Ebola: Europe-Africa research collaborations.

No one would disagree with Giuseppe Ippolito and colleagues1Ippolito G Lanini S Brouqui P et al.Ebola: missed opportunities for Europe–Africa research.Lancet Infect Dis. 2015; 15: 1254-1255Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar about the need to strengthen Europe–Africa research collaborations for health threats such as Ebola. This imperative must, however, build upon the current landscape of partnerships for epidemic diseases research in Africa and elsewhere. The Europe–Africa clinical research response to Ebola has been impressive, and includes vaccine safety studies in west Africa,2Agnandji ST Huttner A Zinser ME et al.Phase 1 trials of rVSV Ebola vaccine in Africa and Europe—preliminary report.N Engl J Med. 2015; (published online April 1.)https://doi.org/10.1056/NEJMoa1502924Crossref PubMed Scopus (296) Google Scholar, 3University of Oxford press releaseTrials of an experimental Ebola virus vaccine progress at speed.http://www.ox.ac.uk/news/2014-11-17-trials-experimental-ebola-vaccine-progress-speedDate: Nov 17, 2014Google Scholar the encouraging results of the ring vaccination trial in Guinea coordinated by WHO,4Henao-Restrepo AM Longini IM Egger M et al.Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial.Lancet. 2015; 386: 857-866Summary Full Text Full Text PDF PubMed Scopus (572) Google Scholar the first ever drug trial in Ebola undertaken by the favipiravir (JIKI) trial consortium (NCT02329054),5Sissoko D, Folkesson E, Abdoul M, et al. Favipiravir in patients with Ebola virus disease: early results of the JIKI trial in Guinea. Conference on Retroviruses and Opportunistic Infections; Boston, MA: Feb 22–25, 2016. Abstract 103-ALB.Google Scholar the RAPIDE consortium trials of brincidofovir (PACTR201411000939962) and TKM-130803 (PACTR201501000997429), and the Ebola-Tx (NCT02342171) and Ebola-CP (ISRCTN13990511) trials of convalescent plasma. With the inclusion of diagnostic, virological, and anthropological research, Europe–Africa Ebola research collaborations have been prolific. These achievements, which should be celebrated, are partly the consequence of investments over the past 5 years in many of the areas highlighted by Ippolito and colleagues. To cite only a few, the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) has been striving to align existing networks since 2011, and has pioneered the development of pre-approved and adaptable syndrome-based protocols. ISARIC has African member networks and is active in building regional capacity and linkages. Affiliated with ISARIC, the European Union (EU)-funded Platform for European Preparedness Against (Re-)emerging Epidemics (PREPARE) is undertaking inter-epidemic syndrome-based studies across Europe, and both ISARIC and PREPARE have begun to address ethical, administrative, regulatory, and legal bottlenecks to rapid research. To accelerate and coordinate funding of a rapid research response to outbreaks, a network of funders has established the Global Research Collaboration for Infectious Disease Preparedness (GloPID-R). The European and Developing Countries Clinical Trials Partnership, funded by the EU, provides substantial support for training and capacity development in Africa in the conduct of clinical trials. At the European country level, initiatives such as REACTing (REsearch and ACTion targeting emerging infectious diseases) and The Global Health Network (TGHN) have emerged to support research preparedness and capacity within low-income and middle-income countries. TGHN is providing free web-based courses to deliver research skills training to researchers in low-resource settings, with more than 40 000 of these being taken online in Africa so far. These many successes and ongoing initiatives should be the platforms from which we continue to strengthen Europe–Africa partnerships and help empower African researchers and institutions. This online publication has been corrected. The corrected version first appeared at thelancet.com/infection on November 16, 2015 This online publication has been corrected. The corrected version first appeared at thelancet.com/infection on November 16, 2015 We declare no competing interests. Ebola: missed opportunities for Europe–Africa researchThe current unprecedented Ebola virus disease outbreak in parts of west Africa, which has caused more than 11 200 deaths, has emphasised how the medical and scientific communities lack specific pathways for tackling relevant logistical, design, and ethical issues for assessment of novel diagnostics, treatments, and vaccines through implementation of appropriate clinical trials.1,2 The phenomenal outbreak arose because of several weaknesses in local, regional, and international public health responses, which delayed provision and implementation of effective interventions. Full-Text PDF CorrectionsHorby PW, Endtz H, Muyembe-Tamfum J-J, et al. Ebola: Europe–Africa research collaborations. Lancet Infect Dis 2015; 15: 1258–59—In this Correspondence, Hubert Endzt, Denis Malvy, and Stephen B Kennedy's names were spelt incorrectly. Piero Olliaro is also affiliated with the Centre for Tropical Medicine and Global Health, Nuffield Department of Health. Fondation Mérieux is part of the France and Erasmus University Medical Centre, Rotterdam, Netherlands. Denis Malvy is also affiliated with the University of Bordeaux. Full-Text PDF Non-randomised Ebola trials—lessons for optimal outbreak researchPeter William Horby and colleagues1,2 contest our views about the need for randomised clinical trials (RCT)3 and the missed opportunities for an effective Europe–Africa research framework4 during the recent Ebola virus disease outbreak in west Africa. In stating their case against the need for randomised studies, the authors quote Byar and colleagues5 as supporting the use of non-randomised designs. However, Byar and colleagues in fact do strongly support randomisation, and recommend randomisation even in phase 1 trials. Full-Text PDF