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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

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