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AFRO-NETS> The African Malaria Network Trust Newsletter



The African Malaria Network Trust Newsletter
--------------------------------------------

Had I been asked how I felt in mid-March 2002 immediately after re-
ceiving the Certificate of Incorporation of the African Malaria Net-
work Trust (AMANET), I would have replied, ?great?. Indeed on that 
day I felt not only greatly pleased, but also very much relieved and 
excited. Since the idea of transforming the African Malaria Vaccine 
Testing Network (AMVTN) into a legally operating entity was suggested 
during the year 2000, a lot of work had to be done; many hurdles had 
to be jumped; obstacle races had to be run. During the summer of 2001 
a very determined team of detractors mounted a blitz-krieg on the 
internet, insisting that AMVTN should remain unchanged mainly orga-
nizing training workshops and conferences, publishing a newsletter 
and maintaining a web-site. They dared to suggest loudly that embark-
ing on the clinical trial of malaria vaccine candidates was unwise. 
It turned out that some of these detractors had vested interests to 
protect, and were part of a wider front.

Through unflinching determination the storm abated and we buried the 
hatchet. After all, how would a testing network deliberately avoid 
activities that are essential to the testing of new disease interven-
tions, if research products have to be developed into disease control 
tools? If molecules from research are going to benefit humankind, 
they should not end in good scientific publications; they should go 
through pre-clinical testing, limited Good Manufacturing Practice and 
eventually the most promising ones should enter clinical and field 
testing. To deliberately refuse to develop intervention products from 
already available and promising antigens is unfair to the scientists 
who discovered and developed them. It is also outright unethical, 
particularly when each year populations are suffering by hundred of 
millions, and dying by hundreds of thousands due to lack of new dis-
ease management tools. 

We surely have a moral obligation to save human lives. At the same 
time, prospective field sites to test promising malaria vaccine can-
didates and other interventions must be prepared in advance. Although 
the latter is a tall order, we cannot and will not shirk this respon-
sibility. So I was very much relieved when AMANET was finally regis-
tered. To put it simply, before registration AMANET did not exist le-
gally and as such could neither mobilize adequate funds for the fore-
seen capacity strengthening activities, nor open a bank account, em-
ploy staff, nor enter contracts.

I would like to seize this opportunity to congratulate and at the 
same time to thank all those across Africa and Europe who worked 
tirelessly to ensure the development of the AMANET constitution. My 
very special thanks go to the AMANET Board of Trustees for overseeing 
the final triathlon of the AMANET Constitution crisscrossing Africa 
for its endorsement.

The incorporation of AMANET, however historical, is but only a first 
short step on a very long journey. The realization of the AMANET mis-
sion and vision will inevitably involve many African and allied ma-
laria research and training institutions, and many stakeholders. We 
shall together embark on determining the needs of prospective sites 
for testing malaria interventions; characterize those sites; advance 
their human resources through short-and long-term training; install 
essential equipment, strengthen their infrastructures; and promote 
networking and good governance at African malaria research and train-
ing institutions. Although the task ahead is enormous, I believe it 
can be done, if we all play our respective parts.

W L Kilama
AMANET Managing Trustee
mailto:wkilama@africaonline.co.tz


--
THE AFRICAN MALARIA NETWORK TRUST

INTRODUCTION

The African Malaria Network Trust (AMANET) is the successor to the 
African Malaria Vaccine Testing Network (AMVTN) whose history was re-
cently presented in the 10th issue of the AMVTN Newsletter of Decem-
ber 2001. That article among other things highlighted AMVTN?s spec-
tacular achievements and underscored, ?the need for deeper-rooted ca-
pacity building, so as to meet a continuum of needs faced by develop-
ing country research institutions, particularly those to be involved 
in clinical and field trials??? whether they are in short- and long-
term training, equipment, infrastructure, and similar ones?. This ar-
ticle will attempt to briefly describe the founding of AMANET, its 
mission and objectives, its administration, its modus operandi and 
its planned activities. 


THE FOUNDING OF AMANET

As was noted earlier, the AMVTN had a slow start, but with time, the 
pace quickened. By the year 2000 at least two training workshops were 
being held annually, the newsletter was appearing regularly, and pe-
riodic reports were being placed on its web-site; it was also clear 
then that AMVTN was capable of even greater outputs. At the same time 
as the African malaria situation deteriorated quickly, there was no 
other Africa-wide or African-led, non-governmental institution dedi-
cated to addressing the mounting scourge. At the same time, there 
were very clear indications that African policy makers and the donor 
community were ready and apparently willing to support new efforts 
that were likely to contribute towards the alleviation of the malaria 
disaster.

The idea of forming a legally established malaria network that would 
succeed AMVTN, and address R & D issues relating to various types of 
malaria interventions was first tabled before the 8th AMVTN Coordi-
nating Committee Meeting that was held in Copenhagen in May 2000. The 
AMANET draft deed and rules were discussed at subsequent AMVTN-CC 
meetings and adopted by its 12th meeting in Ouagadougou on 28 October 
2001. The Founding Conference constituting the General Assembly, de-
bated the draft AMANET constitution at Ouagadougou on 31 October 
2001, article by article and later adopted it. The Assembly comprised 
of representatives from 24 African and allied malaria research insti-
tutions also elected the four founding members of the Board of Trus-
tees. 

These are Prof Francis Kwesi Nkrumah (Ghana), Prof Yadon Mtarima Kohi 
(Tanzania), Prof Robert Tinga Guiguemde (Burkina Faso), and Prof. 
Wenceslaus Kilama (Tanzania). 

The Assembly also elected the following (in alphabetical order) to 
the membership of the Scientific Coordinating Committee:
Arnot, David (UK)
Bojang, Kalifa(Gambia)
Doumbo, Ogobora(Mali)
Druilhe, Pierre (France)
Elhassan, Ahmed (Sudan)
Hall, Lee (USA)
Jepsen, Soren (Denmark)
Kironde, Fred (Uganda)
Kremsner, Peter (Germany)
Kwadwo Koram (Ghana)
Malenga, Grace (Malawi)
Mengesha, Tesfaye (Ethiopia)
Mshinda, Hassan (Tanzania)
Ntoumi, Francine (Gabon)
Okello, David (Zimbabwe)
Sauerwein, Robert (Netherlands)
Sirima, Sodiomon Bienvenu (Burkina Faso)
Trape, Jean-Francoise (France)

The first meeting of the Board of Trustees was held in Abidjan, Ivory 
Coast on 6th and 7th January 2002. Among other things the Board 
elected its Chairman (Prof F K Nkrumah) and the Managing Trustee 
(Prof W L Kilama). The Board also considered and approved various in-
struments of the AMANET Secretariat, including the: 2002 work plan, 
salary structure, terms and conditions of service, financial regula-
tions, establishment and job descriptions, and the budget for the 
first quarter. Most importantly, the BoT carefully examined the 
AMANET Constitution (Deed and Rules) and adopted it after making some 
changes. The most important date in the history of AMANET is 14th 
March 2002 when AMANET was incorporated in Tanzania.


AMANET MISSION AND OBJECTIVES

The mission of AMANET is to promote capacity strengthening, perform-
ance and impact of African malaria R & D and training institutions.


ADMINISTRATION AND MODUS OPERANDI

The governance of AMANET is according to the organogramme shown be-
low:


AMANET ORGANOGRAM

The General Assembly at the apex will have members representing Afri-
can and allied malaria research institution. Its main task is to 
elect the Board of Trustees and members of the Scientific Coordinat-
ing Committee. The Assembly is advisory to the Board of Trustee, and 
will meet every two years to discuss performance reports and propos-
als from the Secretariat. 

The Board of Trustees is the ultimate authority for making decisions 
on policy, investments and other issues. The Constitution allows up 
to ten members. The Scientific Coordinating Committee (SCC) compris-
ing up to 20 senior research scientists, is elected by the General 
Assembly; and will receive, discuss and act on reports from the Se-
cretariat and the Expert Committees (ECs) of the Scientific Advisory 
Panel (SAP). The SCC with report specified matters to the Board.

The Managing Trustee (MT) is the Chief Executive Officer of AMANET 
elected by the Board of Trustees from among its members. The MT is 
responsible to BoT for the day to day administration of the Trust in-
cluding formulation of policy proposals and implementation of the de-
cisions of the Board. The MT is also Secretary to the Board, the Sci-
entific Coordinating Committee and the General Assembly. The Secre-
tariat shall manage the affairs of the Trust. The first meeting of 
the BoT decided that besides the MT, the Secretariat will have a Net-
work Director (ND), Clinical Trials Coordinator (CTC), Finance and 
Administrative Manager (FAM), and a personal secretary.

The Scientific Advisory Panel (SAP) shall be constituted of experts 
from various disciplines who are capable and willing to advise the 
Secretariat, SCC and BoT. Members of SAP are elected by SCC but ap-
pointed by BoT. The Members of Expert Committees will be drawn by the 
Secretariat from SAP to address specific issues.

Members of the Trial Sites Development Committee (TSDC), are ap-
pointed by the Board of Trustees to advise the Board, SCC, and the 
Secretariat on trial sites matters, their needs, required studies, 
and allocation of funds. The current members of the TSDC are Prof A 
ElHassan, Drs K Bojang, O K Doumbo, H Mshinda, F Ntoumi, S B Sirima, 
J-F Trape, and S Jepsen.


PLANNED ACTIVITIES

AMANET will in the short term undertake the following activities at 
prospective malaria intervention trial sites.
- Determine needs for human resources, equipment, and infrastructure;
- Characterize the sites for malaria epidemiology, demography, immu-
  nology, parasitology, entomology, sociology, etc;
- Advise on essential human capacity for research and development of
  malaria interventions;
- Strengthen infrastructure and provide equipment;
- Sponsor clinical and field trials of interventions;
- Promote good governance and networking of institutions undertaking
  malaria research, control and training 

Within its first triennium AMANET will sponsor and/or undertake the 
following activities:
1. Convene Training Workshops on: 
-  Ethics in Health Research in Africa;
-  Operations of Ethics Review Committees;
-  Good Clinical Practice
-  Good Laboratory Practice and Standard Operating Procedures;
-  Strengthening Principal Investigators;
-  Vaccinology in Developing Countries;

2. Publish the biannual AMANET Newsletter;
3. Develop the Afro-Immuno-Assay network;
4. Undertake capacity strengthening at prospective trials sites CNRFP
   in Burkina Faso, CISM in Mozambique, and IPH in Tanzania 
5. Sponsor clinical and field intervention trials as candidate vac-
   cines become available.


ACKNOWLEDGEMENTS

AMANET Secretariat is grateful to the Netherlands Ministry of Inter-
national Cooperation (DGIS), and DG-Research of the European Commis-
sion and DANIDA for their support.


--
SEMINAR ON HEALTH RESEARCH ETHICS IN AFRICA

The recognition of malaria as the leading public health problem in 
African prompted the founding of the African Malaria Vaccine Testing 
Network (AMVTN). One of the main goals of the Network is to undertake 
capacity building of African institutions and scientists for meaning-
ful participation in the global efforts for development and evalua-
tion of candidate malaria vaccines to be used for controlling the 
disease. Since its founding in 1995, the Network has convened several 
capacity building scientific meetings, which therefore have provided 
some experience to the organization of this Workshop. 

As early as during the AMVTN founding conference in 1995, it was re-
alized that the testing of candidate malaria vaccines besides abiding 
to proper scientific study designs and methodologies, should also ob-
serve health research ethics. The conference further noted that ex-
pertise and even awareness in ethics was extremely weak in most Afri-
can research institutions. The conference therefore recommended that 
creating awareness and capacity building for health research ethics 
in African health research institutions were priorities being ad-
dressed by a series of workshops, which were preceded in 1999 by the 
Seminar on Health Research Ethics in Africa.

Workshop Objectives 

The primary objectives of the workshop were to provide a general 
overview of current health research ethics in the international 
sphere, and specifically in Africa. The specific objectives were to 
examine and highlight current health research ethics under the 
themes:
1. History of Health Research Ethics and Codes;
2. Institutional Ethics Review Committees;
3. Principles of Health Research Ethics;
4. Respect for Persons Participating in Research;
5. Elements and Processes of Informed Consent;
5. Justice and Standards of Health Care;
6. Beneficence and Issues of Study Designs;
7. Private and Public Sponsored; and
8. What to do When the Research is Completed

Expectations

The workshop participants were expected to acquire knowledge to be 
applied to the following areas:
- Designing clinical trials complying with health research ethics;
- Design forms for carrying out adequate informed consent processes; 
- Establishment of ethics committees and standard operating proce-
  dures in their home institutions; and 
- Providing training in health research ethics to others.

Workshop Advertisement

The workshop was widely advertised to the target beneficiaries, in 
the AMVTN Newsletter and website, and other sites. The targeted bene-
ficiaries were middle to senior African scientists in the employment 
of African institutions. Preference was given to malaria research 
scientists, key members of ethics review committees, study monitors, 
data safety monitoring boards, research sponsoring agencies, members 
of regulatory bodies, and editors of biomedical journals.

Participants and Venue

The advertisement attracted 45 applicants. Of these, 30 and 5 appli-
cants were initially selected for participation and kept on the re-
serve list respectively. However, due to the changes in the workshop 
venue and dates, the workshop had only 26 participants and 8 facili-
tators. Initially the workshop was to take place in Banjul, The Gam-
bia, 4 to 6 November 2001. Due to logistics and other reasons, the 
venue and dates were changed to Addis Ababa, Ethiopia, 10 to 12 De-
cember 2001.

Programme and Teaching Strategies

Teaching and learning were mostly through interactive methods by lec-
ture presentations, discussions in break- away groups, and in plenary 
discussions. Of the workshop total working time of 1620 minutes, the 
non-core activities including registration, evaluation, lunches, and 
nutritional breaks, took up 455 minutes (28%). The time allocation 
for the core activities were lectures 495 minutes (31%), break-away 
group discussions 400 minutes (25%), and plenary discussions 270 min-
utes (17%). 

Evaluation

The Workshop was evaluated at the end of each day using a self-
administered questionnaire. From day 2 onwards, there was a brief 
feedback presentation on the responses of the previous day. Of the 
possible scores ranging from ?very poor? to ?excellent?, the average 
for most aspects of the Workshop was ?very good?. The aspects ranked 
best in the order of frequency were the interactive teaching ap-
proach, clarity of lecture presentations, and selection of the topics 
and speakers. The choice of the venue and accommodation scored the 
least.


--
RESEARCH AND CURRENT DATA ON MALARIA VACCINES

INTRODUCTION

The Workshop was the third and final one of an annual series related 
to research and current data on malaria vaccines, with an emphasis on 
investigations being conducted at African sites. The primary objec-
tive of the Workshop was to provide a fundamental background as well 
as state-of-the-art data on malaria vaccines and immunity to malaria. 
More specific presentations and discussions were on topics such as 
parasite genetics, malaria in pregnancy, antibody assays, as well as 
ethics in field research. Lecture presentations were followed by in-
teractive debates, group work sessions, and a field site visit. 

PARTICIPANTS

There were 30 participants from 14 African countries, all currently 
undertaking research on parasitic diseases, particularly in malaria. 

OPENING SESSION

Welcoming and other opening remarks were given by Prof W L Kilama who 
is the AMANET Managing Trustee, and by the co-organizers Drs P Alonso 
(Mozambique - Spain), R Thompson (Mozambique), and J Epstein (USA). 
The organizers described the structure of the course, and the par-
ticipants made self-introductions briefly describing their present 
scientific and institutional activities. 

LECTURES 

Malaria Vaccines
?Immunity to Malaria: An Overview? was presented by W Rogers of the 
Naval Medical Research Center [NMRC], USA and Noguchi Memorial Insti-
tute of Medical Research, Ghana. The lecture presented epidemiologic 
observations, depletion experiments, antibody passive transfer and 
correlates of protection. 

?Malaria Vaccines: Where are we now?? was presented by P Alonso from 
the Centro de Investigaçao em Saude de Manhiça [CISM], Mozambique. 
The presentation covered the current malaria control tools including 
vaccines, described the phases of vaccine development, and under-
scored the need for understanding the relationship between inocula-
tion rates and parasitemia/disease/severe disease/mortality with re-
gard to each stage-specific vaccine candidate. 

?Pre-erythrocytic Stage Vaccines? by W Rogers provided a general view 
on vaccine targets using well-established malaria rodent models. The 
presentation also described in detail the current status of the pre-
erythrocytic stage vaccines, including the irradiated sporozoite 
model, and RTS,S/AS02. 

?DNA Vaccines, Focusing on the Prime-Boost Approach? by M. Sedegah 
from NMRC USA, addressed issues related to immunization with differ-
ent DNA constructs and adjuvants with an emphasis on the prime-boost 
model and the need to evaluate inoculation techniques for optimiza-
tion of immunogenicity. A number of combinations for prime-boost were 
discussed. 

?Transmission-Blocking Vaccines? was covered by R Sauerwein from the 
University Medical Centre St. Radboud, The Netherlands. The presenta-
tion discussed the biology of gametocyte formation and the main anti-
gens expressed in this stage of development of the parasite. Emphasis 
was given to the relationship between a successful transmis-
sion­blocking vaccine and its effect on other phases of the parasite 
cycle. As in other talks, aspects of polymorphism/antigenic diversity 
were referred to in relation to vaccine utilization.
 
?Asexual Stage Vaccines? was presented by P Druihle of the Institut 
Pasteur, France. The presentation argued for the need to work mostly 
on human malaria in order to obtain as much data as possible on immu-
nogenic/protective antigen candidates. Data was presented on IgG3, 
which could potentially be used in laboratory assays as a marker for 
correlates of protection. Both the in vitro ADCI method, and in vivo 
passive transfer of antibody in P.-HuRBC-BXN mice were proposed as 
tools to assess the direct and indirect biological effects of anti-
bodies elicited in volunteers by vaccine candidates.

?Vaccines: Development and Clinical Trials? and ?Phase I Clinical 
Trials: An Example? were presented by S Jepsen (Statens Serum Insti-
tut, Denmark), J. Epstein, and R. Sauerwein. A major aspect that was 
introduced was related to the length of time that may be required be-
tween a laboratory produced candidate, its GMP formulation, Phase 
I/II trials, and eventual field application. The required and practi-
cal aspects of ethics, regulatory and safety issues, industrial in-
terests and African site capacities were presented as critical non-
scientific factors with major relevance to vaccinology. 

Voluntary extra-program presentations were made by the participants W 
Okoth AND Simon Kariuki from Kenya Medical Research Institute; Iwalo-
kun Bamidele from Lagos State University, Nigeria; and E Biney, from 
the Medical Research Labs, The Gambia. The talks covered the role of 
researchers in African sites in vaccine trials, malaria control pro-
jects (bednets), and haematological and serological changes secondary 
to anti-malarial therapy. 

In vitro and in vivo Models

?The Critical Importance of Model Systems in Developing Subunit Ma-
laria Vaccines for Humans? was presented by M Sedegah, with a focus 
on DNA vaccines. This covered antigen discovery, delivery systems, 
immune mechanisms, immune enhancement techniques, and product devel-
opment using a Plasmodium yoelii rodent model where host genetics 
play a major role. 

?Immune Responses to the Surface of Malaria Infected Red Cells? by S 
Kinyanjui (KEMRI, Kenya), gave an overall view on the use of roset-
ting/agglutination tests to longitudinally evaluate antibody re-
sponses to var genes. Difficulties in the application of the tech-
nique in relation to parasite densities were expressed, but overall, 
these studies show reduced number of ?virulent? strains present in 
older adults with increased exposure. 

Malaria and Pregnancy

?Malaria and Pregnancy? was discussed by C. Menendez (CISM, Mozam-
bique/ Universitat de Barcelona, Spain) who gave an overall view on 
changes in immunity during pregnancy, sequestration events in the 
placenta, the role of inflammation in placental malaria infection and 
the effect of these factors on both mother and fetus. The data on the 
interaction with HIV was presented. The need for further research on 
parasite genotyping and studies on localized placental immune re-
sponses was emphasized, as well as the proposed control measures for 
the prevention of malaria-related complications in pregnant women. 

Mixed Infections 

?Mixed Infections and Molecular Epidemiology? was presented by A.P. 
Arez (Centro Malaria D. Tropicais [CMDT] ­ IHMT, Portugal) who re-
viewed a number of publications on both human and rodent malaria 
mixed infections in relation to morbidity and mortality. She also 
presented data on work carried out in Guinea Bissau and Mozambique on 
mixed infections (different species) or multiple infections (P. fal-
ciparum genotypes) in both the human and the mosquito hosts. 

These topics were discussed in the context of the overall view of 
population dynamics and vaccines. 

General Subjects

?Vaccines, Hopes, and Hurdles? by V do Rosario (CMDT-IHMT) reviewed 
the presentations which were given during the workshop, discussing 
the data which was presented on each type of vaccine. The presenta-
tion stressed the relevance of malaria models in relation to human 
field data and the importance of the standardization of techniques in 
serological and molecular epidemiological studies. The need for en-
hanced interaction among different groups working on malaria vaccine 
development was underscored as being important to facilitating better 
evaluation of data from different sites. 

 ?Ethics in Collaborative Research in Africa? was presented by W L 
Kilama (AMANET Managing Trustee). It was noted that the rampant pov-
erty and disease, high illiteracy rates, lack of awareness, abuse of 
human rights, ignorance of modern concepts of health, medicine and 
science and weak health care systems negatively influence health re-
search ethics in Africa. It was also argued that in Africa, vulner-
able groups go beyond study subjects and communities to include all 
stakeholders (i.e. researchers, research institutions and even regu-
latory bodies). Despite these weaknesses, health research in Africa 
must respect personal autonomy and do no harm; it must, moreover, be 
based upon justice and good science. 

There has been a rush to test new interventions in poor disease en-
demic countries presenting unique advantages to research ?guests? and 
sponsors. Therefore, there is a paramount need for proper ethics re-
view in Africa despite current deficiencies in African institutional 
(and national) ethics review committees. The year old Pan-African-
Bioethics Initiative (PABIN) was established to, among other things, 
address such shortfalls. There was therefore more justification for 
participatory research that is responsive to the health needs and 
priorities of study communities, whereby all stakeholders are in-
volved in identifying and addressing research problems after develop-
ing appropriate memoranda of understanding.

?Overcoming Difficulties in Implementing Research in African sites? 
comprised panel discussions led by V do Rosario, P Alonso, and R 
Thompson. Dr do Rosário summarized some of the aspects already pre-
sented by other speakers on the interrelation of vaccines with bio-
logical, epidemiological and entomological aspects of control pro-
grams. 

The discussions noted the following:
1. Relevance of molecular epidemiology, vector and host genetics, and
   standardization of techniques in vaccinology comparative studies;
2. Need for basic biological studies on the parasite cycle and its
   capacity for survival.
3. Difficulties in implementing sophisticated research, equipment
   maintenance, getting proposals funded, identification of research
   priorities, and bureaucracy obstacles; 
4. Need for developing policies to help support and maintain research
   staff, who are updated in the newest technologies for immunology
   and molecular biology of malaria vaccine research. 

?From AMVTN to AMANET? by W Kilama introduced the role the African 
Malaria Vaccine Testing Network (AMVTN) has had, since its founding 
in 1995, in the training of African investigators in study design and 
methods, ethics, and data management. Most deliberations from meet-
ings and workshops have been published and have demonstrated this 
network?s role in the conduct of malaria vaccine trials in Africa. In 
2001, AMVTN was transformed by the decision of the Coordinating Com-
mittee into the African Malaria Network Trust (AMANET). An important 
goal of AMANET is to help facilitate research, training, and opera-
tional activities between and within African and non-African research 
institutions. 

WORKSHOPS

?Immunology: T cell Assays? was presented by M. Sedegah. It was 
stressed that, in animal models, both irradiated sporozoite and DNA-
based vaccines, protection is dependent on CD8+ T cells. Furthermore, 
the interaction between CD8+ T cells and infected hepatocytes initi-
ates the destruction of parasitized liver cells. It was demonstrated 
how CTL and ELISPOT assays are conducted, as well as how to measure 
other T cell responses. Assays included proliferation assays, cyto-
kine ELISAs, and MHC tetramer staining techniques. 

?Immunology: Antibody Assays?, in the context of seroepidemiological 
studies and vaccine immunogenicity trials, was presented by C Dobaño 
(NMRC, USA). The presentation reviewed the structure and function of 
antibodies, evidence for the role of immunoglobulin in protection 
against malaria, and the potential immune effector mechanisms against 
Plasmodium. Special emphasis was placed on the erythrocytic asexual 
stages, with a focus on those in vitro assays that have been shown to 
correlate with protection (e.g. ADCI). The common methods for indi-
rect immunofluorescence, ELISA, agglutination assays as well the 
novel flow cytometry based assays for detecting antibodies were ex-
plained in depth. 

There were considerable discussions on the different ways that anti-
body data can be presented, analyzed and interpreted, with the aim of 
helping the participants to organize their results, and to understand 
and critically review scientific publications.

?Molecular Biology: Host Genetics? was covered by W Rogers. The pres-
entation discussed host genetic factors influencing susceptibility to 
severe malaria including sickle cell trait, HLA alleles, and TNF-
promoter polymorphisms. There were also discussions on the design of 
severe malaria case-control studies and problems that may reduce the 
sensitivity of these studies to detect associations. The group re-
viewed in detail the papers dealing with the association between HLA-
B53 and resistance to severe malaria in the Gambia. Finally, consid-
eration was given to approaches to genome-wide screening for malaria 
susceptibility and resistance genes.

?Molecular Biology: Parasite Genetics? was presented by P Cravo 
(CMDT- IHMT). It was shown that the major obstacles to controlling 
malaria morbidity and mortality were the current inability to produce 
a fully protective anti-malarial vaccine and drug resistance. The fo-
cus was primarily on how the knowledge of the genetics of malaria 
parasites can be used to explain the dynamics of drug resistance and 
identification of the genes modulating drug responses. There were in-
teractive discussions of such concepts as genetic cross, selection of 
mutants, Plasmodium sequence databases, and how drug pressure, para-
site genetic diversity and recombination influence selection and 
spread of drug-resistant mutants.

A self-administered questionnaire filled out by participants at the 
close of each day, showed that the workshop was generally considered 
to be very good, generated excellent interactive discussions, and the 
CISM field site visit was very highly regarded. Suggestions were 
given on how to improve future AMANET courses.

ACKOWLEDGEMENTS

This Workshop was primarily funded by AMVTN through the grants from 
EC DG­Research, INCO­Development Programme, and DANIDA. Contributions 
were also gratefully obtained from the Naval Medical Research Center, 
USA; Central Malaria D.Tropicais-IHMT, Portugal; Centro de Investiga-
çao em Saude de Manhiça [CISM], Ministerio de Saude, and Faculdade de 
Medicina, all in Mozambique; and the Unitat de Epidemiologia i Bio-
estadistica, Hospital Clinic, Universitat de Barcelona, Spain. CISM 
is also thanked for organizing the field visit.


--
WORKSHOP ON MONITORING MALARIA INTERVENTION TRIALS IN AFRICA

Call for Applications

Applications are invited from African physicians/scientists in the 
employment of African health research/training institutions, who are 
interested in monitoring malaria intervention trials in Africa. Ap-
plicants must at least be middle to senior level investigators with 
proven prior experience in carrying out clinical and/or field trials. 
Familiarity with clinical/field trials, ethics concerns in the Afri-
can context are desirable. Possession of a GCP certificate is an 
added advantage. Selection is strictly by merit.

The workshop will highlight skills on how to:
- plan a malaria vaccine trial,
- conduct a pre-study visit including evaluation of the capacity of
  the investigator team and facilities at the prospective study site,
- carry out the initiation visit in order to ensure adherence to op-
  erational procedures,
- conduct subsequent routine monitoring visits to assess and assure
  protocol compliance,
- conduct the study completion visit to certify the completeness of
  protocol, recruitment of participants and adequate data recording,
- write the monitoring visit report. 

Experienced facilitators will be drawn from WHO, academia and indus-
try. Teaching methods will include lecturers, panel and break away 
group discussions, and practicals.

Selected participants will be awarded scholarships by the African Ma-
laria Network Trust (AMANET), which will cover costs for economy 
class airfares, tuition and full board. Participants should meet all 
their other costs. 

Instructions will mainly be in English, although efforts are underway 
to include a bilingual English/ French facilitator.
 
Applicants wishing to participate in this Workshop should forward the 
following by e-mail to the address below by 16 September 2002.

1. Full name in capital letters, with family name underlined;
2. Date of birth and nationality;
3. Name, full address, telephone number, fax number, and e-mail ad-
   dress where the applicant is employed;
4. Listing of educational qualifications, including date, place and
   degree(s) obtained;
5. Describe in not more than 15 lines the nature of your current
   post, and any other posts you may have where you need this work-
   shop;
6. Current research interests (not more than 10 lines;
7. A list of your scientific publications, especially those relating
   to clinical/field trials and to the workshop;
8. Names and addresses of two referees (including their telephone,
   fax and e-mail contacts) who you have requested to provide letters
   of recommendation to be sent directly to the address below; and
9. Attach a copy of GCP Certificate.


All applications must be received by 16 September 2002 by E-mail at 
the Address below:

Prof W L Kilama
Managing Trustee, AMANET
Tanzania Commission for Science and Technology Building
Ali Hassan Mwinyi Road, Kijitonyama
P O Box 33207
Dar es Salaam, Tanzania
Tel: +255-22-270-0018
Fax: +255-22-270-0380,
mailto:wkilama@africaonline.co.tz

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