IMPACT AND CHANGE 2012 ANNUAL REPORT
The strength of the past The innovation of today The commitment to tomorrow
IMPACT AND CHANGE 2012 ANNUAL REPORT The strength of the past The innovation of today The commitment to tomorrow
WHO Library Cataloguing-in-Publication Data Impact and change: 2012 annual report. 1.Tropical medicine. 2.Research. 3.Program evaluation. 4.Strategic planning. 5.Annual reports. I.UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. ISBN 978 92 4 150554 3 (NLM classification: WC 680)
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Contents Dr Hiroki Nakatani, TDR Special Programme Coordinator and Assistant Director-General, HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases (HTM), World Health Organization Dr Sue Kinn, Joint Coordinating Board Chair Our contributors Dr John Reeder, TDR Director 4 5 6 8 9 10 10 10 11 12 12 13 15 16 17 17 19 20 20 21 21 22 23 24 26 28 31 32
Major achievements in 2012 Preventing childhood deaths by managing fevers Helping improve the quality of rapid diagnostic tests for malaria Supporting the elimination of river blindness Improving dengue prevention, diagnosis and treatment A series of research priority reports to support policy-makers and funders Supporting the development of effective donor collaborations Expansion of career development fellows
Work in 2013 and beyond Results expected in 2013 Longer term work Just starting
Facts and figures for 2012 Key publications and resources Research publications Research priority reports Reports about TDR Joint Coordinating Board (JCB) Membership of the Scientific and Technical Advisory Committee (Stac) Financial performance summary Performance overview TDR Partnerships TDR governance and management
TDR 2012 contributions table
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Dr Hiroki Nakatani TDR Special Programme Coordinator and Assistant Director-General, HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases (HTM), World Health Organization
I was honoured to become the new Special Programme Coordinator in November 2012, when TDR moved to the same organizational cluster as the WHO communicable diseases control departments of HIV , TB, malaria, and the neglected tropical diseases. This move is intended to strengthen the ongoing loop of research informing practice and practice informing research. In addition, we see ample opportunities for focused collaborations in emerging challenges. For example, TDR is working closely with the TB department to train researchers to identify health system bottlenecks to getting more people diagnosed and treated, with a special focus on multi-drug resistant tuberculosis in Eastern Europe, an emerging and dangerous public health threat. Much more is being planned and the other departments are excited to work with TDR to generate new tools to better combat diseases. I trust this synergy will bring valuable results since TDR has a strong new and focused strategy, as well as a lean and efficient management structure. I commit to you my ongoing support to continuing this important work.
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Dr Sue Kinn Joint Coordinating Board Chair
TDR has a new structure, a new strategy and a new approach – to work more closely in the countries where research needs to be nurtured. TDR has an important role to play in global health research and is an important partner for a range of different groups and programmes. This is a report about the year 2012, midway through TDR’s biennial budget 2012-2013. It covers a sea change in the Programme, both in attitude and approach. There are new initiatives just starting up and more will emerge over the next few years, so this is just the beginning of a series of work that will be worthwhile following. It has been an exciting, and busy, year chairing TDR’s Joint Coordinating Board, seeing all the hard work of the staff come together in the new TDR. Many people will benefit in the years to come as a result of the changes – particularly those in disease endemic countries who live in poverty with little access to any healthcare, and the researchers looking to build a career in low- and middle-income countries and help their fellow citizens. I am proud to be involved in supporting this work, and I look forward to what will be achieved in the near future.
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Thank you to our core contributors who provided overall Programme support in 2012*
Belgium
Japan
Federal Republic of Nigeria
China
Thailand
Ghana
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Impact and change 2012 TDR annual report
Thanks also to the contributors who provided support to specific projects in 2012*
* Listed in order of level of contribution
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Dr John Reeder TDR Director
To foster an effective global research effort on infectious diseases of poverty and promote the translation of innovation to health impact in disease endemic countries. This is TDR’s mission. Developed in 2012 after analysis, discussion and development among our many partners, it is at the core of our new strategy. We have finalized the strategic blueprint and we are now well under way in setting our house in the order needed to deliver on it. We are returning to what we do best: strengthening the capacity of individuals and institutions in low- and middle-income countries to perform research related to their priority health issues; engaging disease endemic countries in setting the health research agenda; and fostering research and developing innovative knowledge that leads to health improvement. In this report, you will see what we have done in 2012, but you will also get a taste of what is to come. We have engaged in exciting work to reduce health system bottlenecks, expand the research infrastructure in low- and middle-income countries, and ultimately, improve the lives of many. TDR is once more making a difference where it counts, among the most neglected people and the remotest communities.
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We have engaged in exciting work to reduce health system bottlenecks, expand the research infrastructure in low- and middleincome countries, and ultimately, improve the lives of many.
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Major achievements in 2012 Making an impact as we approach the target date for achieving the Millennium Development Goals
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Major achievements in 2012
Preventing childhood deaths by managing fevers A new approach bringing together malaria and pneumonia treatment by community volunteers
Helping improve the quality of rapid diagnostic tests for malaria A series of reviews comparing the performance of tests in a standardized way Established in 2007 and now with a series of four reviews published, this evaluation is helping malaria control programmes and offices that buy diagnostic tests to know which ones are reliable and effective. Overall, the majority of resubmitted products evaluated in the 2012 round either maintained or improved their performance. The work, which has been done in partnership with the World Health Organization and the Foundation for Innovative New Diagnostics, has now been handed over to WHO’s Global Malaria Programme to promote stronger integration into malaria programmes.
This work builds on long-term TDR research that shows that trained community health workers (CHWs) can be instrumental in providing primary health care services in under-served health care settings. Such community-based or directed-health care schemes are now being further investigated to see whether CHWs can diagnose and treat fever, which is a symptom of malaria but can also be caused by pneumonia or diarrhoea. These three illnesses are the major cause of childhood death in Africa. The approach is called integrated community case management (iCCM) of malaria, pneumonia and diarrhoea. A widely disseminated supplement of 16 research articles in the American Journal of Tropical Medicine and Hygiene was co-edited by TDR on the topic, and research continues. In 2012, WHO and UNICEF produced a joint statement calling for scaling up of community approaches for diagnosis and treatment of these diseases, noting the growing evidence base for this approach.
Supporting the elimination of river blindness Ivermectin interrupts transmission A major study conclusively showed that treatment with ivermectin not only controls river blindness (onchocerciasis), but it also interrupts transmission and has been able to eliminate the parasite in some endemic areas in Africa. This TDR-supported study, in coordination with the African Programme for Onchocerciasis Control (APOC), builds upon years of partnership in the fight against this disease.
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A second drug being studied Moxidectin is another drug being studied for treatment of river blindness, which could speed up disease elimination and expand the areas in which transmission could be interrupted. Analysis of the data from the Phase III clinical trials that were completed in 2012 will be published in 2013, allowing the community to consider the evidence needed for rational discussion about its future usage.
Reducing dengue mosquito breeding A five-year multi-country research programme carried out in urban and peri-urban Asia concluded in 2012 with a major publication in Pathogens and Global Health. The initiative aimed to identify and test strategies for community-based ecosystem management interventions to reduce dengue transmission. The work took place in six countries of South Asia and South-East Asia using a combined research approach investigating the ecological, biological and social dimensions of dengue vector breeding. It significantly reduced the mosquito densities in some sites and provided a powerful evidence base to guide community-based approaches to dengue vector control in others.
Improving dengue prevention, diagnosis and treatment Handbook for clinical management of dengue This handbook, which is currently in great demand by the public health community, supports the training of healthcare workers to diagnose and treat dengue. It was developed by the WHO Department of Control of Neglected Tropical Diseases and TDR.
Identifying new tools to control dengue mosquitoes
Dengue classification process potential model A revised dengue case classification system was identified through a careful review of past diagnosis and treatment plans. This classification is better able to standardize clinical management, raise awareness about unnecessary interventions, match patient categories with specific treatment instructions, and make the key messages of patient management understandable for all health care staff dealing with dengue patients.
A three-year study in Asia and Latin America was completed in 2012. It examined the efficacy of interventions combining the use of insecticide-treated materials, the targeting of the most productive mosquito larval breeding water containers, and biological control for dengue prevention. The study resulted in both new cost-effective interventions and training of local public health personnel.
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Major achievements in 2012
Major achievements in 2012
A series of research priority reports to support policy-makers and funders The launch of the Global report for research on infectious diseases of poverty in April 2012 initiated a series of research priority reports during 2012 and 2013. The Global Report outlines the issues and challenges and calls attention to the need for multidisciplinary approaches, particularly in three themed chapters on the environment, health systems, and innovation and technology. It also reviews the research funding landscape, examining the key challenges and identifying specific values for funding decisions.
During the course of the year, four additional reports were published within the highly regarded WHO Technical Report series – these were its first reports on research and were based on the work of the TDR Think Tank. They included:
2012
GLOBAL REPORT FOR RESEARCH ON INFECTIOUS DISEASES OF POVERTY
The WHO/TDR Technical Report Series on research • Research priorities for helminth infections • Research priorities for zoonoses and marginalized infections • Research priorities for Chagas disease, human African trypanosomiasis and leishmaniasis • Research priorities for the environment, agriculture and infectious diseases of poverty.
WITH FINANCIAL SUPPORT OF
European Union
Supporting the development of effective donor collaborations Research institutions in low- and middle-income countries now have an important document outlining best practices for funding proposals. The Five keys to improving research costing in low- and middle-income countries was published by ESSENCE on Health Research, a multilateral donor initiative to Enhance Support for Strengthening the Effectiveness of National Capacity Efforts. TDR provides secretariat to this group of donors who are examining how to better support countries through common frameworks, such as this one on costing of research.
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This is essential reading for policy-makers, funders and research leaders.
Marie-Paule Kieny, Assistant Director-General of the World Health Organization’s Health Systems and Innovation.
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Twelve new fellows from developing countries completed their Career Development Fellowships (CDF) with pharmaceutical and research institute partners. There they developed specialized skills not readily taught in academic centres to take home to lead major R&D projects. The ultimate goal is to reduce research bottlenecks as more new products enter the development pipeline, and develop strong research capability in poor countries trying to manage infectious diseases. The Programme has supported 27 fellows from 16 countries since its beginning in 2000, and many are now leading clinical development projects and helping their countries’ institutions increase research capacity.
“I learned so much from my time at Astellas,” Marukutira recalls, describing his work in the company’s anti-infective department, where he was able to observe all phases of a compound’s clinical development. “The training in good clinical practice, project management, research design, writing manuscripts and running a clinical trial – those are the skills I’m using today as principal investigator on one of our main research projects.” Indeed in addition to advancing his own career, the fellowship has allowed Marukutira to have a meaningful impact on his home institution. “At the moment, we have two proposals out for research projects, and this would not have been possible without the expertise I now have,” he says. “That expertise has enhanced our institutional profile, putting us in a position to apply for these grants that we know we can now get.” Gabriel Anabwani, Executive Director of Botswana Baylor Children’s Clinical Centre of Excellence and Marukutira’s mentor, echoes that belief. “We feel the fellowship has had a very positive impact,” he says, explaining that it’s allowed Marukutira to work at a higher level than he had been before. “He’s currently working on a number of projects,” says Anabwani, “including as a principle investigator on a CDC-funded study of adherence to HIV medicines in adolescents in Botswana. What we’re now trying to do is get him into larger research grants – and we’re confident we can do that.” So too is Marukutira, who received another honour last year, the International AIDS Society (IAS)/ CCABA (Coalition for Children Affected by AIDS) Prize for Excellence in Research Related to the Needs of Children Affected by AIDS, for an abstract he presented at the AIDS Conference in Washington, DC – part of a study entitled “The voice of the HIV infected and affected school-age children in Botswana,” on which his mentor, Anabwani, was principle investigator. This prize is awarded to an investigator whose abstract demonstrates excellence in research that is likely to lead to improved services for children affected by HIV and AIDS.
A profile: Dr Tafireyi Marukutira As an asthmatic child, Tafireyi Marukutira came into contact with the medical establishment early and often. “Between the age of 6 and about 16, I was in and out of the hospital all the time,” he says. “I was meeting so many doctors and nurses, and I think that’s one of the main things that initially drew me to the field. I wanted to be like them and I wanted to help myself and those who were asthmatic.” A native of Midlands, Zimbabwe, Marukutira earned his medical degree just as the country’s economy began to unravel, hemorrhaging jobs and plunging millions into poverty. By 2002, fuel shortages, soaring inflation, and the specter of famine had driven tens of thousands of Zimbabweans to flee, resulting in an exodus of talent to neighboring countries. Marukutira, for one, found his way to Botswana. After several posts in the Ministry of Health, he joined the newly opened Botswana-Baylor Children’s Clinical Centre of Excellence, part of the Baylor International Pediatric AIDs Initiative, in Gaborone, and, while there, went on to pursue dual masters degrees in public health and management of HIV/AIDS. In the case of Marukutira, Zimbabwe’s loss was Botswana’s gain. And for the young scientist himself, emigrating to the latter was a crucial step along a career path that would take him from the Midlands to the Midwest of the United States for a twelve-month TDR Clinical R&D Career Development Fellowship in
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Major achievements in 2012
Expansion of career development fellows
the Chicago offices of Astellas Pharmaceuticals where he was commonly known as Tafi.
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Work in 2013 and beyond Increasing our focus on: • Expanding access to those who need it most • Strengthening research capacity where it’s needed
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Results expected in 2013 Work in 2013 and beyond The Guidance Framework for testing genetically modified mosquitoes How best to test for the safety and efficacy of genetically modified (GM) mosquitoes is a development and evaluation project of significant scope. Following on the open field releases conducted in Brazil, the Cayman Islands and Malaysia between 2009 and 2011, the investigators of a TDR-funded project are establishing best-practice guidance with seven modules on the importation, deployment and monitoring of genetically modified mosquitoes designed for the control of malaria and dengue. In addition, a guidance document for testing GM
TDR began its new strategy in 2012 by expanding support to building research capacity and leadership in the countries where it is needed most, while phasing out product development activities. In addition, TDR is helping reduce health systems bottlenecks by supporting intervention and implementation research to find out how to get currently available tools like drugs and diagnostics to more people. This is an overview of TDR’s work in 2013, which ranges from new areas of work that are just beginning to longer-term work expected to generate important results soon. mosquitoes for efficacy and safety and addressing regulatory and ethical, social and cultural issues is being finalized in 2013.
Identifying the best practices for patients with both HIV and TB Results are expected to be published this year from the first study that will provide evidence on the optimal time to start antiretroviral treatment for HIV-infected patients who are relatively healthy with CD4 counts above 350, but who are also being treated for pulmonary tuberculosis (TB). A further study will publish data on whether combination pills for tuberculosis, which are easier to use in the health system, are as effective as taking separate pills.
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Guide to building research capacity The ESSENCE on health research group of funders is producing Seven tips for research capacity strengthening in low- and middle-income countries. This will be the third best practice guideline produced by this group, which is hosted at TDR.
Just starting Work in 2013 and beyond Investigating the impact of environmental and climate change on diseases of poverty A major new research programme has begun in TDR to understand the impact of environmental, social and climate change in sub-Saharan Africa on people’s vulnerability to diseases such as malaria and leishmaniasis (transmitted by mosquitoes and sand flies) and schistosomiasis (for which snails act as intermediate hosts). Those who are the most vulnerable to social, environmental and climate change will be identified, and new tools and strategies will be developed to increase resilience to the climate change impact.
Longer term work Testing new drug regimens to help eliminate visceral leishmaniasis on the Indian subcontinent TDR has collaborations and funding with lead investigators in Bangladesh, India and Nepal and other partner institutions to collectively develop novel approaches to controlling the sandflies (vectors) that transmit the disease, and an effective strategy for point-of-care diagnosis and treatment close to endemic villages. This is part of TDR’s ongoing work to identify the tools to eliminate this disease from these countries.
Surviving severe malaria – looking at the long-term impact on childhood disability A large study to look at long-term neurological and cognitive impacts on children who survived severe malaria has begun. TDR is working with investigators in Bangladesh, Ghana and Tanzania on a new, two-year grant. This builds on earlier research, called Study 13, which found that early treatment with an artesunate suppository averted mortality and major brain injury.
Increasing research capacity to improve disease control TDR has initiated short-term, flexible training through the new IMPACT grants to address a specific public health issue, and is expanding support for the Career Development Fellowships and for Masters and PhD level programmes. In addition, the WHO regions are involved in mapping research priorities and developing the Regional Training Centres for ongoing learning.
Speeding up the use of new tools and strategies where they’re needed most SORT IT is a new training programme to help researchers look at key bottlenecks to implementing tools and strategies that are known to work. It is starting with issues of multidrug- and extensively drug-resistant tuberculosis, a critical issue in many regions of the world. Participants from seven Eastern European countries will begin in 2013 a year-long process of learning how to set up studies to identify problems in diagnosis and treatment, and then implementing the study.
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Impact and change 2012 TDR annual report
facts and figures for 2012 • Publications • Governance • Financial performance • Performance overview • Partnerships • Contributors
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Key publications and resources FACTS AND FIGURES TDR has marked a major capacity strengthening milestone three years ahead of schedule. The percentage of research articles in 2012 acknowledging TDR support with first authors from a developing country reached the 2015 target of 65%. TDR tracks this as one of its key performance indicators because a first author is normally the lead person on the research, so this signifies a growing research capacity in lowand middle-income countries. One of TDR’s key goals is to increase research capacity in those countries, and it does this through targeted training, fellowships and research support, encouraging and supporting publication of research results. In 2012, about two-thirds of the 207 peer-reviewed publications acknowledging TDR support originated from disease endemic country institutions, and 66% were open/free access. In addition, TDR published five scientific publications, five research priority reports, its annual results report, biennial report and the new TDR strategy.
Research publications Pre-referral rectal artesunate treatment of childhood malaria in the community Training manual for community health workers to assess danger signs, provide emergency pre-referral treatment and refer treated children to a health facility. Adaptation to social, environmental and climate change impacts on vectorborne diseases This informal expert consultation report lists prioritized research needs for public health adaptation to social, environmental and climate change impacts on vector-borne diseases in Africa. It was a collaboration with Canada’s International Development Research Centre and the International Research Institute for Climate and Society, hosted by the Ethiopian Climate and Health Working Group in Addis Ababa.
Malaria rapid diagnostic test performance – results of WHO product testing of malaria RDTs: Round 4
(2012) The evaluation programme is co-sponsored by the Foundation for Innovative New Diagnostics (FIND), TDR and the WHO Global Malaria Programme (GMP). Testing is performed at the US Centers for Disease Control and Prevention (CDC). Handbook for clinical management of dengue This handbook supports the training of healthcare workers to diagnose and treat dengue. It was developed by the WHO Department of Control of Neglected Tropical Diseases and TDR.
Five keys to improving research costing in low- and middle-income countries An ESSENCE good practice document (the ESSENCE secretariat and support is at TDR).
All resources are available free of charge in print or via the TDR website (www.who.int/tdr).
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Research priority reports This was an important publication year for a series of research priority reports, which were the output of the TDR Think Tank. The first report was the overarching:
2012-2017 The Think Tank members also produced four reports for the WHO Technical Report series, highlighting research gaps and priorities to be considered in a range of topics: This is an overview of the 2012-2017 strategy for TDR. It includes new mission and vision statements, impact goals, guiding principles, methods of establishing work priorities, and summarizes the organizational structure to conduct this work.
Global Report for Research on Infectious Diseases of Poverty which proposed the following five actions for funders and policy-makers: 1. Create and use a new index of infectious diseases of poverty to serve as a surrogate marker of national socioeconomic development. 2. Implement a “One Health, One World” strategy in relation to research for infectious diseases of poverty. 3. Actively promote research ownership with enabling policies by disease endemic countries. 4. Create an innovation platform to foster a culture of innovation to benefit public health.
The WHO/TDR Technical Report Series on research • Research priorities for helminth infections • Research priorities for zoonoses and marginalized infections • Research priorities for Chagas disease, human African trypanosomiasis and leishmaniasis • Research priorities for the environment, agriculture and infectious diseases of poverty.
TDR Results 2011 Report A measurement of progress in three categories of key performance indicators using established baseline data and targets for 2013-2015.
TDR biennial report
2010-2011 An overview of the research portfolio and other activities during this biennium.
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FACTS AND FIGURES
5. Create an online global platform of research resources to inform on strategies, policies and funding commitments.
Reports about TDR Making a difference: TDR strategic plan
TDR governance and management FACTS AND FIGURES TDR is co-sponsored by UNICEF , UNDP, the World Bank and WHO, and it is through these international, multilateral organizations that TDR has such an extensive reach and support. WHO acts as the executing agency of the Programme, and provides close ties with its departments for a continuous loop of research informing policy and policy informing research, which in turn supports planning and priority setting at international, regional and national levels. TDR’s overall management responsibility is ensured by the TDR Special Programme Coordinator, who is an Assistant Director-General of WHO. Dr Hiroki Nakatani, who heads the HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases cluster, has had that responsibility since TDR was organizationally moved to that group in 2012 to support closer ties to the control departments. Day-to-day management is provided by the TDR Director (see Figure 1). TDR staff members number 30 after a reduction of 34 since January 2012. They come from all regions of the world and are based in Geneva, Switzerland. TDR’s top governing body is its Joint Coordinating Board (JCB), which includes a mix of representatives from developed and developing countries (see Figure 2). A Standing Committee composed of representatives from the four co-sponsoring agencies provides guidance and oversight on an ongoing basis. It is in the process of being expanded to include members of the JCB and Chair of STAC to provide representation beyond the co-sponsors. Programmatic and technical review comes from the Scientific and Technical Advisory Committee (STAC), which included 21 scientists in 2012 but is being reduced to 15 in 2013. Members serve in their personal capacities to represent a range of research disciplines.
Figure 1. The TDR structure
Director’s office Director TDR Communications External relations and governing bodies
Portfolio and programme management unit
Research capacity strengthening and knowledge management unit
Intervention and implementation research Vectors, environment and society unit Intervention research unit
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Impact and change 2012 TDR annual report
Joint Coordinating Board (JCB) The Board comprises 34 members: 12 members selected by the resource contributors to the Programme (including seven constituencies of two governments sharing one seat); 12 government
representatives chosen by the six regional committees of WHO; six members representing other cooperating parties selected by the JCB itself; and the four co-sponsoring agencies. Following a decision at JCB(35) in June 2012, the Board will be reduced by six members as of 1 January 2014.
Figure 2. JCB memberships (as of 1 January 2012)
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FACTS AND FIGURES
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FACTS AND FIGURES
Membership of the Scientific and Technical Advisory Committee (STAC) 1 January - 31 December 2012
Term of membership Chair, Professor Mario-Henry RODRIGUEZ-LOPEZ Researcher at the Center for Research for Infectious Diseases, National Institute of Public Health, Cuernavaca, Morelos, Mexico Professor Maged AL-SHERBINY Assistant Minister for Scientific Research, Ministry of Higher Education and State Ministry for Scientific Research, Cairo, Egypt Professor Fatima ALVAREZ-CASTILLO Assistant to the Dean for Research, College of Arts and Sciences, University of the Philippines, Philippines Professor Myriam AREVALO-HERRERA Professor, School of Health, Department of Clinical Laboratory, Universidad del Valle, Cali, Colombia Dr Vicente Y. BELIZARIO, Jr Vice-Chancellor for Research and Executive Director, National Institutes of Health, University of the Philippines, Ermita, Manila, Philippines Professor Fred N. BINKA Dean, School of Public Health, College of Health Sciences, University of Ghana, Korle-Bu Campus, Ghana Dr Yves CHAMPEY Medical Doctor, Advisor to the Director General of Evry Genopole, Paris, France Dr Carol A. DAHL Executive Director, The Lemelson Foundation, Portland, USA Professor Asma ELSONY Director, The Epidemiological Laboratory, Khartoum, Sudan Professor Bruno GRYSEELS Director, Institute of Tropical Medicine, Antwerp, Belgium
2009-2014
2010-2013
2009-2012
2010-2013
2008-2013
2009-2012
2008-2013
2008-2013
2010-2013
2012-2013
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Impact and change 2012 TDR annual report
STAC is the committee that peer reviews TDR’s research plans and work.
Term of membership Dr Ikram GUIZANI Head of Laboratory, Institut Pasteur de Tunis, Ministère de la Santé Publique, Tunis-Belvedere, Tunisia Dr Peter Jay HOTEZ Dean, National School of Tropical Medicine, Baylor College of Medicine; and Professor, Pediatrics and Molecular & Virology and Microbiology, Baylor College of Medicine, USA Dr Vishwa KATOCH Secretary to the Government of India, Department of Health Research and Director General, Indian Council of Medical Research, Ministry of Health and Family Welfare, New Delhi, India Dr Poloko KEBAABETSWE Director, Health Service Research Unit, University of Botswana, Gaborone, Botswana Professor Johnstone KUMWENDA Dean, Faculty of Medicine, College of Medicine, University of Malawi, Malawi Professor Christos (Kitsos) LOUIS Chairman, Department of Biology, University of Crete, Heraklion, Crete, Greece Dr Florencia LUNA Director, Bioethics Program of FLACSO, Latin American University of Social Sciences, Buenos Aires, Argentina Professor Lenore MANDERSON Medical Anthropology and ARC Federation Fellow and Director, Social Sciences and Health Research Unit, Caulfield Campus Monash University, Caulfield East, Australia Professor Anne J. MILLS Vice Director for Academic Affairs, London School of Hygiene and Tropical Medicine, London, United Kingdom Dr Anand WICKREMASINGHE Dean of the Faculty of Medicine & Professor of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
2012-2013
2009-2012
2010-2013
2012-2013
2011-2012
2008-2013
2012-2013
2012-2013
2008-2013
2012-2013
Impact and change 2012 TDR annual report
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FACTS AND FIGURES
Financial performance summary FACTS AND FIGURES This report covers the first year of the 2012-2013 biennium budget, which is a transitional period that moves TDR out of the difficult financial situation in 2011.Since then, a new strategy covering 2012-2017 has been developed under the leadership of the new Director, John Reeder, taking into consideration the findings and recommendations from the TDR interim external review. The Programme structure was revised to become leaner and more cost-effective. New budget and finance processes and systems are now in place for strong financial management and enhanced accountability, with a focus on financial monitoring and anticipation of potential opportunities and issues. A detailed financial recovery plan has been developed for 2012-2013, providing for full implementation of the new strategy starting in 2014 (see Figure 3). Sixty-three percent of the Programme Budget will be allocated to technical operations activities in 2014-2015 (this does not include technical support salary costs).
Figure 3. Comparison of 2012-2013 and 2014-2015 Programme budgets (US$ million)
60
50
Operations activity 18.9 M (32%)
40
US$ million (M)
Operations support activity 5.5 M (9%)
Operations activity 37.8 M (63%)
30
20
Personnel (including reorganization) 31.0 M (51%)
Operations support activity 4.2 M (7%) Personnel 18.0 M (30%)
10
0
Outstanding commitments 4.6 M (8%)
2012-2013
2014-2015
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Impact and change 2012 TDR annual report
Implementation of the 2012-2013 financial recovery plan is well under way, providing for full implementation of the new strategy starting in 2014
Figure 4. Interim 2012-2013 budget implementation, as of 31 December, 2012, halfway through the biennium
2012-2013 Programme Budget
US$ 60 M
Total implementation (2012)
US$ 26 M
0
10
20
30
40
50
60
US$ million
1
Implementation includes (i) expenditures in 2012 and (ii) any commitments made in 2012 (encumbrances).
Impact and change 2012 TDR annual report
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FACTS AND FIGURES
Performance overview FACTS AND FIGURES TDR is using its Performance Assessment Framework to measure progress in the implementation of its vision and strategic plan. The framework, together with its monitoring and evaluation matrix, are being revised. A new set of key performance indicators, adapted to TDR’s new strategy (2012-2017), will be implemented starting in 2013. The indicators below reflect TDR’s new portfolio that focuses on two core areas: i) intervention and implementation research, and ii) capacity strengthening and knowledge management. The indicators reflect the new knowledge and tools that have helped shape global health policies of WHO and in a number of developing countries. In line with its core principles and values, TDR has continued to give priority to the needs of least developed countries. Vulnerable populations and gender-relevant projects remain at the core of TDR’s research and capacitybuilding efforts. Both the percentage of grantees from disease endemic countries (DECs) and the percentage of authors of journal articles from DECs rose in 2012.
Expected results
Key performance indicators
Baseline (2007) §
Target
Progress (+n*)
Source
Achievement of scientific and strategic objectives/outcomes 1. Countries and major funding agencies use TDR scientific and strategic reports to set research priorities 1.a Number and evidence of DECs using TDR scientific and strategic reports in strategy and priority setting Number and evidence of major funding agencies using TDR reports in strategy and priority setting Evidence that TDR reports are perceived as a credible authoritative source of information Number and evidence of new/strengthened national governance structures for health research in DECs Number and evidence of new/strengthened functional networks led by DECs Number and evidence of health research institutions that accessed further funding attributable to TDR Proportion of TDR grantees' publications with first author from DEC institutions TDR survey; interpretive analysis; references
---
10 (2015)
0
1.b
---
3 (2015)
2 (+2)
TDR survey; interpretive analysis; references TDR survey; interpretive analysis; references
1.c
---
Positive assessment
Not measured in 2012
2.
DECs are leading new/ strengthened health research initiatives
2.a
---
5 (2015)
0
TDR reports
2.b
---
10 (2015)
5 (+2)
TDR reports; network documentation
2.c
---
10 (2015)
8 (+3)
TDR survey; interpretive analysis
2.d
59% for the year 2007
65% (2015)
65% (n=207)
Pub Med; TDR repository
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Impact and change 2012 TDR annual report
Expected results
Key performance indicators
Baseline (2007) §
Target
Progress (+n*)
Source
3.
New/improved knowledge, tools and implementation strategies are used in DECs
3.a
Number and evidence of cases of breakthrough scientific knowledge which has advanced the development of new/ improved tools and strategies Number and evidence of use of new/improved drug, diagnostic or vector control tools Number and evidence of use of new/improved casemanagement, control or implementation strategies
---
6 (2015)
7
TDR reports; evidence
3.b
---
12 (2015)
10 (+3)
WHO and country policies; evidence of use
3.c
---
12 (2015)
8 (+3)
WHO and country policies; evidence of use
Application of core values 4. DECs are playing a critical leadership role in research related activities 4.a Evidence of DEC leadership in research related activities Proportion of TDR grants/ contracts awarded to DECs (over total number and total funding) Case study 72% (n) (232 /324) 70% (US$ 2.8/4.1M) 59% (61/103) 35% (n) (112 /324) 40% (US$ 1.6/ 4.1M) 43% (n) (53 /124) 78% (US$ 1.4/ 1.8M) 32% (n) (105 /324) 22% (US$ 0.9/ 4.1M) 28% (29/103) Reports; case studies; references
N/A
N/A
4.b
74% (n) 55% ($) (2008)
80% 65% (2013)
TDR and WHO databases
4.c
Proportion of DEC experts in TDR advisory committees Proportion of TDR grants/ contracts awarded to low-income countries (over total number and total funding) Proportion of TDR grants/ contracts relevant to gender issues and/or vulnerable populations (over total number and total funding) Proportion of females among grantees/contract recipients (over total number and total funding)
57% (2009)
55% (2013)
TDR and WHO databases
5.
Promotion of equity in research and activities
5.a
28% (n) 23% (US$) (2008)
30% 26% (2013)
TDR and WHO databases
5.b
---
Tbd (2013)
TDR and WHO databases
5.c
34% (n) 26% (US$) (2008)
50% 50% (2013)
TDR and WHO databases
5.d
Proportion of female experts in TDR advisory committees
36% (2009)
50% (2013)
TDR and WHO databases
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FACTS AND FIGURES
Expected results
Key performance indicators
Baseline (2007) §
Target
Progress (+n*)
Source
FACTS AND FIGURES
6.
Working in partnerships following formal collaborative framework
6.a
Number and evidence of formal partnerships in line with TDR strategy TDR partnerships are perceived as useful and productive
---
Tbd (2013)
14
Signed agreements TDR survey; interpretive analysis; references
6.b
---
Positive assessment
Case study
7.
Initiatives, tools and strategies incubated and transitioned are sustainable
7.a
Number and evidence of projects transitioned to and sustained by institutions, organizations or agencies for at least two years Number of new organizations incubated within TDR Number of effective tools and strategies developed which have been in use for at least 2 years
7
Tbd (2015)
8
Signed agreements
7.b
3
6 (2015)
5
Legal establishment Consultation with disease control programmes
7.c
56
65 (2015)
57 (+6)
Management performance 8. Effective quality assurance 8.a Proportion of new research studies that follow international norms and standards Quality plan; monitoring reports; audit reports; study reports
---
100% (2013)
**
9.
Effective resource mobilization
9.a
Financial resources made available for the biennium to cover planned activities (US$ millions) Proportion of funds spent according to workplans
74.3 (2006– 2007) 86% (2006– 2007)
100 (2012– 2013)
** 85.6 (2010-11) ** 90% (2010-11) 64% expected results on track or achieved
TDR financial contributions
10.
Efficient management
10.a
90% (2012–2013)
TDR and WHO databases
10.b
Proportion of workplans on track ---
Tbd (2012–2013)
TDR reports
10.c
Evidence of leadership in responding to opportunities and to managerial challenges Proportion of positive satisfaction response from TDR grantees, partners and donors Proportion of positive satisfaction response from TDR staff Tbd: N/A: DEC: M:
---
---
Qualitative description
TDR annual report
11.
Overall satisfaction with management
11.a
---
Tdb (2012–2013)
**
TDR surveys; interpretive analysis TDR survey; interpretive analysis
11.b
---
Tbd (2012–2013)
**
§ * * * ---
Baseline year is 2007, unless specified otherwise Progress made in 2012 Measured at the end of each biennium Not available
To be determined based on the first measure in 2011 Not applicable Disease endemic countries Million
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Impact and change 2012 TDR annual report
TDR Partnerships TDR connects with the highest levels of national government, and with clinics in remote locales. We have broad collaborations with private industries, disease control programmes, academia, research institutions and nongovernmental organizations. This is a list of current ongoing agreements. PARTNERSHIP African Programme for Onchocerciasis Control (APOC), Ouagadougou, Burkina Faso National Institute of Parasitic Diseases (IPD), Chinese Center for Disease Control and Prevention (China CDC), Shanghai, China Drugs For Neglected Diseases Initiative (DNDI), Geneva, Switzerland Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland Heidelberg University, Germany
Having a greater impact by working together.
ORGANIZATION Public-private partnership
COLLABORATIVE PROJECT(S) Public-private partnership
Research institution
Collaboration in the identification of gaps and research priorities for infectious diseases
Product Development Partnership
VL elimination; Drug discovery (compound development) Diagnostics evaluation and development International Research Consortium on Dengue Risk Assessment, Management, and Surveillance (IDAMS) Safety pharmacology of artemisinins when used to reverse pathophysiology of malaria in pregnancy (ARTEMIP) Coordination rationalization and integration of antimalarial drug discovery initiatives (CRIMAlDDI)
Not-for-profit foundation
Research institution
Liverpool School of Tropical Medicine, United Kingdom
Research institution
London School of Hygiene and Tropical Medicine, United Kingdom Merck Pharmaceuticals Novo Nordisk Thammasat University, Thailand Latin American and Caribbean Center on Health Sciences Information, PAHO, World Health Organization National Center for Drug Screening, Shanghai, China United Nations Economic Commission for Africa
International research institution
TB Reach Initiative
Pharmaceutical company Pharmaceutical company Research institution Research institution
Clinical trial tuberculosis treatment Drug discovery Capacity building TropIkA.net knowledge platform
Research institution
Drug discovery (screening network)
International organization
African Network for Drugs and Diagnostics Innovation (ANDI)
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FACTS AND FIGURES
TDR 2012 contributions table FACTS AND FIGURES TDR is able to conduct its work thanks to the commitment and support from a variety of funders. These include our long-term core contributors from national governments and international institutions, as well as designated funding for specific projects within our current priorities.
elping to make H a difference.
Contributor African Programme for Onchocerciasis Control (APOC) Belgium Bill & Melinda Gates Foundation China (People's Republic of) Cuba Drugs for Neglected Diseases initiative (DNDi) European Commission Foundation for Innovative New Diagnostics (FIND) Germany Ghana Global Alliance For TB Drug Development International Development Research Centre (IDRC) Japan Luxembourg Malaysia Netherlands Nigeria Norway Oxford University Panama Pfizer Inc Royal Tropical Institute (KIT) Sweden Switzerland Thailand Turkey United Kingdom of Great Britain and Northern Ireland United States of America World Bank World Health Organization/Implementation Research Platform
US$ Amount 400,000 1,856,762 516,184 55,000 9,573 623,799 2,214,550 198,334 1,090,850 45,000 193,500 7,271,068 300,000 1,675,603 25,000 400,000 200,000 2,475,248 78,493 7,000 200,000 241,937 5,209,884 1,839,465 48,780 5,000 3,804,033 601,525 1,660,000 270,000
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Impact and change 2012 TDR annual report
ISBN 978 92 4 150554 3
TDR/World Health Organization 20, Avenue Appia 1211 Geneva 27 Switzerland Fax: (+41) 22 791-4854 tdr@who.int www.who.int/tdr
The Special Programme for Research and Training in Tropical Diseases (TDR) is a global programme of scientific collaboration established in 1975. Its focus is research into neglected diseases of the poor, with the goal of improving existing approaches and developing new ways to prevent, diagnose, treat and control these diseases. TDR is sponsored by the following organizations:
World Bank