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Monitor evaluate improve: TDR results 2011 report: measuring results

16 octobre 2012 Organisation mondiale de la santé

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TDR Results 2011 Report Measuring results

For research on diseases of poverty UNICEF • UNDP • World Bank • WHO

TDR/STRA/12.1 Copyright © World Health Organization on behalf of the Special Programme for Research and Training in Tropical Diseases 2012 All rights reserved. The use of content from this health information product for all non-commercial education, training and information purposes is encouraged, including translation, quotation and reproduction, in any medium, but the content must not be changed and full acknowledgement of the source must be clearly stated. A copy of any resulting product with such content should be sent to TDR, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland. TDR is a World Health Organization (WHO) executed UNICEF/UNDP/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases. This information product is not for sale. The use of any information or content whatsoever from it for publicity or advertising, or for any commercial or income-generating purpose, is strictly prohibited. No elements of this information product, in part or in whole, may be used to promote any specific individual, entity or product, in any manner whatsoever. The designations employed and the presentation of material in this health information product, including maps and other illustrative materials, do not imply the expression of any opinion whatsoever on the part of WHO, including TDR, the authors or any parties cooperating in the production, concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delineation of frontiers and borders. Mention or depiction of any specific product or commercial enterprise does not imply endorsement or recommendation by WHO, including TDR, the authors or any parties cooperating in the production, in preference to others of a similar nature not mentioned or depicted. The views expressed in this health information product are those of the authors and do not necessarily reflect those of WHO, including TDR. WHO, including TDR, and the authors of this health information product make no warranties or representations regarding the content, presentation, appearance, completeness or accuracy in any medium and shall not be held liable for any damages whatsoever as a result of its use or application. WHO, including TDR, reserves the right to make updates and changes without notice and accepts no liability for any errors or omissions in this regard. Any alteration to the original content brought about by display or access through different media is not the responsibility of WHO, including TDR, or the authors. WHO, including TDR, and the authors accept no responsibility whatsoever for any inaccurate advice or information that is provided by sources reached via linkages or references to this health information product. Printed by the WHO Document Production Services, Geneva, Switzerland

Summary

TDR RESULTS 2011 REPORT 1. 2. 3. Summary ..................................................................................................................... 2 Introduction ................................................................................................................. 3 Meeting TDR’s scientific and strategic objectives ..................................................... 3 Stewardship outcomes - Countries and major funding agencies use TDR scientific and strategic reports to set research priorities.............................................................................................. 4 Empowerment outcomes – Disease endemic developing countries (DECs) are leading new/ strengthened health research initiatives ................................................................................................ 5 Research outcomes - New/improved knowledge, tools and implementation strategies are used in DECs ........................................................................................................................................ 7

Applying TDR core values to our work ...................................................................... 9 DECs are playing a critical leadership role in research related activities ............................................. 9 Promotion of equity in research and activities .................................................................................... 11 Working in partnerships following formal collaborative framework ................................................. 15 Initiatives, tools and strategies incubated and transitioned are sustainable ........................................ 16

Managing effectively ................................................................................................. 16 Effective quality assurance ................................................................................................................. 16 Effective resource mobilization .......................................................................................................... 17 Efficient management ......................................................................................................................... 18 Overall satisfaction with management ................................................................................................ 21

Learning from success and failure ............................................................................ 21 Annex 1: TDR monitoring and evaluation matrix .............................................................................. 24 Annex 2: List of TDR research grant (TSAs) relevant to gender issues and/or vulnerable populations .......................................................................................................................................... 28 Annex 3: List of TDR partnerships with signed agreements and joint workplans.............................. 32 Annex 4: List of TDR Expected Results 2010-2015 .......................................................................... 33 Annex 5 - Tools and strategies developed or contributed by TDR and that have been in use for at least 2 years ............................................................................................................................... 37

ANNEXES......................................................................................................................... 24

TDR Results Report 2011

Summary

For a second consecutive year, TDR’s Performance Assessment Framework has been used to measure results. The current report was submitted for review and was endorsed by the TDR Scientific and Technical Advisory Committee (STAC) in April 2012. 2011 was a year of change, when TDR embarked on a major reorganization which included a reduction in personnel and budget. Despite these reductions, significant achievements have been made which are highlighted in this report. The areas where progress was slower than anticipated and/or the scope of the planned deliverables had to be reduced are also outlined. Progress against initial targets is summarized in the monitoring and evaluation matrix presented in Annex 1. In line with its core principles and values, TDR has continued to give special priority to the needs of least developed countries. Vulnerable populations and gender-relevant projects continue to remain at the core of TDR ’s research and capacity building efforts. Capacity building efforts resulted in new networks and additional institutions that accessed further funding attributable to TDR support. At the same time, TDRsupported research generated new knowledge and tools that have helped shape the policies of WHO and in a number of disease endemic developing countries. Further details on technical achievements, financial aspects and other elements are available in the TDR Expected Results list (see Annex 4), the 2011 Team Annual Reports, the TDR Research report and TDR’s Financial Report for 2010-2011 respectively. An important role of the TDR Results Report is to inform and fine-tune TDR’s workplan and to improve the Programme’s performance overall. Lessons learnt from recent successes and failures have been included at the end of the document to highlight measures taken to effectively move forward a new strategy for 2012-2017 with a stronger TDR. Several external reviews conducted in 2011 provided TDR with valuable input for shaping its new strategy (which is being presented to the TDR Joint Coordinating Board (JCB), for adoption in June 2012). These include the TDR interim external review commissioned by the JCB, a pharmaceuticals R&D external review and various external R&D project reviews. Findings were discussed with the Standing Committee in October 2011 and a sub-group of the STAC in November 2011, which led to the approval of the TDR 2012-2013 interim workplan and budget.

TDR Results Report 2011

Introduction

The 2011 TDR Results Report was reviewed and endorsed by STAC in April 2012. Minor changes have been made to this version to update the content and reflect suggestions made by STAC. Addressing a difficult financial situation: reviewing priorities In addition to presenting an overview of progress made on TDR ’s key performance indicators, illustrated with examples and qualitative analyses, the 2011 Results Report takes into consideration the context of change and reorganization that took place during the period covered by it. Further information provided by the interim external review and the product R&D external review that took place respectively from September to October and November 2011 has also been taken into consideration. Measuring what TDR does and how it does it This report measures progress in three categories of key performance indicators using established baseline data and targets for 2013-2015. 1 These comprise: progress made on strategic objectives, application of core values and measurement of managerial effectiveness. Results and deployment of ongoing activities from January to December 2011 are referred to or described as part of the implementation of the current TDR 10-year Vision and Strategy and Business Plan (2008-2013). TDR’s performance assessment framework, on which this report is based, includes mainly indicators at the outcome level; it usually takes years for the immediate outputs (deliverables) of research and capacity building to translate into outcomes and impact. TDR receives the 2011 Gates Award for Global Health In 2011 TDR won the prestigious Gates Award for Global Health for its contribution to global health. The award recognized decades of hard work in supporting and advocating for research to address infectious diseases associated with poverty; capacity building of researchers in disease-endemic countries (DECs); and providing research evidence to fight against diseases such as onchocerciasis, dengue, tuberculosis, malaria, Chagas disease, leishmaniasis, leprosy, etc. Moving forward In 2011 there were a number of deliverables achieved due to the efforts and resources invested during previous years. Progress towards the achievement of TDR outcomes is presented in this report. Measures taken in order to enhance the Programme ’s management, address the financial situation and review TDR’s strategic directions are presented in the ‘Learning from success and failure’ section. These feed into the development of a new strategy for 2013-2017 and the revision of TDR’s budget for 2012-2013 for the transition to its new strategic directions.

Meeting TDR’s scientific and strategic objectives

The indicators covering TDR’s three scientific/strategic functions (Stewardship, Empowerment and Research) were established at the outcome level, i.e. assessment of changes that occurred as a result of

See summary measurement in the TDR monitoring and evaluation matrix, Annex 1

TDR Results Report 2011 TDR’s work. Targets were set for 2015 to allow a period of two years after the end of the 2008-2013 business plan implementation for outcomes to materialize.

Stewardship outcomes - Countries and major funding agencies use TDR scientific and strategic reports to set research priorities TDR's Stewardship function (STE) aims to facilitate the global and regional health research agenda setting for infectious diseases of poverty through knowledge management and harmonization of stakeholder efforts. In 2011, progress in Stewardship activities was slower than planned. Some deliverables were delayed and others had their scope reduced. Countries and major funding agencies use TDR scientific and strategic reports to set research priorities Key performance indicators Baseline (2007) __

Target (2015) 10

Progress (2011)

Source

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

0 (report published in 2012) 0 (reports in progress) 0 (reports in progress)

TDR Survey 1 ; interpretive analysis; references TDR Survey 1 ; interpretive analysis; references TDR Survey 1 ; interpretive analysis; references

1.b

1.c

Positive assessment

Indicators 1a, 1b and 1c - Progress towards outputs and outcomes Production of technical and scientific reports – The launch of the Global Report for Research on Infectious Diseases of Poverty, initially planned for 2011, took place in April 2012. The report provides a holistic and interdisciplinary analysis of research development and proposes options for action. It is organized in six chapters and draws from the findings of a Think Tank for research on infectious diseases of poverty that was constituted with over 130 international experts organized in ten working groups. The Global Report 2 will be supplemented by a number of disease-specific and thematic reference group reports (up to 6) that go into detail on the scientific gaps and opportunities in their respective areas of knowledge. They are mainly targeted at policy-makers and researchers at country and regional levels and will be published in 2012-2013 as WHO Technical Series Reports. The European Commission, a major funder of the reports, expressed interest in using them to develop its priority agenda for research on infectious diseases of poverty and hosted the launch of the Global Report in Brussels, on 17 April 2012. Once the reports are published, the extent to which they will be used by countries and funding agencies to set research priorities will be evaluated through a survey in 2013-2014 (TDR survey #1). The 2011 interim external review of the Programme highlighted some concerns of external stakeholders that the contents of the Global Report may quickly become out-dated in the context of global scientific progress. This will be taken into consideration in the design of the survey. ESSENCE on Health Research monitoring and evaluation framework – ESSENCE (Enhancing Support for Strengthening the Effectiveness of National Capacity Efforts), hosted in TDR and for which TDR plays a secretariat role, is an effort to harmonize internationally funded research programmes and align them with the priorities of disease endemic countries, in line with the principles of the Paris Declaration and Aid Effectiveness and the Accra Agenda for Action. In 2011, ESSENCE agreed to a common framework to monitor and evaluate health research capacity 2

See online publication http://www.who.int/tdr/stewardship/global_report/en/index.html

TDR Results Report 2011 strengthening initiatives. In doing so, it utilized some of the learning gained by TDR in establishing its own performance assessment framework. The ESSENCE performance monitoring and evaluation framework has already influenced policies of funders in this area. For example, Wellcome Trust, the European and Developing Countries Clinical Trials Partnership (EDCTP) and the Global Health Research Initiative (GHRI) have harmonised their individual frameworks.

Empowerment outcomes – Disease endemic developing countries (DECs) are leading new/ strengthened health research initiatives The overall goal of TDR’s Empowerment function is to support health research capacity strengthening on infectious diseases of poverty for individuals and institutions through regional networks and partnerships. Progress has been made on individual and institutional capacity strengthening, as well as in developing a training curriculum on implementation research. However, not all 2015 targets will be met. Activities related to strengthening national governance structures for health research in disease endemic countries (indicator 2a) have been limited. As per the recommendations of the sub-group of STAC that met in November 2011, a new approach that combines and integrates research and capacity building at the institutional and individual level will be developed as part of TDR’s new strategy. The key performance indicators used to assess empowerment results will then be reconsidered.

DECs are leading new/strengthened health research initiatives Key performance indicators 2.a 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

Baseline (2007) __

Target (2015) 5

Progress (2011) 0 5

Source TDR reports on development of NHRS TDR reports Network documentation Interview, TDR reports

2.b

(+2 )

2.c

__ 59% in 2007

5 (+3 ) 61% (n=233)

2.d

65%

Bibliographic review



Progress made in 2011

TDR Results Report 2011 Indicator 2a - Strengthened national governance structures for health research in disease endemic countries Activities related to this outcome have been put on hold due to TDR ’s reorganization and the need to refocus on core competencies. Indicator 2b - Established/strengthened functional networks led by disease endemic countries A new Asia-wide EcoHealth network emerged out of the TDR and International Development Research Centre (IDRC, Canada) research initiative on "Eco-Bio-Social Research on Dengue in Asia". It is hosted and facilitated by the teams originally involved in the project, and it supports the local identification, production and implementation of tools to manage vector density through ecologically sound practices. ISHReCA (Initiative to Strengthen Health Research Capacity in Africa), which was incubated by TDR, has the potential to serve as an important network of health researchers in Africa. It now has over 1500 members from 43 countries, showing its important role to link with other networks among health research stakeholders. One of ISHReCA's successes in 2011 was to raise additional resources from other funders, including Wellcome Trust, the Swedish International Development Agency (Sida) and the Netherlands Organisation for Scientific Research (NWO) / the Netherlands Foundation for the Advancement of Tropical Research (WOTRO). TDR's support to ISHReCA has helped leverage additional funding. This allowed the establishment of the network at the University of Yaoundé, Cameroon in November 2011. Indicator 2c - Health research institutions that accessed further funding attributable to TDR Three examples of institutions that benefited from TDR support and were able to access further funding are listed below. Fondation Congolaise pour la Recherche Médicale, Brazzaville currently networks with funding institutions, research networks and institutions from developed countries (as can be seen in the video clip linked below 3 ) to provide opportunities favourable to health research in Congo. TDR has provided individual long term capacity building support for the Director – Professor Francine Ntoumi. Having provided important contributions to TDR-supported research in the field of visceral leishmaniasis (VL), two institutions from developing countries succeeded in securing external funding from other sources to further their participation in this field of research.   The Rajendra Memorial Institute of Medical Sciences of Patna, India, has competed and obtained funding from the Grand Challenges Canada programme. The International Center for Diarrheal Disease Research in Bangladesh was awarded funds from the UBS Optimus Foundation.

Indicator 2d - Peer reviewed publications from TDR grantees with first author from institutions in disease endemic countries Updated in 2011, the percentage is almost identical to the 2010 results, with both values in between the baseline and the target for 2015. In 2011, a total of 233 peer-reviewed publications acknowledged TDR support. This represents a significant increase (+33%) when compared with 2010 data. Out of the total number, 143 publications (61%) had their lead authors from DECs (Figures 1 and 2).

http://www.youtube.com/watch?v=_x_SjpOln6U&feature=plcp&context=C39dd49cUDOEgsToPDskJFilb_jJj3LStQbxjvofyM

TDR Results Report 2011

Figure 1 - Number of peer reviewed publications supported by TDR with first author from institutions in DECs and non-DECs

Figure 2 - Progress towards targets related to the proportion of peer reviewed publications from TDR grantees with first author from institutions in DECs

The distribution of 2011 publications by disease topic is illustrated in Figure 3, as a comparison with the period 2002-2006. The same dominant topics occur, with malaria remaining the largest slice. The percentage of publications on TB increased significantly over the same period. There is no trend towards increasing the ratio of neglected diseases versus malaria and TB.

Figure 3 – Percentage of disease topics in publications supported by TDR in 2002-2006, compared to 2011

Research outcomes - New/improved knowledge, tools and implementation strategies are used in DECs TDR’s contribution to Millennium Development Goals 4, 5 and 6 comes through developing new knowledge and tools such as interventions and evidence for policy-making. During 2011, several achievements in this area were reached. Progress is ongoing on projects ranging from biomedical research to implementation and operational research. Further details about progress and achievements linked to TDR-supported research can be found in the 2011 Research Report, which synthesizes the main points of the 2011 annual research team reports.

TDR Results Report 2011 New/improved knowledge, tools and implementation strategies are used in DECs Key performance indicators 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 developed Number and evidence of use of new/improved case- management , control or implementation strategies developed

Baseline (2007) 0

Target (2015) 6

Progress (2011) 7 (+2 ) 7 (+2 )  

Source

Team annual reports; Research Annual Report WHO / country documentation and policies; evidence WHO / country documentation and policies; evidence

3.b

3.c

5 (+1)

Indicator 3a - Breakthrough scientific knowledge which has advanced the development of new / improved tools and strategies New synthetic routes for enantiomerically-pure L-praziquantel have been identified through an innovative, open-access process supported jointly by TDR and the Australian Research Council (ARC) and conducted by the University of Sydney. This has prompted a pharmaceutical company to launch the development of a new praziquantel paediatric formulation. New evidence of house reinfestation with triatomine bugs in Argentina and Bolivia after spraying and increasing resistance to pyrethroids is providing important information for public health officers to adjust policy and practice. Characterizing and preventing reinfestation by triatomine bugs and knowing their particular resistance status are now key components of the global strategy for elimination of Chagas disease in the Americas. Indicator 3b - New/improved drug, diagnostic or vector control tools developed and used 50 malaria diagnostic RDTs were tested in 2011 in collaboration with country institutions and the Foundation for Innovative New Diagnostics (FIND). TDR-supported work has evaluated the quality, performance and stability of rapid diagnostic tests available commercially to detect malaria at low parasite densities. Evaluations of a wide range of tests have informed procurement and control policies supporting the elimination of malaria. The tests have also been shown to be instrumental in improving malaria case management. African countries use new evidence on insecticide resistance to assist in readjusting their malaria control policies. The network supported by TDR consists of seven partners and involves institutes in Angola, Benin, Burkina Faso, Chad, Sudan, South Africa and the United Kingdom. The network has identified 20 sentinel sites in five African countries for biannual monitoring with five insecticides (permethrin, deltamethrin, fenitrothion, DDT and bendiocarb). Indicator 3c - New/improved case- management, control or implementation strategies developed and used An evidence-based strategy to support the elimination of visceral leishmaniasis has been developed in collaboration with control programmes in countries and leading institutions from Bangladesh, India and Nepal, the WHO Neglected Tropical Diseases (NTD) Department, the Drugs for Neglected Diseases initiative (DNDi), and One World Health (OWH). The strategy includes point of care rapid diagnostic test and treatment with Ambisome combined with active case detection in villages, as well as vector control measures. The rationale for the strategy has been published in Lancet Infectious Diseases. Implementation has been initiated in Bangladesh and India. 

Progress made in 2011

TDR Results Report 2011

Applying TDR core values to our work

DECs are playing a critical leadership role in research related activities TDR promotes further engagement and leadership of DEC researchers and research managers in scientific activities in general. This is done through early involvement of key stakeholders developing ownership of the initiatives (indicator 4a), through prioritizing awards of TDR grants/contracts (indicator 4b), and through membership in TDR advisory committees (indicator 4c). DECs are playing a critical leadership role in research related activities Key performance indicators 4.a Evidence of DEC leadership in research related activities

Baseline

Target (2013) __

Progress (2011) Case study 59% (n) (312 / 527) 64% ($) ($5.0M / $7.8 M)

Source Reports; case studies; references

__ 74% (n)

4.b

Proportion of TDR grants/contracts awarded to DECs (over total number and total funding)

80% (n) 65% ($)

55% ($) (2008)

TDR/WHO database

4.c

Proportion of DEC experts in TDR advisory committees

57% (2009)

55%

58% (87 / 151)

TDR/WHO database

Indicator 4a - Evidence of DEC leadership in research related activities The African Network for Drugs and Diagnostics Innovation (ANDI) promotes African-led product R&D innovation through the discovery, development and delivery of affordable new tools, including those based on traditional medicines. Initiated at TDR in 2008 and benefitting from specified funds from the European Commission, ANDI is now hosted at the United Nations Economic Commission for Africa (UNECA) in Addis Ababa, and is supported by African leadership and commitments from regional stakeholders, governments and private corporations. The goals of ANDI will be accomplished through a new approach that will lead to outcomes such as4:    Increased research and development collaboration among African institutions and countries, including the management of Centres of Excellence in health innovation; Supported public-private partnerships and new African organizations that develop and manufacture new drugs, diagnostics and other health products; Long term economic sustainability through R&D and access to health products in Africa.

In 2011, the ANDI Board was established as the official start of ANDI’s governance in Africa. The Board, chaired by the Minister for Public Health and Sanitation in Kenya and the Minister for Science and Technology in South Africa, will oversee the activities of ANDI. Other members include representatives from Egypt, South Africa, Kenya, Nigeria and Central Africa, as well as representatives from main stakeholder organizations (UNECA, WHO, African Development Bank and European Commission). Health experts and Africans in the diaspora shall also have permanent representation on the Board. The inaugural ANDI Board meeting was hosted by UNECA on 11 and 12 January 2011. Also in 2011, the establishment of the ANDI Scientific and Technical Advisory Committee (STAC) took place, with the first ANDI STAC meeting held in April 2011 in Addis Ababa. The objective of this meeting was to deliberate on the review of 117 applications for the call for ANDI centres of excellence and 207 Letters of Intent (LoIs) for research projects. The second STAC meeting was held 4

Further details can be found on the Network’s website at http://www.andi-africa.org/

TDR Results Report 2011 in October 2011. The collective work of ANDI STAC, ANDI Secretariat and the Innovation Networks’ unit at TDR resulted in the identification of 32 institutions that were accredited as ANDI centres of excellence during the fourth ANDI Stakeholders’ meeting in Addis Ababa from 24 to 27 October 2011. The short-listing of the top 50 applications for final full proposal review by ANDI STAC resulted in the identification of two projects having an early win potential and the recommendation for establishing five networks regrouping African institutions and specific centres of excellence around targeted activities or technologies. Finally, 332 abstracts were proposed for either the parallel oral sessions or poster sessions of the Stakeholders ’ meeting. A call for establishing ANDI regional hubs was issued late in 2011. Three applications were received from Southern, Eastern and Western regions. As a stand-alone regional network, ANDI intends to work in collaboration with other stakeholders to promote African leadership in health research and drug and diagnostics innovation in Africa. Indicator 4b - Proportion of TDR grants/contracts awarded to DECs (over total number and total funding) In 2011, 59% of the number of new and ongoing grants/contracts (312/527) and 64% of total funds (US$ 5.0 million/ US$ 7.8 million) went to DEC scientists and institutions. Due to reduced available funding, the total amount awarded for activities decreased significantly compared to 2010. However, the proportion of funds awarded to DECs has increased to 64% (Figures 5, 6), and is now close to the 2013 target of 65%. At the same time, the percentage of number of contracts and grants awarded to DECs has decreased when compared to 2010 data (Figures 4, 6).

Figure 4 - Proportion of TDR grants/contracts awarded to DECs and non-DEC countries in 2011 (n= 527)

Figure 5 - Funding distribution to DECs and non-DEC countries in 2011 (total US$ 7,8 M)

Figure 6. Progress towards targets related to the % of TDR grants/contracts awarded to DECs

Indicator 4c - Proportion of DEC experts in TDR advisory committees Fifty-eight percent of experts in TDR advisory committees are from DECs (Figure 7); the number continues to remain stable (Figure 8), around the 2013 target value. The target is expected to be met.

TDR Results Report 2011

Figure 7 - Proportion of DEC/non-DEC experts in TDR advisory committees ( 2011)

Figure 8. Progress towards targets related to the proportion of DEC experts in TDR advisory committees.

Promotion of equity in research and activities The extent to which TDR has mainstreamed equity in its portfolio was assessed in 2011 based on the distribution of awards and funding to low income countries, to female investigators and to projects relevant to gender issues and vulnerable populations (indicators 5a, 5b and 5d). The proportion of female membership in TDR advisory committees is also estimated as a measure of gender equity (indicator 5c). While clear progress has been made in engaging low-income countries in TDR research activities, addressing gender unbalance in TDR research and activities remains a challenge. Promotion of equity in research and activities Key performance indicators 5.a Proportion of TDR grants/contracts awarded to low-income countries (over total number and total funding)

Baseline

Target (2013) 30% 26%

Progress (2011) 30% (156 / 527) 42% (US$ 4 / $ 7.8 M) 40% (n) (55 / 136) 61% ($) (US$ 2.8 / 4.5 M) 35% (183 / 527) 17% ($ 1.3 M / 7.8 M) 32% (51 / 157)

Source

28% (n) 23% ($) (2008)

Grant proposals TDR/WHO database

5.b

Proportion of TDR grants/contracts relevant to gender issues and vulnerable populations

35%

TDR/WHO database

5.c

Proportion of females among grantees/contract recipients (over total number and total funding) Proportion of females in experts in TDR advisory committees

34% (n) 26% ($) (2008)

50% 50%

TDR/WHO database

5.d

36% (2009)

50%

TDR/WHO database

TDR Results Report 2011 Indicator 5a - Proportion of TDR grants/contracts awarded to low income countries In 2011, the total amount of funds used for contracts and grants (US$ 7.8 million) decreased compared to 2010 (US$ 18.6 million). However, the proportion of TDR grants/contracts awarded to low income countries5 increased (percentage of funds), while there was a decrease in the percentage of number of contracts and grants. This is likely due to the fact that large clinical trials and contracts associated with these have been ongoing in low-income countries (e.g. Bangladesh, Burkina Faso, DR Congo, Tanzania, Uganda and Zambia) and received funding with priority due to ethical considerations and reduced flexibility in downsizing or postponing activities.

Figure 9 - No. and proportion of grants/contracts according to recipient country income level (2011)

Figure 10 - Funding proportion according to recipient country income level (2011)

Figure 11 - Progress towards targets related to the proportion of TDR grants/contracts awarded to low income countries

LIC countries with less than US$ 1000 gross national income per capita, as defined by the World Bank (2010)

TDR Results Report 2011 Indicator 5b - Proportion of TDR grants/contracts relevant to gender issues and/or vulnerable populations Research on vulnerable populations includes all research that addresses pregnant women, adolescents, children, the elderly, nomads, poor urban populations, refugees, populations in post-conflict situations, prisoners, those who cannot give consent (unconscious) and persons with mental or behavioural disorders.6 Gender research and analysis address infectious diseases from the angle of social roles and relations, and resulting inequalities between women and men. 7 The specific projects ongoing in TDR in 2011 that explicitly address gender issues, women’s health and vulnerable and hard to reach populations are illustrated in figures 12 and 13, and enumerated in the list of projects in Annex 2. Forty per cent of TDR grants/contracts (55/136) and 61% of their funding (US$ 2.8 million/ US$ 4.5 million) awarded in 2011 addressed explicitly these issues.

Figure 12. TDR grants according to their relevance to gender and/or vulnerable populations (n=136)

Figure 13. Funding to gender-related and/or vulnerable populations (total = US$ 4.5 M)

Figure 14. Percentage of TDR grants according to their relevance to gender and/or vulnerable populations, progress

Indicator 5c - Proportion of females among grantees/contract recipients (over total number and total funding) The proportion of females among grantees/contract recipients remained relatively low (figures 15, 16 and 17). During the period of reduced funding in 2011, the amount of funds received by female principal investigators (PIs) decreased from 25% in 2010 to 17% in 2011. The main obstacle in progressing towards the target (set at 50%) remains the low numbers of female PIs in developing countries.

6 7

Based on criteria of WHO’s Ethics Research Committee http://www.who.int/rpc/research_ethics/en/checklist_for_PI.pdf Additional information is available at http://www.who.int/gender/whatisgender/en/index.html This amount only includes figures reflected in Technical Service Agreements (TSAs) between WHO/TDR and collaborating institutions. It does not include contracts with individuals Agreements for Performance of Work (APWs)



TDR Results Report 2011

Figure 15. Gender rate among grantees/contract recipients in 2011 (n=527)

Figure 16. Funding distribution to PIs, by gender, in 2011: (total US$ 7.8 M)

Figure 17. Progress towards targets regarding proportion of female grantees/contracts recipients

Indicator 5d - Proportion of female experts on TDR advisory committees Females continue to represent less than one third of experts on TDR advisory committees (figure 18). This rate has remained approximately the same since 2008 (figure 19) and it is relatively low compared to the target. In the context of a potential revision of the advisory committee model, a clear strategy to increase the ratio of female experts is needed if the 2013 target is to be reached. If membership on advisory committees were to be revisited, the target may be achieved more easily.

Figure 18 - Gender rate among experts on TDR advisory committees in 2011 (total 157)

Figure 19 - Progress towards gender balance targets

TDR Results Report 2011 Working in partnerships following formal collaborative framework Formal partnerships have been established based on legal instruments such as a memorandum of understanding, material transfer agreement, collaboration agreement or grant agreement. They aim to achieve common objectives through a joint workplan, to be co-implemented by partners. Working in partnerships following formal collaborative framework Key performance indicators 6.a Number and evidence of formal partnerships in line with TDR strategy TDR partnerships are perceived as useful and productive

Baseline (2007) __

Target (2013) Tbd

Progress (2011) 14 Proposal from partners to receive the 2011 Gates Award for Global Health

Source Signed agreements Reference letters; interviews by external review group

6.b

Positive assessment

Indicator 6a - Formal partnerships in line with TDR ’s strategy The number of formal partnerships has been revised to reflect new developments in 2011 as described below. The number of formal agreements at the end of 2011 was 14. A detailed list of formal agreements is annexed (Annex 3). A Memorandum of Understanding was signed with the Chinese Center for Disease Control and Prevention (China CDC) in June 2010, creating a framework for collaboration on research priorities for infectious diseases, with a particular focus on developing collaboration in Africa. A major collaboration agreement was signed with the Drugs for Neglected Diseases initiative (DNDi) for the implementation of new treatment modalities in support of the elimination of visceral leishmaniasis in Bangladesh and India with funding from the Bill and Melinda Gates Foundation. A five-year research and capacity building programme on dengue carried out in partnership with the International Development Research Centre (IDRC) of Canada between 2006 and 2011 in six countries of South Asia and South-east Asia (India, Indonesia, Myanmar, Philippines, Sri Lanka and Thailand) came to a successful conclusion. A similar formal partnership with IDRC on Chagas disease and dengue is ongoing in Latin America and the Caribbean. During the same period, some partnerships ended. For example, Pfizer withdrew from the partnership that supported the development of Moxidectin, leaving TDR as sole sponsor of the ongoing clinical trial and any further development towards registration. Indicator 6b - TDR partnerships are perceived as useful and productive The proposed survey #3 was not carried out in 2011 due to TDR ’s reorganization. The interim external review interviewed TDR partner institutions and provided feedback on the perceived value of collaborating with TDR. On TDR’s relationship with DEC institutions, the external reviewers wrote: “TDR has a wide network of research institutions with which it works closely and it is evident that relationships are generally good. Institutions recognize the contributions made by TDR to research both in terms of funding and support. The contribution that empowerment/ capacity building has made to research being undertaken is acknowledged and felt to be a major strength of TDR in DECs.” 8

In addition, organizations and researchers that had worked with TDR in the past nominated TDR for the 2011 Gates Award for Global Health.

Ollier L, Ormond L, Visser-Valfrey M, Interim External Review and Evaluation of The Special Programme for Research and Training in Tropical Diseases (TDR), December 2011

TDR Results Report 2011 Initiatives, tools and strategies incubated and transitioned are sustainable Initiatives, tools and strategies incubated and transitioned are sustainable Key performance indicators 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

Baseline (2007) 7

Target (2015) tbd 6

Progress (2011) 8 5 (+1) 51

Source

Signed agreement Legal establishment Consultation with disease control programmes

7.b 7.c

Indicator 7a - Projects transitioned to and sustained by institutions, organizations or agencies for at least two years No change to this indicator occurred in 2011. As TDR aims at transferring some research projects to partners and stakeholders as part of the transition to the new strategic plan, this number is expected to increase in 2012-2013. Indicator 7b - New organizations incubated within TDR ISHReCA (Initiative to Strengthen Health Research Capacity in Africa) has received ongoing financial and technical support from TDR, which hosted the secretariat in its Geneva office until June 2011. ISHReCA holds great potential for Africa in catalysing and stimulating processes for building health research capacity, contributing to health research priority setting and translating knowledge on key research and policy issues facing the continent. The establishment of the network on the African continent in 2011 and the development of the new 2012 workplan based at a new hosting institution (University of Yaoundé, Cameroon) were two key contributions to progress in 2011. Indicator 7c - Effective tools and strategies developed which have been in use for at least 2 years TDR has contributed to the development of numerous tools and strategies against tropical diseases. This has been done by funding and coordinating research and development activities, supporting researchers to pursue innovative ideas, and facilitating dialogue and interactions between various institutions and stakeholders. The list in Annex 5 includes such interventions and strategies. Compared to last year, we removed from the list the items that are no longer in use, and we added new ones. New tools and strategies having come out after 2009 will make the list in the future, should they be in use for more than two years.

Managing effectively

Effective quality assurance TDR is aiming for the highest standards in the activities it supports. Good practices applied include the International Conference on Harmonization (ICH) standards and guidelines, good clinical practices (GCP), WHO/TDR good clinical laboratory practices (GCLP) and OECD good laboratory practices (GLP). The WHO Ethics Research Committee, as well as local ethics review committees in countries, approve and oversee supported studies that involve human subjects. Effective quality assurance 

Progress made in 2011

TDR Results Report 2011 Key performance indicators Baseline (2007) __

Target (2013) 100%

Progress (2011) ----

Source Monitoring, audit reports, regulatory feedback

8.a

Proportion of new research studies that follow international norms and standards

Indicator 8a - Proportion of new research studies that follow international norms and standards Monitoring reports, audit reports and study reports evaluating the quality of the studies are being compiled and archived. Four clinical site audits were conducted in 2011, along with extensive clinical monitoring. Recommendations for improvement are being addressed by the sites. Plans to measure the proportion of new research studies that follow international norms have been delayed to 2012 due to TDR’s reorganization.

Effective resource mobilization Effective resource mobilization Key performance indicators 9.a Financial resources made available for the biennium to cover planned activities (US$ millions)

Baseline

Target

Progress

Source

74.3 (2006–07)

100 (2012–13)

77.4 (2008-2009) 85.6 (2010-2011)

TDR financial contributions

Indicator 9a - Financial resources made available to cover planned activities In 2010-2011, US$ 85.6 million was raised, an amount which is higher than that raised in the previous biennium (US$ 77.4 million). It includes a total of US$ 3.2 million advance payments from WHO, which will need to be repaid in 2012-2013. Taking into account carry-forward from the 2008-2009 biennium (US$ 8.8 million), the total amount made available was US$ 94.4 million (see figure 20). This corresponds to 78% of the JCB-approved budget of US$ 121 million for the 2010-2011 biennium, on which the expected results planning was based. In 2011, during a period of cash shortfall, key donors continued to support TDR and a few provided additional funding or supported TDR in advancing funds due in 2012. This led to a reduction in the funding gap and allowed TDR to continue implementing priority activities. Starting mid-2011, TDR’s ability to raise the funds needed to cover the cost of planned activities has been monitored on a monthly basis, and decisions on expenditures have been made based on forecasted income.

US$ 26.6M 22%

Total funds available

US$ 94.4M 78%

Funding gap to meet JCBapproved budget of US$ 121M

Figure 20 – Proportion of JCB-approved budget US$ 121 million that was funded in 2010-2011

TDR Results Report 2011

Efficient management Efficient management Key performance indicators 10.a Proportion of available funds spent according to workplans Proportion of business line workplans on track Evidence of leadership in responding to opportunities and to managerial challenges

Baseline (2007) 79% (2006–07)

Target 90% (2012–13)

Progress 91% (2008-2009) 91% (2010-2011) 65% on track or achieved (March 2012 data) Qualitative description

Source

TDR/WHO database

10.b

Tbd (2012–13)

team annual reports Reports to governing bodies and staff association

10.c

___

Indicator 10a - Proportion of available funds spent according to workplans Out of US$ 94.4 million made available during the biennium, a total of US$ 86.2 million has been expended9. This represents a financial implementation rate of 91%. However, it is important to note that all funds that were not spent are mainly committed (encumbrances, advances and liabilities). Compared to the initial workplan, the cash shortfall in 2010-2011 affected mostly funds allocated to activities and programme support (Figure 21). Due to the high recruitment level in 2010, reorganization costs in 2011 and a strong Swiss Franc, personnel costs increased significantly.

US$ Million

60 39 38.3 35 JCB-approved budget US$ 121M Expenditure 20

13 8.9

0 BL activities Opperation support Personnel

Figure 21 – JCB-approved budget of US$ 121M vs. actual expenditure in 2010-2011* (million US$)

The expenditures split by area of work (Figure 22) include the cost of personnel and activities.

As per the International Public Sector Accounting Standards (IPSAS), the official balance at the end of the biennium only takes into account expenses where goods have been delivered or services provided and excludes all encumbrances, i.e. commitments made for goods to be provided or services to be rendered are not included.

TDR Results Report 2011 Admin charges 4% Operation Support 18%

Stewardship 13%

Empowerment 10%

Neglected Priorities 7% Community-Based 3% Visceral Leish 3%

Drug Discovery 4%

Product Development 5% Vectors 4% Helminths/NTDs 7% Diagnostics 9%

Malaria 6%

TB/HIV 7%

Figure 22 – Split of 2010-2011 expenditures by work areas, including staff costs 



Total amount US$ 86.2 million, does not include encumbrances (according to IPSAS rules adopted by WHO). As per the International Public Sector Accounting Standards (IPSAS) the official balance at the end of the biennium only takes into account expenses where goods have been delivered or services provided and excludes all encumbrances i.e. commitments made for goods to be provided or services to be rendered are not included.

TDR Results Report 2011 Indicator 10b - Proportion of business line workplans on track TDR has a list of expected results to be achieved within the period 2010-2015 (see Annex 4). The list is updated on a regular basis. All the results are generated by activities in TDR workplans, usually in collaboration with institutions in countries, and are contributing to Millennium Development Goals 4, 5 or 6. Results are directly linked to WHO Organization-Wide Expected Results (OWER) 1.005 and 2.006, to which TDR is a major contributor. Some expected results were delayed in 2010 and 2011 due to various reasons, including reduced funding and personnel (from a high of 108 fixed- and short-term staff in 2010 to 67 in April 2011) and problems that external partners or stakeholders in the projects encountered. Figure 23 shows how the ratio of expected results status evolved between October 2011 and March 2012. The higher proportion of expected results transitioned out or stopped follows the recommendations of governing and advisory bodies to focus the new strategy on fewer areas.

3% 21% 37% 15% Achieved On track Delayed Transitioned/stopped

29% 20%

39%

36%

Oct 2011

Mar 2012

Figure 23 – Status of expected results 2011-2015, comparison Oct 2011 vs. Mar 2012

Indicator 10c - Evidence of leadership in responding to opportunities and to managerial challenges 2011 presented TDR with the challenge of moving towards expected results, while being aware that the planned working budget could not be fully funded. Difficult choices had to be made by senior management, under the oversight of the Programme’s governing bodies whose approval was sought throughout the process. The reorganization of TDR took place in response to a critical financial situation. This led to some teams merging, some expected results being transitioned out and a prioritization exercise taking place. A significant reduction in the internal workforce also took place. The reorganization was accompanied by streamlining and simplifying internal processes, while ensuring better control and increased transparency of financial and performance-related systems. As TDR’s executing agency, WHO moved quickly to appoint a new Director who is expected to provide strong leadership for steering the Programme successfully towards the goal of further enhancing the Programme’s cost effectiveness and impact on global health. As commissioned by the JCB, an independent external review took place in September and October of 2011. The review identified various strengths and weaknesses related to the TDR structure, functions and systems. A detailed report, including recommendations, was submitted to the Standing Committee and the JCB. The TDR 2012 budget was developed in part in response to these recommendations and was approved in December 2011. A series of other reviews was organized in 2011, including the internal annual portfolio review, where topics such as prioritization, project funding and repackaged cross-cutting activities were discussed. The product R&D external review looked at major product R&D projects and clinical trials and

TDR Results Report 2011 provided recommendations on the way forward, management, partnerships and expected results related to those projects. The recommendations fed into the “mini-STAC” meeting convened in November 2011, which provided recommendations on prioritizing expected results and planned costs associated with them (included in the 2012-2013 budget). Following discussions with the Standing Committee, the budget for 2012-2013 has been reduced from US$ 70 million to US$ 60 million, in line with a refocusing on TDR’s core strengths and a more conservative approach to forecasted income. A new strategy will be outlined under the oversight of the governing bodies in 2012.

Overall satisfaction with management Overall staff satisfaction Key performance indicators Baseline (2007) Target Progress Source TDR surveys 2, 3 and 4 Letters from partners TDR survey 5; interpretive analysis

11.a

Proportion of positive satisfaction response from TDR grantees, partners and donors

Tbd (2012–13)

To be measured in 2012 To be measured in 2012

11.b

Proportion of positive satisfaction response from TDR staff

Tbd (2012–13)

Indicator 11a - Proportion of positive satisfaction response from TDR grantees, partners and donors A survey is planned for 2012. TDR is working towards reassuring donors and partners that TDR will continue as a strong player in research and capacity building in the field of infectious diseases of poverty. TDR’s partnerships with local researchers in DECs is seen as beneficial not only to research capacity in the countries, but to leveraging regional and global action momentum on infectious diseases of poverty. Below is what a former TDR grantee wrote in his support letter to the Committee that awarded TDR the 2011 Award: “An important convening achievement of TDR is its contribution to the International Ministerial Meetings on Health Research organized with the Global Forum on Health Research with resultant declarations like the Accra Declaration (2006), Algiers Declaration and Bamako Declaration of 2008. African scientists, many trained with funding from TDR, have been instrumental in the organization of these fora.” 10

Indicator 11b - Proportion of positive satisfaction response from TDR staff There was no survey carried out in TDR during 2011 to determine staff satisfaction. Given the difficult context of the reorganization, the survey will be conducted once the TDR structure has stabilized.

Learning from success and failure

The interim external review conducted in September-October 2011 compiles an in-depth assessment of TDR strengths and weaknesses and highlighted a number of areas for improvement. They have been discussed with the Standing Committee and a sub-group of STAC in Nov 2012. The main 10

Professor David Ofori-Adjei, Letter in support of TDR’s nomination for the 2011 Gates Award for Global Health

TDR Results Report 2011 follow-up actions on specific recommendations have been compiled (see TDR Interim External Review- synopsis of follow-up action document) and are summarized below. Enhancing TDR governance A JCB working group on governance has been established to review TDR’s governance arrangements and make recommendations to the JCB. The group is expected to focus on the role and function of the TDR governing bodies, how best to enhance their commitment and to streamline effective decisionmaking processes. The nature of co-sponsorship and how TDR can best benefit from its links with its co-sponsor group is also likely to be examined by the group. Strengthening management accountability at all levels In response to the recommendations of the interim external review to strengthen management accountability at all levels, TDR has already begun implementing measures such as basing budget and finance processes on expected results and integrating technical and financial reports - regular discussion of these are conducted at senior management and team leader meetings. The new strategy currently being written will be accompanied by improved definition of the roles and responsibilities of managerial staff, in parallel with clear management processes. A comprehensive review of competencies across TDR will be undert aken in the context of TDR’s reorganization. Organizational learning and performance management The TDR Performance Assessment Framework will be adapted to the new strategy (including further defining targets and indicators) and will guide organizational learning. A system to facilitate the monitoring of progress towards targets is being developed in collaboration with the Special Programme of Research, Development and Research Training in Human Reproduction. Regular review of progress will inform TDR staff of both technical and financial status. An organizational learning platform is being established to allow discussion of results and share lessons learned. Linking technical and financial aspects at all three levels of performance measurement (TDR, team and project) has been initiated, and currently several steps have been undertaken. Among these, adding the cost of personnel to team outcomes and expected results will allow a better understanding of the effort required to produce each expected result. Setting clear priorities and managing risks effectively There is a plan to develop a priority setting and risk management process, together with the new strategy, to instil a culture and process of risk management at project, portfolio and programme level. The number of scientific advisory committees will likely be reduced, however they will be more involved and even more accountable for priority setting in the future. Mobilizing and maximizing resources In order to ensure a positive balance at the end of the 2012-2013 biennium, specific targets for resource mobilization have been identified and fundraising efforts are being monitored on a regular basis. The new TDR strategy will be accompanied by a new communications strategy which is expected to support the resource mobilization efforts. In financial management, the budget is set in line with projected income. A system has been established to monitor planned expenditures and projected income month by month. Cash flow forecasting is done in parallel for undesignated and designated funds to prevent any cash-flow issues. Designated funds that are received are placed in specific awards linked to activity workplans, to facilitate monitoring of expenditures as well as reporting to donors. In order to account for the entire cost of a deliverable, including staff costs, timesheets will be developed and introduced. Consultations with WHO and other stakeholders are ongoing.

TDR Results Report 2011 Focusing on key strategic directions Based on TDR’s comparative advantage and following the recommendations of mini-STAC (November 2011), TDR will focus its resources on outcomes and outputs where the added value (potential impact) is higher. The approach to stewardship activities will be reviewed in the context of the new strategy, working from TDR’s role as a major neutral party in consolidating evidence for action and identifying priority gaps for research in diseases of poverty. Building upon past capacity strengthening successes, the new strategy will integrate institutional and individual capacity development efforts into a coherent approach to strengthening DEC capacity and leadership in health research. Another important impact area is represented by research activities, with the focus shifting towards implementation research and operational research for infectious diseases of poverty.

TDR Results Report 2011

ANNEXES Annex 1: TDR monitoring and evaluation matrix Baseline (2007§) Target (year) Progress (+n )

Expected results

Key performance indicators

Source

Achievement of scientific and strategic objectives/outcomes a. 1. Countries and major funding agencies use TDR scientific and strategic reports to set research priorities (Stewardship function) 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 __ 10 (2015)

0 (report published in 2012) 0 (reports in progress) 0 (reports in progress)

TDR survey 1 ; interpretive analysis; references TDR survey 1 ; interpretive analysis; references TDR survey 1 ; interpretive analysis; references TDR reports

3 (2015) Positive assessment

5 (2015)

b. 2. DECs are leading new/strengthened health research initiatives (Empowerment function)

10 (2015)

5 (+2)

TDR reports Network documentation

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

__ 59% for the year 2007

10 (2015)

5 (+3) 61% (n=233)

Interview, TDR annual reports

65% (2015)

Bibliographic review

§ 

Baseline year is 2007, unless specified otherwise Progress made in 2011

TDR Results Report 2011

Expected results a. 3. New/improved knowledge, tools and implementation strategies are used in DECs (Research on Neglected Priority Needs function)

Key performance indicators 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 case- management , control or implementation strategies

Baseline (2007§) 0

Target (year) 6 (2015)

Progress (+n ) 7 (+2)

Source

BL annual reports; evidence

12 (2015)

7 (+2) 5 (+1)

WHO/country documentation and policies; evidence WHO/country documentation and policies; evidence

12 (2015)

Application of core values a. Evidence of DEC leadership in research related activities

__ 74% (n) 55% ($) (2008)

__ 80% (n) 65% ($) (2013)

Case study 59% (n) (312 / 527) 64% ($) ($5.0M / $7.8 M)

Reports; case studies; references

DECs are playing a critical leadership role in research related activities (DECs playing a pivotal role)

Proportion of TDR grants/contracts awarded to DECs (over total number and total funding)

TDR/WHO database

Proportion of DEC experts in TDR advisory committees

57% (2009)

55% (2013)

58% (87 / 151) 30% (156 / 527) 42% (US$ 4 / $ 7.8 M) 40% (n) (55 / 136) 61% ($) (US$ 2.8 / 4.5 M) 35% (183 / 527) 17% ($ 1.3 M / 7.8 M) 32% (51 / 157)

TDR/WHO database

Proportion of TDR grants/contracts awarded to low-income countries (over total number and total funding)

28% (n) 23% ($) (2008)

30% 26% (2013)

Grant proposals TDR/WHO database

b. 5. Promotion of equity in research and activities (Equity) c.

Proportion of TDR grants/contracts relevant to gender issues and or vulnerable populations

35%

TDR/WHO database

Proportion of females among grantees/contract recipients (over total number and total funding)

34% (n) 26% ($) (2008)

50% 50% (2013)

TDR/WHO database

Proportion of females in experts in TDR advisory committees

36% (2009)

50% (2013)

TDR/WHO database

TDR Results Report 2011

Expected results a. 6. Working in partnership following formal collaborative framework (Effective partnerships)

Key performance indicators Number and evidence of formal partnerships in line with TDR strategy TDR partnerships are perceived as useful and productive 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

Baseline (2007§) __

Target (year) Tbd (2013)

Progress (+n ) 14 Partners nominated TDR for the Gates Global Health Award in 2011

Source

Signed agreements Reference letter; interviews by external review group Signed agreement

b. a.

Positive assessment Tbd (2015)

8 5 (+1) 51 11

Initiatives, tools and strategies incubated and transitioned are sustainable (Sustainability)

b. c.

3 56

6 (2015)

Legal establishment Consultation with disease control programmes

65 (2015)

Management performance 8. Effective quality assurance a. Proportion of new research studies that follow international norms and standards Financial resources made available for the biennium to cover planned activities (US$ millions) Proportion of available funds spent according to workplans __ 74.3 (2006–07)

100% (2013)

----

Monitoring, audit reports, regulatory feed-back TDR financial contributions

Effective resource mobilization

100 (2012–13)

77.4 (2008-09) 85.6 (2010-11) 91% (2008-09) 90% (2010-11) 65% expected results on track or achieved Qualitative description To be measured in 2012

79% (2006–07)

90% (2012–13)

TDR/WHO database

10. Efficient management

b. c.

Proportion of business line workplans on track Evidence of leadership in responding to opportunities and to managerial challenges Proportion of positive satisfaction response from TDR grantees, partners and donors

Tbd (2012–13)

team annual reports Reports to governing bodies and staff association TDR surveys 2, 3 and 4 Interpretive analysis

__ Tbd (2012–13)

11. Overall satisfaction with management

As mentioned on page 16, under Indicator 7c, this year’s report includes only tools and strategies that are still in use, wherefrom the decrease compared to baseline.

TDR Results Report 2011

Expected results

Key performance indicators

Baseline (2007§) __

Target (year) Tbd (2012–13)

Progress (+n ) To be measured in 2012

Source TDR survey 5; interpretive analysis

Proportion of positive satisfaction response from TDR staff

TDR Results Report 2011

Annex 2: List of TDR research grant (TSAs) relevant to gender issues and/or vulnerable populations Project ID A90075 B00289 A90195 A90299 A90293 A70604 A90363 A80556 A70334 A70176 A60514 A40066 Title Improving health care delivery in urban communities in Africa using the community directed approach Introduction of rapid syphilis tests in developing countries Community-Directed Interventions for Improving Health Care Delivery among Datooga Nomadic Communities in Central Tanzania Management of peridomestic animals for the control of Chagas disease Formative strategy to improve communication for dengue prevention Innovative dengue vector control intervention and network based on novel tools and eco-bio-social strategies Community-Directed Interventions for improving health care delivery in Nomadic Pastoral Karamajong Communities in Uganda Evaluating the feasibility & cost effectiveness of community treatment of malaria of different severity in Uganda Efficacy & safety of rectal artesunate in paediatric patients-a randomised-controlled study in Kilosa & Mtwara, Tanzania Use of anti-retroviral therapy within TB/HIV/AIDS control setting in Tanzania A multi-centre randomized control trial of Gatifloxacin-containing short-course regimen for the treatment of PTB Can community directed intervention strategy be applied for homemanagement of childhood malaria among Nomadic Fulani populations Pilot pregnancy register, Uganda Innovative community-based ecosystem management interventions for improved Aedes control and dengue prevention in Mexico Development of community interventions for the control of nondomiciliated triatomines in the Yucatan peninsula, Mexico Moxidectin Phase 3 studies Pilot study to assess the feasibility of a medicines in pregnancy Ajayi Croft Kaatano Pennington de Sanchez Bisset Lazcano Kittayapong Nsungwa-Sabiiti Nsungwa-Sabiiti Mrango Mfinanga Odhiambo Akogun PI name Ikeoluwapo Oyeneye Simon Lawrence Godfrey Mugisha Pamela Marie Juan Andres Pattamaporn Jesca Jesca Zakayo Eliadi Sayoki G. Joseph Oladele Benjamin Sex F M M F M F F F M M M M Institution University of Ibadan College of Medicine London School of Hygiene and Tropical Medicine National Institute for Medical Research, Mwanza Research Centre Universidad del Valle de Guatemala Instituto de Medicina Tropical "Pedro Kouri" Mahidol University Faculty of Science Ministry of Health Ministry of Health National Institute for Medical Research (NIMR) National Institute for Medical Research (NIMR) Kenya Medical Research Institute Federal University of Technology City Ibadan London Mwanza Guatemala Habana Bangkok Kampala Kampala Dar es Salaam Dar es Salaam Nairobi Yola Country Nigeria United Kingdom Tanzania Guatemala Cuba Thailand Uganda Uganda Tanzania Tanzania Kenya Nigeria

A90164 A90297

Byamugisha Manrique-Saide

Josaphat Pablo Camilo

M M

Makerere University Medical School, Mulago Hospital Universidad Autonoma de Yucatan

Kampala Merida

Uganda Mexico

A90276 A90145 A90152

Dumonteil Opoku Were

Eric Olivier Nicholas Obuobisa Edwin

M M M

Universidad Autonoma de Yucatan Onchocerciasis Chemotherapy Research Centre (OCRC) Moi University

Merida Hohoe Eldoret

Mexico Ghana Kenya

TDR Results Report 2011

Project ID registry in Kenya A80554 A90292 A90080 A90192 A90358 A20141 A60482 A90072 A90457 A60486 A30224 A90612 B00531 A90356 A90361 A90295 A90296 A90372

Title

PI name

Sex

Institution

City

Country

Community based treatment of febrile illness of under five children by community health workers Situational analysis and innovative intervention for improved dengue disease prevention in Salto (Uruguay) Improving health care delivery in urban communities in Africa using the community Bolgatanga and Wa, Northern Ghana Community-Directed Interventions for improving health care delivery in nomadic communities in Africa, N.Eastern Nigeria Community-directed intervention for improving health care delivery in Nomadic Communities in Africa: Formative phase Research on integrated home & community management of mal & pneumonia in children under-five in Uganda Management of pre-existing program, assessment need and community perception for vector control in Bangladesh Improving health care delivery in urban communities in African using the CDI approach Kinshasa, Congo DR Evaluation de l'impact de la prise en charge communautaire: enquéte de bse dans la Province de l'Equateur (RDC) Role of rapid diag. testing in context of home manage. of childhood with Coartem: an open randomized controlled trial Introduction of Anti-retroviral therapy within TB control settings Uganda Elimination of congenital syphilis in Haiti through scaling up of rapid testing and same day treatment Improved quality of diagnostic services for malaria in pregnancy Community-Directed Interventions for improving health care delivery in nomadic communities in Africa Community-directed intervention for improving NTDs control strategies in nomadic communities in Mali Empowering communities to dengue control: an echo-health analysis and an integrated approach in Fortaleza, Brazil Ecobioosocial approach for the design & implementation of a sustainable strategy for dengue vector control in Girardot Interventions sanitaires sous directive communautaire chez les nomades Bororo du Mont Manengouba

Mathanga Basso Adongo Akogun Okeibunor Rutebemberwa Mondal Maketa Banza Tiono Adatu-Engwau Pape Tinto Massa Coulibaly Caprara Carrasquilla Taptue Fotso

Don P. César Philip Baba Oladele Benjamin Joseph Chukwudi Elizeus Dinesh Tevuzula Vivi Kalambayi Alfred B. Francis Jean William Halidou Khalid Yaya Ibrahim Andrea Gabriel Jean Claude

M M M M M M M F M M M M M M M M M M

University of Malawi Universidad de la Republica Navrongo Health Research Centre Common Heritage Foundation University of Nigeria Department of Sociology Makerere University Institute of Public Health International Centre for Diarrhoeal Diseases Research, Bangladesh University of Kinshasa School of Pharmacy University of Kinshasa School of Pharmacy Centre National de Recherche et de Formation sur le Paludisme National Tuberculosis/Leprosy Programme Les Centres GHESKIO Institut de Recherche en Sciences de la Santé (IRSS) School of Environmental Health Malaria Research and Training Center University of Bamako Universidade Estadual do Ceara Fundacion Santa Fe de Bogota Groupe de Recherche en Santé Publique (GRSP)

Blantyre Montevideo Navrongo Yola Nsukka Kampala Dhaka Kinshasa Kinshasa Ouagadougou Wandegeya Port au Prince Bobo-Dioulasso Tanga Bamako Fortaleza Bogota Yaoundé

Malawi Uruguay Ghana Nigeria Nigeria Uganda Bangladesh Congo, Dem. Rep. Congo, Dem. Rep. Burkina Faso Uganda Haiti Burkina Faso Tanzania Mali Brazil Colombia Cameroon

TDR Results Report 2011

Project ID A50560 A60044 A90281 A60513 A60820 B10022 A80104 A70592 A80110 A80196 A80084 A90074 A80553 A80629 A90022 A90294 A90456 A90458 B00259

Title Multi country study to evaluate impact of early initiation of HAART on TB treatment outcomes TB patients co infected HIV Safety and efficacy of intermittent preventive treatment in pregnancy in Uganda An eco-bio-social approach to implement integrated techniques to control T. infestans in Bolivian poor communities A multi-centre randomised trial of gatifloxacin containing shortcourse requirements for the treatment of pulmonary TB A multicentre randomised controlled trial of a Gatifloxacin containing short course treatment of pulmonary TB (Oflotub) Small grant on "Prevalence of TB in relation to socio-demographic, environment & economic determinants, Nepal, A61095) Conduct of Phase 3 study for moxidectin in Butembo, DRC Protocol development, training and site preparations for validating rapid syphilis testing for PMTCT programs Conduct of Phase 3 study for moxidectin in Lofa County, Liberia Conduct of Phase 3 study for moxidectin Centre de Recherche en Maladies Tropicales de l'Ituri (C.R.M.T- ITURI), Rethy Identification of determinants of Adherence to the prevention means of malaria in the DRC Health care delivery using community-directed intervention approach: a formative study in Monrovia, Liberia Feasibility & acceptability of an integrate community based diagnosis & treatment strategy of malaria at different degrees Home and community management of malaria and pneumonia in children under-five in Burkina Faso Cluster randomized trial of rapid diagnostics tests for home management of mal in children aged 6 to 59 months in Gambia Meeting capacity-building & scaling-up challenges to sustainably prevent & control dengue in Machala, Ecuador Mesurer l'impact de la prise en charge des cas de paludisme sur la mortalité infanto-juvénile Measuring the impact of community case management of childhood disease on childhood mortality in Malawi Malaria rapid diagnostic tests (RDTs) in pregnancy: detection of placental malaria Pym Byaruhanga Lardeux Diallo Lo Koju Kanza Wilfert Bolay Bakajika Kayembe Kennedy Abdoulaye Sirima Palmer Breilh Libite Zanera Hopkins

PI name Alexander Stephen Romano N. Frédéric J.R Mouctar Bocar Rajendra Eric Catherine M. Fatorma Karmo Didier Kapuku Kalambayi P. Stephen B Traore Sodiomon Bienvenu Ayo Elizabeth Salome Jaime Paul Roger Deric Heidi

Sex M M M M M M M F M M M M M M F M M M F

Institution Medical Research Council St. Francis Hospital Nsambya Institut de Recherche pour le Développement (IRD) Ministère de la Santé Publique Programme National de Lutte Contre la Tuberculose Dhulikhel Medical Institute, Dhulikhel Hospital Université Catholique de Graben (UCG) Elizabeth Glaser Pediatric AIDS Foundation Liberia Institute for Biomedical Research Hôpital General de Référence de Rethy Kinshasa School of Public Health University of Liberia Groupe de Recherche Action en Santé (GRAS) Groupe de Recherche Action en Santé (GRAS) CIAM-Public Health Research and Development Universidad Andina Simon Bolivar Institut National de la Statistique National Statistical Office Foundation for Innovative New Diagnostics (FIND)

City Durban Kampala La Paz Conakry Dakar Kathmandu Butembo Chapel Hill Charlesville Rethy Kinshasa Monrovia Ouagadougou Ouagadougou Serrekunda Quito Yaoundé Zomba Kampala

Country South Africa Uganda Bolivia Guinea Senegal Nepal Congo, Dem. Rep. United States Liberia Congo, Dem. Rep. Congo, Dem. Rep. Liberia Burkina Faso Burkina Faso Gambia, The Ecuador Cameroon Malawi Uganda

TDR Results Report 2011

Project ID A50636

Title An evaluation of the impact of early initiation of HAART on TB treatment outcomes to TB patients coinfected with HIV Mwaba

PI name Peter

Sex M

Institution University Teaching Hospital

City Lusaka

Country Zambia

TDR Results Report 2011 Annex 3: List of TDR partnerships with signed agreements and joint workplans Ongoing formal partnerships 1 African Programme for Onchocerciasis Control (APOC) Centre for Parasitic Infection Research at Shanghai China (CDC, China) Drugs for Neglected Diseases initiative (DNDi) Foundation for Innovative New Diagnostics (FIND) Heidelberg University, Germany Organization Public-private partnership Research Institution Legal agreement MoU Collaborative project(s) Work in the area of onchocerciasis Collaboration in the identification of gaps and research priorities for infectious diseases VL elimination Drug discovery (compound development) Diagnostics evaluation and diagnostics 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 rationalisation and integration of antimalarial drug discovery initiatives (CRIMALDDI) TB Reach Initiative Clinical trial tuberculosis treatment Drug discovery Capacity building TropIKA.net knowledge platform

MoU

Product Development Partnership Not-for-profit foundation Research Institution

Collaboration agreement and MTA Grant agreement Collaboration agreement (consortium) Collaboration agreement (consortium)

4 5

Liverpool School of Tropical Medicine, UK

Research Institution

Liverpool School of Tropical Medicine, UK

Research Institution

Collaboration agreement (consortium) Collaboration agreement MoU and MTA MoU (including also NCDS) MoU MoU

8 9 10 11 12

London School of Hygiene and Tropical Medicine, UK Merck Pharmaceuticals Novo Nordisk (NN) Thammasat University The Latin American and Caribbean Center on Health Sciences Information/PAHO/WHO The National Center for Drug Screening, Shanghai, China (NCDS) UN Economic Commission for Africa

Research Institution Pharmaceutical company Pharmaceutical company Research Institution Research Institution

Research Institution

TSA and MOU

Drug discovery (screening network) ANDI

International organization

MoU

TDR Results Report 2011 Annex 4: List of TDR Expected Results 2010-2015

1. Capacity building Current individual leadership development grants maintained and completed Current institutional leadership development grants maintained and completed Current career development fellowships maintained and completed Current capacity-building research grants maintained Implementation research training curriculum developed and tested in country institutions Regional training centre established in Indonesia and operational Regional training centre established in Kazakhstan and operational Regional training centre established in the Philippines and operational Regional training centre established in Colombia and operational Strengthened implementation research in African countries for malaria control & elimination by 2011 Regional training centre established in Africa and operational New individual leadership development grants awarded --> no new grants awarded in 2011 New institutional leadership development grants awarded --> no new grants awarded in 2011 New career development fellowships awarded --> no new grants awarded in 2011 New capacity-building research grants --> no new grants in 2011 Regional small grants scheme --> no new grants awarded in 2011

Status On track On track On track On track On track On track On track On track On track Delayed Delayed Delayed Delayed Delayed Delayed Delayed

Updated target date ongoing ongoing ongoing ongoing 2013 2013 2013 2013 2013 2012 2013 ongoing ongoing ongoing ongoing ongoing

2. Knowledge management South-south regional networks on schistosomiasis and other helminth zoonoses - RNAS in Africa and RNAS+ in Asia - received significant funding from other organizations in 2010 ISHReCA established by 2011 African Network for Drug and Diagnostics Innovation (ANDI) - operational by 2011 Regional network for drug and diagnostics innovation - Latin America by 2013 Regional network for drug and diagnostics innovation - Asia by 2012 Global Report on Research for Infectious Diseases of Poverty published by 2010 and used --> to be published and launched in April 2012 WHO technical reports series on gaps and opportunities for research and R&D financing

Status Achieved Achieved Achieved Achieved On track Delayed Delayed

Updated target date

2012 2012 2013

TDR Results Report 2011

3. Vectors, Environment and Society Complete and annotated genomic sequence of the tsetse fly genome generated by 2011 Situation analysis of eco-bio-social dimensions of dengue conducted in Asian cities Sustainable Community-of-Practice of researchers in Asia on dengue and eco-health Guidance framework for testing GM mosquitoes --> publication to follow in 2012 Innovative community-based ecosystem management interventions for better disease prevention of dengue provided in Asia HAT vector control methods and strategies and implementation guidance Web-based repository/clearinghouse of tools and resources for stakeholders involved in community health research, policy and practice developed Glossina genome exploited for innovative vector control strategies: exploited by 2013 Malaria vector control methods and strategies developed and used Situation analysis of dengue and Chagas disease addressing ecological, biological and social issues based on a cross-disciplinary "eco-bio-social" research framework conducted in Latin America Innovative community-based ecosystem management interventions for better disease prevention of dengue and Chagas disease provided in Latin-America Sustainable Community-of-Practice of researchers in Latin America on dengue and Chagas disease Evidence on vector-borne diseases population health vulnerabilities due to climate change Tools for health officials to implement adaptation measures related to climate-change impact on vector-borne diseases Community of practice related to public health adaptation to climate change impact on vector-borne diseases Dengue vector control methods and strategies in Asia by 2012 Dengue vector control methods and strategies in Latin-America by 2013 Improved Chagas vector control methods and strategies by 2012 A field-tested, community-accepted, safe and effective treatment package for malaria episodes of varying degrees of severity at the community level by 2012 Evidence on the added value of Community-Directed Interventions (CDI) to enhance access to health - scale-up of CDI strategy developed by 2011 and implementation by countries started in 2012 Alternative community-based intervention strategies targeting under-served populations developed in 2012

Status Achieved Achieved Achieved Achieved Achieved On track On track On track On track On track On track On track On track On track On track On track Delayed Delayed Delayed

Updated target date

2012 2012 2013 2013 2014 2014 2014 2015 2015 2015 2012 2013 2013 2013

Delayed

2014

Delayed

2014

TDR Results Report 2011

4. Intervention research Evidence for effective implementation of RDT for VL diagnosis- recommended by national governments, by 2010 Recommendations on the use of serological tests for TB diagnosis by 2011 Recommendations on the use of interferon gamma release assays for TB diagnosis by 2011 Third round of malaria RDTs evaluation by 2011 Evaluation of 7 VL diagnostics tests made available by 2011 Improved scale up of anti-retro-viral treatment in resource-limited settings for HIV-infected TB patients including children and women Evidence on VL drug use and cost effectiveness - database constructed and analysed paper published Chagas PCR standardization and validation of surrogate markers for treatment outcomes in 2010, and used by countries from 2011 on WHO Pregnancy Register for malaria treatment - developed and piloted in 5 countries Praziquantel treatment for schistosomiasis - data available and treatment recommended Miltefosine in treatment of VL, phase 4 study in Bangladesh completed by 2010 Miltefosine safety and efficacy for PKDL assessed, published by 2010 Safety and efficacy of VL combination therapies assessed in 2010 Usefulness of miltefosine under real conditions assessed in 2012 Safety and efficacy of Ambisome assessed in Bangladesh and Nepal in 2012 L-praziquantel progressed to registration and production by commercial partner Evidence on the performance of malaria RDT in fourth round of testing is being used for procurement Strengthened operational/implementation research and capacity for tuberculosis care and control in the WHO European Region Molecular markers for O. volvulus ivermectin treatment response Evidence-based guideline for Dengue surveillance Evidence-based guideline for Dengue outbreak response Evaluation of Dengue RDT --> IgM & IgG RDTs evaluated in 2011; IgM & NS1 Dengue RDT delayed for 2012 Evidence base for schistosomiasis control - 2 systematic reviews completed by 2011 and informing WHO/NTD Department Safety and efficacy data of nifurtimox/eflornithine combination treatment for HAT (stage II) available to complement existing dossier at WHO Essential List, by 2010 Dengue predictive value study for warning signs VL vector control and case management monitoring and evaluation toolkit developed and implemented by primary health care institutions in Bangladesh, India, and Nepal Safety and feasibility of single dose AmBisome in India assessed by 2014 Cost-effective strategy for VL case detection and case management and related case detection manuals and guidelines developed and implemented in high-endemic districts.

Status Achieved Achieved Achieved Achieved Achieved Achieved Achieved Achieved Achieved Achieved Achieved Achieved Achieved On track On track On track On track On track On track On track On track Partially achieved Delayed Delayed Delayed Delayed Delayed Delayed

Updated target date

2012 2012 2012 2013 2014 2014 2014 2015 2012 2012 2012 2013 2014 2015 2015

TDR Results Report 2011

5. Projects in transition Best practices guidance for the deployment of genetically modified mosquitoes for malaria and Dengue control --> five modules out of seven will be delivered in 2012 Lead and drug candidates identified and product development through formal partnerships - TDR discovery network TropIKA.net knowledge sharing platform being transitioned to partners by Q4/2012 Anti-helminthic drug candidates identified and progressed to development by TDR partners- 4 drug candidates identified by 2011 Guidelines for managing PKDL patients implemented by 2014 Safety and efficacy data on gatifloxacin combination to reduce TB treatment from 6 months to 4 months - to complete data analysis and report of Phase III trial Tuberculosis specimen and strain banks transitioned to partners by Q1/2013 Validated framework for introduction of syphilis diagnostics in Africa applied by 2011 Data for policy decisions on the timing of combined TB and antiretroviral therapy for HIV / TB patients depending on CD4 status - Phase III trial to be completed and reported Moxidectin safety and efficacy data for the registration of the drug for the treatment of onchocerciasis will be available by 2013. - Phase III trial to be completed and reported Rectal artesunate registered by 2011, partnership for authorization and access Evidence for optimal implementation of GeneXpert MTB-RIF in low and middle income countries National governance structure for health research developed/strengthened: 10 by 2015 Shortened pentamidine treatment: evidence provided and treatment recommended - stop once follow-up ends Benzonidazole for chronic Chagas disease treatment and suitability of PCR for treatment follow up - stopped engagement Methods/process for mass drug administration assessment (MDA) - methods to measure benefit/risk of drugs used in MDA programme - recommendation on adoption of process/methods made by control programmes

Status Partially achieved / Stopped Transition Transition Transition Transition Transition Transition Transition Transition Transition Transition Transition Stopped Stopped Stopped Stopped

Updated target date 2012

2012 2012 2012 2012 2013 2013 2013 2013 2013 2014

2012

TDR Results Report 2011 Annex 5 - Tools and strategies developed or contributed by TDR and that have been in use for at least 2 years # Year Tools / strategies Leprosy - WHO recommendation for use of multidrug therapy (MDT) for leprosy following its registration in 1980 by Ciba-Geigy. Schistosomiasis - Diagnostic urine-filtration technique in disease control use African trypanosomiasis - Card agglutination diagnostic test for trypanosomiasis (CATT) in disease control use. Onchocerciasis - Ivermectin registered by Merck, and donation programme begins Chagas disease - Improved agglutination blood test for rapid screening of transfusion blood in disease control use. African trypanosomiasis - Eflornithine® registered by Marion Merrel Dow. Onchocerciasis - Rapid epidemiological mapping of onchocerciasis (REMO) in disease control use. Filariasis - Single-dose treatment with DEC or ivermectin is shown to be an appropriate treatment regimen, providing the basis for a new global control strategy based on mass drug administration. Leishmaniasis - Direct agglutination diagnostic test (DAT) and standard leishmania skin test antigen in disease control use. Chagas disease, sleeping sickness and leishmaniasis - Parasite genome sequencing project launched in meeting in Brazil, co-sponsored by TDR and FIOCRUZ. Sequences published in 2005. Onchocerciasis - Effectiveness of mass drug administration with ivermectin in preventing posterior segment eye disease, visual impairment and blindness demonstrated in longitudinal studies in Africa. Visceral leishmaniasis - Liposomal amphotericin B registered by NeXstar. Schistosomiasis - Method for rapid identification of urinary schistosomiasis in highly endemic communities validated and in control use. Onchocerciasis - Importance of onchocercal skin disease determined, providing the basis for extending onchocerciasis control to forest areas in Africa. Lymphatic filariasis - Drug delivery strategies developed for lymphatic filariasis elimination in Africa. Schistosomiasis - Guidelines for diagnosis of female genital schistosomiasis completed. Malaria - Final results of large field trials of insecticide-treated bednets involving 400 000 people in Ghana, Burkina Faso, Kenya and The Gambia demonstrate that insecticide-treated bednets could reduce overall childhood mortality by around 20%. Onchocerciasis - Community-directed treatment (ComDT) of onchocerciasis with ivermectin becomes the mainstay of APOC mass drug administration delivery strategies following multi-country field studies testing the model’s efficacy. Leprosy - Improved multidrug therapy based on rifampicin, oflaxacin and minocycline (ROM) used for leprosy control. Malaria - A TDR-supported pan-African conference on research in Dakar, Senegal decides to create the Multilateral Initiative on Malaria. Malaria - Home management of malaria approach adopted as a strategy by WHO. Lymphatic filariasis - Safety demonstrated for albendazole as treatment.

1 1981 2 1983 3 1983 4 1987 5 1989 6 1990 7 1993 8 1994

9 1994 10 1994

11 1994

12 1994 13 1995 14 1995 15 1996 16 1996 17 1996

18 1996

19 1997 20 1997 21 1998 22 1998

38 #

TDR Results Report 2011 Year Tools / strategies Lymphatic filariasis - Rapid mapping of filariasis in control use. HINARI, a partnership for Health InterNetwork Access to Research Initiative, is launched with TDR as part of the partnership in the area of research capacity building. Malaria - Germline transformation of Anopheles mosquitoes. WHO published the Operational guidelines for ethics committees that review biomedical research TDR initiates several partnerships for developing capacity in bioinformatics. Malaria - Evidence for policy – Reducing potential for artemisinins resistance via use of artemisinins combination therapy (ACT) in uncomplicated malaria Malaria - Genome sequencing of Anopheles gambiae completed by TDR-fostered consortium. The Strategic Initiative for Developing Capacity in Ethical Review (SIDCER) is inaugurated. Malaria – Unit-dose packaging of Coartem® to ensure adherence and suitability for home management of malaria in collaboration with Novartis. Lymphatic filariasis - Longitudinal studies produce evidence that mass drug administration would be required for more than 4–6 years in most places to eliminate lymphatic filariasis. Sexually transmitted diseases - TDR-led evaluation of rapid syphilis diagnostic tests led to those with acceptable performance being placed on the WHO procurement list at negotiated pricing for member states. African trypanosomiasis - International Glossina Genomics Initiative (IGGI) to fully sequence the tsetse fly genome launched. Malaria - Regulatory label extension is obtained for the use of Coartem® (oral treatment of artemether + lumefantrine) in infants and young children above 5 kg in weight. Visceral leishmaniasis - The health ministers of India, Nepal and Bangladesh sign a Memorandum of Understanding pledging to eliminate kala azar (visceral leishmaniasis) from their countries by 2015. Visceral leishmaniasis - Validation of RK39 as a diagnostic for use in India but not in Africa, incorporated into visceral leishmaniasis elimination programme. Onchocerciasis - RAPLOA (rapid assessment procedure for determining areas of Loa loa endemicity) developed, validated and incorporated into disease control use. Malaria - Results from studies in Ghana indicate that the proportion of caregivers using ACTs correctly in terms of promptness, dosage and number of days is more than 90%, leading to reduced delay in seeking treatment. WHO published the Operational Guidelines for the Establishment and Functioning of Data and Safety Monitoring Boards Malaria - Evidence for pre-referral treatment use provided in WHO Malaria Treatment Guidelines Dengue - Multi-country studies validating pupal productivity survey methods for dengue vector control are published, demonstrating method effectiveness. Initial results from multi-country studies demonstrate potential for expanding the community-directed treatment strategy for ivermectin, established under APOC, to deliver a broader, integrated set of interventions, including insecticide-treated bednets a Leishmaniasis - Paromomycin is registered for use in India through the Institute for One

23 2000 24 2000 25 2000 26 2000 27 2001 28 2001 29 2002 30 2002 31 2003 32 2003

33 2003

34 2004 35 2004 36 2005

37 2005 38 2005 39 2005

40 2005 41 2006 42 2006 43 2006

44 2007

39 #

TDR Results Report 2011 Year Tools / strategies World Health. 45 2007 46 2008 Tuberculosis - WHO Policy recommending reduction of the number of smears for the diagnosis of tuberculosis and defining a new sputum smear-positive case Community-directed interventions (CDI), an integrated approach for improved access to vital drugs and preventive measures, including for malaria, in remote African communities. Schistosomiasis - Evidence for dosage of Praziquantel for the control of schistosomiasis Malaria - Mefloquine-artesunate combination drug has been developed for malaria treatment and introduced in Brazil. Dengue - Dengue diagnostics test available at negotiated price (new ones in evaluation) Tuberculosis - WHO Policy on line probe assays and second-line drug susceptibility testing African trypanosomiasis - the tsetse fly genome sequenced, assembled and annotated by the International Glossina Genomics Initiative (IGGI) Consortium

47 2008 48 2008 49 2008 50 2008 51 2010

TDR/STRA/12.1

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

Informations clés

Organisation Organisation mondiale de la santé (OMS)

Type de document Technical Documents

Date d'adoption 16 octobre 2012

Source Organisation mondiale de la santé