the<br />
most accessed area of the whole platform, with a total of<br />
over 10.5 million page views from over 785,000 sessions.<br />
Individuals from 195 countries across the globe have<br />
utilised <strong>The</strong> Training Centre.<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> continues to operate<br />
a free and open access Training Centre that<br />
provides research staff and healthcare workers<br />
of all roles, all regions and all disease areas<br />
with the ‘how-to’ training materials, resources,<br />
seminars, and toolkits required to safely conduct<br />
high quality research in resource-limited<br />
settings. <strong>The</strong> Training Centre is extremely<br />
popular and is the most accessed area of the<br />
whole platform, with a total of over 10.5 million<br />
page views from over 785,000 sessions. In<br />
2018, <strong>The</strong> Training Centre saw a 60% increase<br />
in traffic with Africa still the continent accessing<br />
it the most, with 31% of the overall traffic.<br />
Individuals from 195 countries across the globe<br />
have utilised <strong>The</strong> Training Centre.<br />
Each course is developed from material donated<br />
by respected organisations and institutions<br />
such as the World <strong>Health</strong> Organization, the<br />
Multi Regional Clinical Trials Center at Harvard<br />
University, Nuffield Council of Bioethics, the<br />
Geneva Foundation for Medical Education and<br />
Research, and many more. All courses are peer<br />
reviewed before launch, reviewed periodically<br />
and accessible in slow-speed internet areas.<br />
<strong>The</strong> online training courses continue to be<br />
hugely popular with 2018 seeing over 260,000<br />
modules taken by over 53,000 eLearners.<br />
Compared to 2017, this was a 58% and 63%<br />
increase, respectively, bringing the total overall<br />
modules taken to 600,000 by 110,000 eLearners<br />
with over 250,000 certificates awarded.<br />
In order to understand how impactful <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> Training Centre’s eLearning courses are to<br />
the research staff and healthcare workers that<br />
make up the overwhelming majority of the<br />
memberships, each course has an online survey<br />
incorporated. <strong>The</strong>se surveys continue to provide<br />
extremely positive feedback with 96% stating<br />
they would recommend the eLearning courses<br />
to a colleague. Once users have completed a<br />
course they are asked how confident they are<br />
at implementing a course-specific task, on a<br />
scale of 1 to 10 (1 = not confident at all, 10 =<br />
extremely confident). Across all of <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> <strong>Network</strong>’s courses, 85% percent of users<br />
rated their confidence of completing the coursespecific<br />
tasks between 7 to 10.<br />
In <strong>2019</strong>, <strong>The</strong> Training Centre’s Virtual Learning<br />
Environment will be upgraded to provide<br />
eLearners with an improved learning experience<br />
including a searchable table of courses, a<br />
personal course dashboard, updated course<br />
navigation, and much, much more. Several<br />
exciting new courses are already in development<br />
with multiple international organisations to<br />
meet identified knowledge gaps and these will<br />
be made available throughout the year.<br />
16 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre<br />
<strong>The</strong> Training<br />
Centre currently<br />
offers 30 open<br />
access online<br />
training courses<br />
consisting of<br />
80 individual<br />
learning modules<br />
including over<br />
50 modules<br />
translated into<br />
a variety of<br />
languages such as<br />
French, Spanish<br />
and Portuguese.<br />
260,000<br />
modules taken by over<br />
53,000 eLearners<br />
in 2018<br />
96%<br />
of eLearners said they would<br />
recommend the eLearning<br />
courses to a colleague<br />
85%<br />
of users rated their<br />
confidence of completing<br />
the course-specific<br />
tasks between 7 to 10<br />
250,000<br />
Certificates awarded<br />
<strong>The</strong> 5 most popular courses are:<br />
1 ICH Good Clinical practice E6 (R2)<br />
2 Research Ethics<br />
3<br />
Introduction to Clinical Research<br />
4 Essential Elements of Ethics<br />
5 Introduction to Good Clinical Laboratory Practice<br />
“WHAT eLEARNERS SAY<br />
“Very much helpful in a way that I know how<br />
and why should clinical trials and research be<br />
conducted.”<br />
Nurse, Malawi<br />
“It helped me a lot because I was able to get the<br />
information I needed to advance my argument in<br />
meetings and for references.”<br />
Project manager, Ghana<br />
“I have developed experience in<br />
research proposal and report<br />
writing. I have published articles<br />
and even have got research grant<br />
award in my institution currently<br />
with topics related to sexual and<br />
reproductive health.”<br />
Nurse, Ethiopia<br />
“It improved the standard how I do<br />
things and the confidence how I<br />
handle my work.”<br />
Nurse, Kenya<br />
“I was able to generate research<br />
questions and conduct more<br />
clinically relevant research.”<br />
Doctor, Nigeria<br />
17
“WHAT eLEARNERS SAY<br />
“I was equipped with knowledge<br />
on safety and quality for the<br />
realization of reliable results.”<br />
Laboratory Staff, Kenya<br />
“I work in the neonatal unit and<br />
the knowledge I acquired is<br />
really helping me to know how<br />
to measure and monitor their<br />
growth.”<br />
Nurse, Nigeria<br />
“It helped me to consciously<br />
ensure accuracy and<br />
completeness of any data am<br />
recording”<br />
Pharmacist, Nigeria<br />
“It gives some credibility to the<br />
training and quality control<br />
performed onsite.”<br />
Investigator, Thailand<br />
“<strong>The</strong>se resources were very<br />
helpful during the initial phases<br />
of my transition from clinician<br />
to researcher and I use them<br />
mostly in my research role.”<br />
Investigator, Gambia<br />
“It helped me to review the<br />
research proposals assigned<br />
to me as a member in research<br />
ethics committee in my faculty.”<br />
Lecturer, Egypt<br />
”<br />
“I coordinate clinical<br />
activities in a<br />
fistula centre in my<br />
country, it gave me a<br />
broad appreciation<br />
of the problem and<br />
who the patients are<br />
and the experiences<br />
they have probably<br />
before they visit our<br />
facilities”<br />
Project manager, Ghana<br />
280,000<br />
Modules taken and eLearners per year<br />
240,000<br />
200,000<br />
600,000<br />
Modules Taken<br />
160,000<br />
120,000<br />
110,000<br />
eLearners<br />
80,000<br />
40,000<br />
Modules taken<br />
eLearners<br />
2011 2012 2013 2014 2015 2016 2017 2018<br />
18 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre<br />
eLearning Courses Hosted on<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre<br />
Course<br />
Number<br />
of Modules Translations<br />
Acute Pneumococcal and Meningococcal Meningitis 1<br />
Basic Malaria Microscopy 5<br />
Children and Clinical Research 1 Spanish<br />
Congential Cytomegalovirus 1<br />
Data Safety Monitoring Boards for Clinical Trials 1 French<br />
Essential Elements of Ethics 11<br />
Ethics and best Practices in Data Sharing 1<br />
Ethics in epidemics, emergencies and disasters: Research, 7<br />
surveillance and patient care<br />
Ethics of Ancillary Care in Research 1<br />
Good Clinical Laboratory Practice 4<br />
Herpes Simplex Virus Encephalitis 1<br />
HIV Neuropathy 1<br />
How to Conduct GCP Inspections/Audits at the Clinical 1<br />
Investigator Site<br />
ICH Good Clinical Practice E6 (R2) 1 French, Spanish, Russian, Portuguese, Vietnamese<br />
INTERGROWTH-21 st course on maternal, fetal and 2 Spanish, Portuguese<br />
newborn growth monitoring<br />
Introduction to Clinical Research 1 French, Spanish, Portuguese, Mandarin, Vietnamese,<br />
Swahili<br />
Introduction to Collecting and <strong>Report</strong>ing Adverse Events 1<br />
Introduction to Data Management For Clinical 1<br />
Research Studies<br />
Introduction to GCLP 1 Spanish<br />
Introduction to Informed Consent 1<br />
Introduction to Reviewing Genomic Research 1 French, Spanish, Portuguese,<br />
Maternal Infections 6<br />
Neurological Infectious Diseases 17<br />
Obstetric Fistula 4 French<br />
Preterm infant feeding and growth monitoring: 3 Spanish, Portuguese, Russian, Italian<br />
Implementation of the INTERGROWTH-21 st protocol<br />
Research Ethics 14<br />
<strong>The</strong> Research Question 1 French, Spanish, Mandarin, Vietnamese<br />
<strong>The</strong> Study Protocol: Part one 1 French<br />
<strong>The</strong> Study Protocol: Part two 1 French<br />
19
Case Study<br />
<strong>The</strong> INTERGROWTH-21 st<br />
Project<br />
<strong>The</strong> INTERGROWTH-21 st Project<br />
123,000<br />
INTERGROWTH-21st<br />
Tools Downloaded<br />
from 195 Countries<br />
6,662<br />
Courses Taken<br />
2,816<br />
eLearners<br />
3,470<br />
Certificates<br />
<strong>The</strong> International Fetal and Newborn Growth Consortium<br />
for the 21 st Century (INTERGROWTH-21 st )<br />
is a collaboration between 300 researchers and<br />
clinicians from 27 institutions in 18 countries and<br />
coordinated from the University of Oxford. <strong>The</strong><br />
objective is to improve perinatal health within a<br />
global context, thus reducing preterm birth and<br />
poor intrauterine growth.<br />
<strong>The</strong> INTERGROWTH-21 st project aimed to extend<br />
the established World <strong>Health</strong> Organization’s (WHO)<br />
Child Growth Standards into the foetal and neonatal<br />
period. Research findings from three populationbased<br />
studies provided new ways of classifying<br />
preterm and small for gestational age newborns.<br />
Furthermore, the INTERGROWTH-21 st Consortium<br />
have produced a new international equation for<br />
estimating gestational age through ultrasound,<br />
based on the first international crown-rump length<br />
standards.<br />
In addition to these tools and resources, an<br />
accompanying course has been developed, and<br />
is hosted on the <strong>Global</strong> <strong>Health</strong> Training Centre in<br />
English, Spanish and Portuguese. <strong>The</strong> objective<br />
of the course is to guide eLearners through the<br />
methodology of maternal, foetal and newborn<br />
growth monitoring, and the application of the<br />
INTERGROWTH-21 st international growth standards.<br />
At the end of 2018, this two-module course had<br />
6,662 modules taken by 2,816 eLearners with 3,470<br />
certificates awarded (certificates per module).<br />
20 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre<br />
Case Study<br />
<strong>The</strong> INTERGROWTH-21 st<br />
Project<br />
WHO Toolkit for research<br />
and development of paediatric<br />
antiretroviral drugs and<br />
formulations<br />
In 2018, <strong>The</strong> <strong>Global</strong> <strong>Health</strong> Training Centre<br />
developed and launched the online<br />
version of the WHO toolkit for research and<br />
development of paediatric antiretroviral drugs<br />
and formulations. Research and development<br />
of antiretroviral drugs and formulations for<br />
children has traditionally lagged behind that of<br />
adult versions of the drugs. <strong>The</strong> toolkit consists<br />
of ten modules and provides online access for<br />
drug manufacturers, regulatory authorities,<br />
and more widely by the global research<br />
community, to help facilitate and accelerate the<br />
development of HIV drugs for children.<br />
21
Leadership from the<br />
Regions to Drive Capacity<br />
for Research<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> is involved<br />
in two preparedness<br />
initiatives. By working<br />
to develop research<br />
capacity, these networks<br />
are encouraging and<br />
building the skills of<br />
clinical and laboratory<br />
researchers.<br />
<strong>The</strong> Research Capacity <strong>Network</strong>, REDe –<br />
established through a single work package<br />
that is common and runs across three EUfunded<br />
Zika consortia (ZIKAction, ZIKAlliance<br />
and ZikaPLAN) in Latin America and the<br />
Caribbean.<br />
This Project has received funding<br />
from the European Union’s Horizon<br />
2020 research and innovation<br />
programme under grant agreement<br />
No.s 734548, 734584, 734857<br />
<strong>The</strong> African coaLition for Epidemic Research,<br />
Response and Training (ALERRT) – a clinical research<br />
and response network for epidemic infections in<br />
sub-Saharan Africa.<br />
This <strong>Network</strong> is supported by the European<br />
& Developing Countries Clinical Trials<br />
Partnership (EDCTP) 2 Programme under<br />
the European Union - grant agreement<br />
number RIA2016E-1612. Its initial focus is<br />
on advancing rapid and coherent research<br />
response in sub-Saharan Africa (SSA).<br />
Case Study:<br />
Setting up Platforms in Latin America<br />
As the Zika consortia started to set up their various observational<br />
and pregnancy cohort studies, REDe assisted by hosting a series<br />
of webinars – one of which was the concept of conducting a study<br />
walkthrough using the research platform.<br />
This is a great way to explain the whole study to everyone<br />
involved. <strong>The</strong> importance of involving all staff was emphasised<br />
so that everyone can work through what happens to a<br />
participant at each stage, what the tasks of a particular<br />
member of staff would be, and how these tasks are<br />
conducted. This task-specific approach means that<br />
staff learns the study procedures by ‘doing’, rather<br />
than simply reading the study manual. This<br />
method is easy to do as the costs are low and<br />
it helps flag any problems that may not have<br />
been previously identified, e.g. a problem<br />
could be anything from the logistics of getting<br />
a participant from the examination room to<br />
another part of the hospital to take consent, to<br />
missing a check box on the case report form.<br />
22 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Driving Capacity for Research<br />
REDe means ‘network’ in Spanish and<br />
Portuguese, pronounced as the word<br />
‘ready’ in English - for being prepared.<br />
We think that this is quite apt for<br />
creating a preparedness network in<br />
Latin America and the Caribbean in the<br />
event of outbreak.<br />
So, researchers are READY to respond in<br />
an outbreak situation, using the ZIKA<br />
outbreak as a platform.<br />
To meet this objective, <strong>The</strong> <strong>Network</strong> links<br />
together experienced research groups, creating<br />
and strengthening a cadre of experienced,<br />
willing research staff, undertaking highquality<br />
research, and ethical data capture. <strong>The</strong><br />
locally led alliance of partners coordinate and<br />
contribute to the knowledge, research tools and<br />
training; fostering links between experienced<br />
and inexperienced research platforms, which<br />
underpins the strength of these networks.<br />
As a strong component of these networks, the<br />
regional faculty programme runs extensive<br />
training events in and around the world, based<br />
on the perceived research capacity needs of<br />
each target setting. Many research centres<br />
have specifically chosen to run blended learning<br />
programmes and open workshops focusing on<br />
clinical research ethics or career development<br />
for researchers, responding to demand in<br />
these areas. To date, these Research Capacity<br />
<strong>Network</strong>s, REDe and ALERRT, have run 40<br />
workshops across 14 countries. <strong>The</strong> following<br />
short excerpts briefly describe some of these<br />
networks’ faculty activities:<br />
INDIA: Clinical research workshops have<br />
been conducted for healthcare workers,<br />
laboratory staff and nurses, with the aim to<br />
introduce the importance of research and the<br />
opportunities it offers.<br />
NIGERIA: Building research capacity<br />
for clinical research professionals through<br />
workshops, blended learning programmes,<br />
networking initiatives, training opportunities,<br />
and the creation of online toolkits. In July 2018, a<br />
two-day workshop took place in Abuja with over<br />
350 attendees.<br />
HONDURAS: Platforms conducting<br />
regulatory standard clinical trials most<br />
commonly discuss difficulties with regulatory<br />
processes; as this stage creates significant<br />
barriers to conducting timely, and further<br />
research, creating a need for increased and<br />
standardised documentation such as Standard<br />
Operating Procedures (SOPs). This Regional<br />
Faculty works alongside ethical and regulatory<br />
review boards to provide training to its members,<br />
bringing together the local research community<br />
through conferences, workshops and events.<br />
SOUTH AFRICA: Pioneers of the<br />
blended learning initiatives and trailblazers of a<br />
‘twinning’ initiative in which one platform works<br />
alongside a more experienced vaccine platform,<br />
to learn about Phase I studies. This faculty has<br />
also hosted numerous free workshops appealing<br />
to research staff at all levels.<br />
23
WORKSHOP FEEDBACK<br />
Case Study:<br />
Response to the plague<br />
outbreak – capacity<br />
building workshop for<br />
local research staff<br />
“This platform will be of great<br />
help for our training and<br />
development in the field of<br />
health, and will help us to be<br />
more updated as it is a global,<br />
interactive and dynamic<br />
platform.”<br />
Doctor, Madagascar<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong>, ALERRT and<br />
Institut Pasteur de Madagascar ran a<br />
workshop to support research capacity<br />
development in Madagascar in response to<br />
the outbreak of the plague.<br />
<strong>The</strong> aim was to:<br />
• work with local research organisations<br />
to describe the health research capacity<br />
gaps in Madagascar,<br />
• see if a shared goal could be found<br />
where these organisations would like to<br />
be in terms of research being led from<br />
the country, and<br />
• determine a set of short, medium and<br />
longer-term mechanisms for addressing<br />
these.<br />
<strong>The</strong>re were several components to the<br />
workshop including:<br />
<strong>The</strong> next steps:<br />
Access to shared training and capacity<br />
development opportunities was a clear<br />
finding – in response to this there are<br />
several initiatives including setting up a<br />
<strong>Health</strong> Research <strong>Network</strong> in Madagascar,<br />
and establishing an exchange programme<br />
around a Disease Surveillance System.<br />
A Disease Surveillance System is the<br />
fundamental starting point for health<br />
research and addressing critical capacity<br />
gaps. Unless there is an understanding of<br />
the population, their access to healthcare,<br />
what the healthcare structure is and what<br />
diseases are affecting the population, it<br />
is impossible to plan drug and vaccine<br />
studies.<br />
• preparation meetings with institutions<br />
such as: MISA (Computer Science<br />
Mathematics and Applied Statistics)/<br />
University of Antananarivo; INSTAT<br />
(National Institute of STATistics); IPM<br />
(Institute Pasteur Madagascar) –<br />
Epidemiology, Clinical Research Unit,<br />
Plague Unit, Clinical Biology Center,<br />
Mycobacteria Unit and Virology Unit;<br />
LARTIC (<strong>Health</strong> Information system<br />
laboratory); Hospital in Befelatanana<br />
in Antananarivo; Faculty of Medicine,<br />
University of Antananarivo,<br />
• workshops with focus groups activities<br />
– introducing a qualitative research<br />
element<br />
• debrief meetings.<br />
24 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Driving Capacity for Research<br />
Case Study:<br />
Data Sharing Workshop<br />
With the “Open Science” revolution, researchers<br />
are expected to provide open access to<br />
information about their study’s methods,<br />
analyses and results. Funders argue that data<br />
sharing can enable faster evidence generation.<br />
However, data sharing is a relatively new<br />
phenomenon and considerable confusion still<br />
exists around what it means to share data,<br />
how it can be achieved, and how to overcome<br />
potential barriers.<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> ran a workshop<br />
to bring together experts who shared their<br />
experience on the issues and challenges of<br />
data sharing. Professor Oumar Gaye, Université<br />
Cheikh Anta Diop de Dakar, Senegal, along with<br />
Professor Philippe Guérin, Infectious Diseases<br />
Data Observatory (IDDO), University of Oxford,<br />
United Kingdom and Professor Trudie Lang, <strong>The</strong><br />
<strong>Global</strong> <strong>Health</strong> <strong>Network</strong>, University of Oxford<br />
presented.<br />
Professor Oumar Gaye’s presentation specifically<br />
honed in on malaria as a case study and as a<br />
community that has embraced responsible,<br />
collaborative data sharing, discussing the<br />
pathway undertaken to establish the trust and<br />
collaboration that now exists.<br />
Professor Trudie Lang gave an overview of <strong>The</strong><br />
<strong>Network</strong> and explained their efforts to progress<br />
capacity building initiatives. <strong>The</strong> <strong>Network</strong><br />
is currently collaborating with <strong>The</strong> European<br />
Clinical Trials Partnership (EDCTP), to develop a<br />
“Knowledge Hub” that will address the training<br />
needs of EDCTP’s grantees with regards to<br />
protocol development, data management and<br />
data sharing.<br />
Professor Philippe Guerin spoke of the<br />
importance of data sharing, the challenges it<br />
presents and the benefits to be gained, as well<br />
as more broadly about the scope and objectives<br />
of IDDO.<br />
Breakout<br />
Session<br />
As part of the<br />
interactive breakout<br />
session, participants were<br />
divided into three groups,<br />
with each group assigned<br />
a topic for discussion.<br />
<strong>The</strong> topics included:<br />
1 <br />
<strong>The</strong> perceived barriers<br />
to data sharing<br />
2 <br />
<strong>The</strong> potential<br />
opportunities and<br />
benefits of data sharing<br />
3 <br />
<strong>The</strong> training and<br />
resources required for<br />
data sharing<br />
25
Research Capacity<br />
Activity, Honduras<br />
<strong>The</strong> Nigerian<br />
Regional Faculty<br />
An induction meeting on <strong>The</strong> <strong>Global</strong> <strong>Health</strong><br />
<strong>Network</strong> and REDe platforms took place<br />
in the computer laboratory of the Nursing<br />
School with the participation from the<br />
undergraduate students who are attending<br />
the Rural Community Nursing class. This<br />
class was part of the ‘Research Methodology<br />
Module’ of the curriculum. Students take<br />
theory classes for four weeks, and then<br />
transfer to different hospitals and health<br />
centres in the country. As part of the module,<br />
the students are expected to conduct a<br />
research study in the community.<br />
<strong>The</strong> objective of the induction meeting was<br />
to inform the students about <strong>The</strong> <strong>Network</strong><br />
and REDe resources and tools, to strengthen<br />
their research capacity with emphasis on<br />
research methodology and research<br />
ethics courses (i.e. Introduction to<br />
Clinical Research, <strong>The</strong> Research<br />
Question, <strong>The</strong> Study Protocol:<br />
part 1 and 2, and Good Clinical<br />
Laboratory Practice). <strong>The</strong><br />
platform was explored<br />
in real time and most<br />
of the students<br />
proceeded to their<br />
registration using<br />
the computers in<br />
the laboratory.<br />
<strong>The</strong> Nigerian<br />
Regional Faculty<br />
organised a free<br />
clinical research<br />
capacity building<br />
workshop in<br />
July 2018, which<br />
was attended by<br />
over 200 nurses,<br />
pharmacists,<br />
laboratory and<br />
social scientists.<br />
26 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Driving Capacity for Research<br />
<strong>The</strong> opening speech was given by Mr Umar<br />
Aliyu, Head of Department and Deputy Director<br />
of Nursing Services at the National Hospital,<br />
Abuja. Dr Saleh Garba, Head, Department of<br />
Nursing Science, Ahmadu Bello University, Zaria<br />
followed with a presentation on ‘Implementing<br />
research results in clinical practice; the<br />
experience of nursing professionals’.<br />
WORKSHOP FEEDBACK<br />
“<strong>Network</strong>ing and sharing is very important in<br />
building capacity in clinical research, as that is a<br />
very typical way of improving and strengthening<br />
the knowledge of local research, therefore enabling<br />
and empowering them to do better clinical research,<br />
comparable to the standards in other parts in the<br />
world, and that is very important because as they<br />
are now able to do research embedded in the local<br />
context, solving real-life problems that enhances that<br />
community or society.” Doctor, Nigeria<br />
<strong>The</strong> presenter highlighted barriers to implementation<br />
of clinical research findings by nurses in Nigeria<br />
and made suggestions on ways to improve the<br />
implementation of research results by nurses.<br />
Further talks were conducted on Pharmacovigilance<br />
in Clinical Research, where participants were<br />
encouraged to get involved in research studies<br />
while carrying out their routine clinical duties.<br />
<strong>The</strong> role that clinicians and nurses (since they<br />
are with the in-patients 24 hours a day) play in<br />
pharmacovigilance was also discussed, such as the<br />
importance of reporting adverse drug reactions and<br />
documentation, e.g. photographic and documented<br />
records of such incidents.<br />
27
Developing Careers and Fostering<br />
Team Capabilities<br />
A mechanism for tracking professional<br />
development and measuring changes in<br />
capacity development<br />
<strong>The</strong> Professional<br />
Development Scheme<br />
(PDS) was devised to give<br />
health research staff a<br />
mechanism to record<br />
their research skills and<br />
experience. Measuring<br />
the acquisition of<br />
research competencies<br />
also generates<br />
comprehensive data on<br />
the impact of capacity<br />
development initiatives.<br />
Lack of recognition for working in research is<br />
widely cited as an impediment to its conduct.<br />
<strong>The</strong>re is a lack of career structure for the many<br />
roles involved in research (investigators, trial<br />
managers, nurses, local healthcare workers),<br />
and a lack of understanding of who does<br />
what. Competency frameworks exist for some<br />
individual job roles, but these are infrequent;<br />
thus a global framework describing all of the<br />
roles and responsibilities in a research team<br />
was needed. <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> in<br />
conjunction with the WHO Special Programme<br />
for Research and Training in Tropical Diseases<br />
(TDR) combined 28 frameworks created by<br />
external groups, with information from 116 job<br />
descriptions obtained from partners in clinical<br />
trial units worldwide and from the web, to<br />
create a widely encompassing framework<br />
derived from 11 different roles. <strong>The</strong> resulting<br />
framework presents 50 competencies required<br />
throughout a study lifecycle, from assessment<br />
of scientific literature to results dissemination<br />
via project management, public engagement or<br />
grant application. It is applicable to studies that<br />
may differ in design, geographical location, and<br />
disease and can be adapted to the particular<br />
needs of specific projects or roles.<br />
<strong>The</strong> research competency framework forms the<br />
core component of the PDS; an innovative and<br />
unique online tool providing researchers with a<br />
reliable mechanism to record their skillset, track<br />
their career development and identify gaps in<br />
their knowledge.<br />
“Ground-breaking tool to measure<br />
the impact of capacity development “<br />
28 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Developing Careers<br />
<strong>The</strong> PDS provides a step-by-step process for<br />
all researchers to document their career thus<br />
gathering further points as they gain experience<br />
and vocational research skills. Members assess<br />
their research competencies, are awarded a<br />
membership level and are required every year<br />
to go through a review process to update their<br />
points and progress through the 25 levels of the<br />
scheme. <strong>The</strong> PDS is an audited and highly robust<br />
system that provides ongoing recognition for<br />
research staff to support and guide their career<br />
development and identify training and skills<br />
gaps.<br />
By collecting and collating the data from all<br />
members of a team this system enables<br />
platforms or groups to showcase their<br />
experience, and monitor and report their team’s<br />
capacity development over time. This facility<br />
provides a reporting system that measures<br />
progress on the development of research<br />
capabilities and allows study managers or<br />
consortia to quickly and easily produce reports<br />
for their specific programme or teams. This<br />
scheme is entirely unique and very powerful<br />
as it provides robust evidence that can be used<br />
to seek investment and funding to address<br />
capacity gaps. Research coordinators, funders<br />
and sponsors can be given access to data on<br />
large networks, individual platforms or specific<br />
staff roles; thus measuring the impact of<br />
capacity development initiatives.<br />
29
Assessing Barriers and<br />
Enablers to Research, and<br />
Measuring the Impact of<br />
the Platform<br />
<strong>The</strong> research resources<br />
available on <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> <strong>Network</strong> have<br />
been downloaded<br />
and accessed many<br />
hundreds of thousands<br />
of times. To understand<br />
how the information is<br />
being used, <strong>The</strong> <strong>Network</strong><br />
is setting out to assess<br />
the impact the resources<br />
are making on research<br />
and practice, starting<br />
in the area of child<br />
development.<br />
<strong>The</strong> <strong>Network</strong> has served as a mechanism<br />
for disseminating growth and development<br />
resources and training for a research consortium<br />
called INTERGROWTH-21 st and these have<br />
been downloaded by over 120,000 healthcare<br />
workers and researchers in 195 countries. Due<br />
to the popularity of the INTERGROWTH-21 st<br />
resources on the platform, <strong>The</strong> <strong>Network</strong>, in<br />
collaboration with the Nuffield Department of<br />
Women’s & Reproductive <strong>Health</strong>, is undertaking<br />
a comprehensive mixed methods study to<br />
understand the impact of these resources.<br />
<strong>The</strong> findings from the study will determine<br />
where the gaps exist and help to understand<br />
whether the resources benefited both practice<br />
and research, and to guide <strong>The</strong> <strong>Network</strong> in<br />
making even more resources available to take<br />
advantage of areas of opportunity.<br />
<strong>The</strong> strongest themes repeated throughout the survey responses were:<br />
1 Ongoing availability of research staff in the clinic and the laboratory<br />
2 Institutional mandate to engage in research<br />
3 Career development and support for research work within clinical and<br />
laboratory roles<br />
4 Strategic use of funding to allow healthcare centres to build infrastructure:<br />
rather than a ‘platform’ within a healthcare centre<br />
Thus we believe these themes could be tackled by working at a healthcare<br />
delivery level approach, which is exactly what we are doing with <strong>The</strong><br />
<strong>Global</strong> <strong>Health</strong> <strong>Network</strong>.<br />
30 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Barriers and Enablers to Research and Measuring Impact<br />
<strong>The</strong> latest Ebola outbreak and rapid spread of<br />
the Zika virus epidemic highlighted the lack of<br />
research capacity in low-resource regions in both<br />
the ability to undertake observational research<br />
to describe the diseases and subsequently<br />
to set up the regulatory standard clinical<br />
trials to assess potential drugs and vaccines.<br />
<strong>The</strong>se outbreaks also made visible the lack<br />
of research being done day to day to address<br />
local healthcare needs of these communities.<br />
We would argue that it is the lack of day-today<br />
research that is the true problem, because<br />
if that capacity were in place, these researchers<br />
could respond to an outbreak.<br />
In preparation for future epidemics, the<br />
World Bank led a taskforce to establish an<br />
understanding of what research capacity exists<br />
at present across low- and middle-income<br />
countries (LMICs) for conducting vaccine<br />
research. <strong>The</strong> <strong>Network</strong>’s platform utilised its<br />
resources to assess the research capacity in<br />
LMICs. <strong>The</strong> uptake of the survey was very popular<br />
with over 5,000 responses. <strong>The</strong> overwhelming<br />
response from the survey demonstrates<br />
how well <strong>The</strong> <strong>Network</strong> communicates with<br />
researchers and healthcare workers in LMICs.<br />
within those institutions. This has resulted in<br />
situations where a state-of-the-art research<br />
group within a hospital has their own laboratory<br />
to work on one disease (e.g. HIV or malaria),<br />
but are also just hundreds of metres away from<br />
other clinical groups who have no experience in<br />
producing high quality research.<br />
<strong>The</strong> gaps and issues reported by the researchers<br />
who responded to the survey shows that research<br />
should be embedded in healthcare delivery,<br />
and in order for this to happen, institutions and/<br />
or governments need to recognise the value of<br />
research. If research activities are limited to one<br />
disease or protocol, then the ability for research<br />
is not extended beyond that specific therapeutic<br />
area. This is not conducive to long-term research<br />
capacity, and furthermore, limits the ability to<br />
effectively respond to outbreaks. Importantly,<br />
we have shown that the skills, infrastructure,<br />
regulatory ability and oversight do not differ<br />
significantly between disease or research types.<br />
As the skillset for conducting clinical research is<br />
therefore largely similar, it would be possible<br />
to make improvements in research capacity<br />
by working with healthcare-providing facilities<br />
instead of isolated groups.<br />
We already knew that over the past twenty<br />
years there has been a steady increase in the<br />
amount of regulatory standard clinical trials<br />
occurring in low-resource countries. <strong>The</strong>se<br />
studies have largely been led by publicprivate<br />
partnerships and have assessed drugs<br />
and vaccines for HIV, TB and Malaria. <strong>The</strong>se<br />
programmes have made a remarkable impact<br />
and have left teams within research platforms<br />
well equipped, trained and able to undertake<br />
clinical research. Further, these studies can<br />
largely be credited for the strong capacity that<br />
does exist in limited resource settings. However,<br />
whilst these externally sponsored programmes<br />
have invested in specific teams within hospitals<br />
and/or universities, we found that the skills and<br />
abilities have not necessarily been transferred<br />
31
What Next?<br />
In 2013, the WHO said that unless<br />
low- and middle-income countries<br />
(LMICs) become the generators and<br />
not the recipients of health research<br />
data, then there will never be any real<br />
improvement in the greatest burdens<br />
to public health in these countries. Our<br />
survey findings echoed this call and<br />
produced unique evidence to show<br />
why we need to strengthen research<br />
awareness and capacity in low-income<br />
countries with a high burden of disease.<br />
If we can equip these regions with<br />
the skills and resources to undertake<br />
research on the everyday disease<br />
burdens that cause such high levels<br />
of early mortality, then interventions<br />
and prevention approaches can be<br />
identified and tested, which could bring<br />
significant change in health outcomes.<br />
<strong>The</strong>n, with this embedded ability to<br />
undertake research, these vulnerable<br />
regions would also be better placed to<br />
lead and undertake their own research<br />
response within outbreaks.<br />
32 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
Strategic Development<br />
<strong>The</strong> Strategic<br />
Development<br />
Plan<br />
<strong>The</strong>refore, central to our strategic development<br />
plan is to strengthen regional engagement<br />
and leadership of <strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong>.<br />
Here, the intent is that the concept, approach<br />
and platform are taken up with partners in<br />
the region who will lead regional hubs. <strong>The</strong>se<br />
hubs can coordinate the regional capacity<br />
development network and use <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> <strong>Network</strong> platform as the central vehicle<br />
for connecting research organisations and<br />
sharing expertise and skills locally, between<br />
healthcare organisations, universities, health<br />
charities and government health agencies. <strong>The</strong><br />
main focus, however, will be running the faceto-face<br />
activities that work so well in engaging<br />
frontline healthcare workers in research and<br />
using evidence in practice. Here, we have<br />
toolkits of activities that have proven to work<br />
so well, such as supported learning sessions,<br />
reciprocal monitoring and research quality<br />
management, workshops and mentoring. <strong>The</strong><br />
mix of these ‘on the ground’ activities and the<br />
resources, communities and training online<br />
is a sustainable and long-term solution for<br />
delivering real research capacity development<br />
that supports more and better research in the<br />
most underserved regions, and that works for<br />
any disease and in any healthcare setting.<br />
Our most exciting development that we are<br />
currently working on is about discoverability<br />
and information architecture. Our vision here<br />
is to harness the technology that is used<br />
commercially so widely to persuade us to book<br />
a hotel or order a book. Our goal is to provide<br />
researchers and healthcare workers in clinics<br />
and laboratories with information that they<br />
would not have known existed. So, for example,<br />
if there was a researcher planning a study on<br />
Leishmaniasis in Ghana they might have found<br />
a protocol on this platform. What we want<br />
to build in, using machine learning, is that<br />
alongside the protocol, they would be offered<br />
case report forms, standard outcome measures,<br />
a consent template, and a guide for community<br />
engagement; all focused on Leishmaniasis and<br />
encompassing all that the team would need to<br />
conduct a world-class study using standards and<br />
practices that are out there, but were previously<br />
unknown to this team. With this technology we<br />
could allow researchers to discover resources,<br />
tools, guidance and training that can enable<br />
high quality research that generates fast and<br />
better data that is ready to be shared.<br />
In order to deliver the ability to share<br />
information to enable world-class standard<br />
research anywhere in the world, <strong>The</strong> <strong>Global</strong><br />
<strong>Health</strong> <strong>Network</strong> needs to apply the very best<br />
digital technology. Here, we are focusing<br />
on growing the scale and discoverability of<br />
information. We need this platform to be<br />
accessible everywhere and to run at optimum<br />
speed, even in low-bandwidth regions. We are<br />
exploring cloud technology and placing <strong>The</strong><br />
<strong>Global</strong> <strong>Health</strong> <strong>Network</strong> platform in strategic<br />
hubs across the globe. All the resources and<br />
content are designed to work on all devices and<br />
on low-band width internet; we also continually<br />
ensure the platform is fully compliant with all<br />
data privacy laws and regulations.<br />
33
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> Collaborators<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> Funders<br />
Brain Infections <strong>Global</strong><br />
Brain Infections UK<br />
Centre for Immunology and Vaccinology, Imperial College London<br />
Childhood Acute Illness and Nutrition <strong>Network</strong><br />
Clinton <strong>Health</strong> Access Initiative<br />
Collaborative Initiative for Paediatric HIV Education and Research<br />
Columbia University Mailman School of Public <strong>Health</strong><br />
CONSISE<br />
DF/NET Research<br />
Drugs for Neglected Diseases Initiative<br />
East African Consortium for Clinical Research<br />
Elizabeth Glaser Pediatric AIDs Foundation<br />
ELSI2.0<br />
Epidemic Diseases Research Group Oxford<br />
ETHOX<br />
Faculty for Capacity Development<br />
Geneva Foundation for Medical Education and Research<br />
<strong>Global</strong> Alliance for Musculoskeletal <strong>Health</strong><br />
<strong>Global</strong> <strong>Health</strong> Clinical Consortium<br />
Industry Liason Forum<br />
Infectious Diseases Data Observatory<br />
Infectious Diseases Research Institute<br />
Institute of Infections and <strong>Global</strong> <strong>Health</strong>, University of Liverpool<br />
INTERGROWTH-21 st<br />
International AIDS Vaccine Initiative<br />
International Committee for Congenital Anomaly Surveillance Tools<br />
International Maternal Pediatric Adolescent AIDS Clinical Trials <strong>Network</strong><br />
International Partnership for Microbicides<br />
International Severe Acute Respiratory and Emerging Infection Consortium<br />
International Vaccine Institute<br />
INTERPRACTICE-21 st<br />
IQVIA<br />
Kings College London<br />
KWTRP KEMRI Wellcome Trust Research Programme<br />
Liverpool School of Tropical Medicine<br />
London School of Hygeine and Tropical Medicine<br />
Magee Women's Research Insitute<br />
Maternal <strong>Health</strong> Task Force<br />
Medicines for Malaria Venture<br />
Medicines Patent Pool<br />
MORU Mahidol Oxford Tropical Medicine Research Unit<br />
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal<br />
Sciences, University of Oxford<br />
NurioID e-Learning<br />
OUCRU Oxford University Clinical Research Unit<br />
Oxford Maternal & Perinatal <strong>Health</strong> Institute<br />
Paediatric European <strong>Network</strong> for Treatment of AIDS<br />
PATH<br />
Pregnancy Care Integrating translational Science, Everywhere <strong>Network</strong><br />
TB Alliance<br />
TDR, the Special Programme for Research and Training in Tropical Disease<br />
<strong>The</strong> Aga Khan University<br />
<strong>The</strong> <strong>Global</strong> Pregnancy Collaboration<br />
<strong>The</strong> Mutli-Regional Clinical Trials Center if Brigham and Women’s Hospital Harvard<br />
<strong>The</strong> Royal Liverpool and Broadgreen University Hospitals<br />
<strong>The</strong> Synergist<br />
<strong>The</strong> United States President’s Emergency Plan for AIDS Relief<br />
<strong>The</strong> Walton Centre NHS Foundation Trust<br />
<strong>The</strong> Worldwide Prison <strong>Health</strong> Research & Engagement <strong>Network</strong><br />
TRICLINIUM Clinical Development (Pty) Ltd<br />
UNICEF<br />
Wellcome<br />
World <strong>Health</strong> Organisation<br />
WorldWide Antimalarial Resistance <strong>Network</strong><br />
ZIKACTION<br />
ZikAlliance<br />
ZikaPLAN<br />
European Union Horizon<br />
2020 Research and<br />
Innovation Programme<br />
©<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong> <strong>2019</strong><br />
34 I THE GLOBAL HEALTH NETWORK ANNUAL REPORT <strong>2019</strong>
<strong>The</strong> Strategic Development Plan<br />
CONTACT<br />
<strong>The</strong> <strong>Global</strong> <strong>Health</strong> <strong>Network</strong><br />
Nuffield Department of Medicine Research Building (NDMRB)<br />
University of Oxford<br />
Old Road Campus<br />
Roosevelt Drive<br />
Oxford<br />
OX3 7FZ<br />
Professor Trudie Lang, Director: trudie.lang@ndm.ox.ac.uk<br />
Liam Boggs, Senior Operations Manager: liam.boggs@ndm.ox.ac.uk<br />
35