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Presented by Michel Alary, MD, Ph.D. Professor, Université Laval, Québec

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Presented by Michel Alary, MD, Ph.D. Professor, Université Laval, Québec

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  1. Experience of North-South collaboration for capacity building in HIV prevention research in francophone AfricaZannou DM1, Minani I2, Labbé AC3, Anagonou SY1, Massinga Loembé M2, Ndjoyi A4, Darveau A5, Guedou F2, Ouendo M6, Belleau M2, Alary M2. 1Faculté des sciences de la santé, Cotonou, Bénin; 2Centre hospitalier affilié universitaire de Québec, Canada; 3Hôpital Maisonneuve-Rosemont, Montréal, Canada; 4Faculté de médecine, Université des Sciences de la Santé, Libreville, Gabon; 5Faculté des sciences & Génie, Université Laval, Québec, Canada; 6Institut régional de santé publique, Ouidah, Bénin. Presented by Michel Alary, MD, Ph.D. Professor, Université Laval, Québec Afri-Can Synchronicity Forum Entebbe, Janaury 17-19, 2013

  2. BENIN – WEST AFRICA Some specific information on the country

  3. BENIN West Africa • Population : ~ 8,760,000 • Gross National Income per capita : 690 USD Economic Ranking : 178/210 (World Bank, 2009) • Human development : 163/177 Annual expenses in health per capita : 46 USD • Life expectancy : 54/55 (M/W) (WHO, 2008)

  4. HIV in BENIN • HIV Prevalence, general population : ~1.2%(DHS, 2006) • High risk groups for transmission : Sex workers (20.4% in 2012 vs. 53.3% in 1993) Clients of Sex Workers (2.3% in 2012 vs. 8.4% in 1998) (Integrated behavioural and biological survey, 2012) • Epidemic largely concentrated (World Bank report, 2008) • ARV program established in 2002

  5. Benin-Canada collaboration in HIV issues prior to GHRI • CIDA-funded projects from 1992 to 2006 • Focus on sex workers and their male partners • Behavioural, empowerment, clinical and structural components • CIHR research funding showed that it prevented ~40-50% of the overal HIV epidemic in Benin • Studies evaluating the syndromic approach for STIs and rapid diagnostics for NG (WHO-funded) • Site for 2 multicentre phase 3 microbicide trials • Construction of a FSW-dedicated clinic in 1996 (UNAIDS funding)

  6. Existing Laboratory structure - 2004 • Laboratory Level CL2 • Fine equipment for molecular diagnosis (STD, SDA, PCR) • Transferred to the National Aids Control Programme (Ministry of Health) in 2008

  7. GLOBAL HEALTH RESEARCH INITIATIVE (GHRI)

  8. RENFORCEMENT DES CAPACITÉS DE RECHERCHE EN PRÉVENTION DU VIH EN AFRIQUE FRANCOPHONE2007-2009 Collaboration : Benin, Canada, Gabon IDRC grant # 104051-004 http://www.idrc.ca/en/ev-121546-201-1-DO_TOPIC.html

  9. Partners • Centre hospitalier affilié universitaire de Québec & Laval University : • Dr Michel Alary, Dre Marguerite M. Loembé, Michelyne Belleau (Unité de recherche en santé des populations URESP, CHA) • Dr André Darveau (Département de Biochimie et de Microbiologie Faculté de Sciences et Génie) • University of Montreal : • Dre Annie Claude Labbé (Département de Microbiologie et d’infectiologie, Hôpital Maisonneuve-Rosemont (HMR) et Professeure adjointe de clinique, Université de Montréal)

  10. Partners (2) • Benin : • Université d’Abomey-Calavi Pr Severin Anagonou & Pr Marcel Zannou • Institut Régional de santé publique Dr Edgard M. Ouendo • GRAFED-ONG Dr Fernand Guédou • Gabon : • Université des Sciences de la Santé Pr Angélique Ndjoyi

  11. Strategies • Training of African researchers, clinical and technical resources • Support to the creation of the national Ethics Committee for health research • Creation of a HIV/STI Prevention Research Unit

  12. Objectives 1. To provide Beninese investigators with training and support for the writing of grant applications 2. To increase the critical mass of highly competent medical and paramedical personnel for the implementation of preventive trials 3. To promote the creation of a Research Ethics Committee in Benin 4. To contribute to the establishment of a research unit in HIV and STIs prevention in Benin

  13. RESULTS Objective 1 : To provide Beninese investigators with training and support for the writing of grant applications • Two doctorate students and one Master’s student on epidemiology program at Laval University, Quebec, Canada (Dr Michel Alary, Responsible) • Two training sessions held on the writing of research protocols for grant applications (18 part. /8 women) • Two co-investigators of the project have fully completed the online training course on ethics for health research within a specific program at the University of Montreal

  14. Results (2) : Objective1(continued) • Participation in International Conferences: • Four African investigators attended ICASA conference held in Dakar, Senegal, December 2008 • The Chairwoman of the EC participated to the “IIIèmes Rencontres Internationales Francophones en Bioéthique” that were held in Quebec, October 20-22, 2008 • One physician attended the 17th Annual Canadian Conference on HIV/AIDS Research held in Montreal, April 2008 • Two physicians attended the ATARAO Symposium that was held in Montreal in October 2008 • One of them also participated to the 15th Annual Canadian Conference on International Health that was held in Ottawa, October 2008 and won an award for the excellence of his communication • Two of them participated to the Conference on Retroviruses and Opportunistic Infections (CROI), held in Montreal, winter 2009 • One oral presented at the “  International Society for Sexually Transmitted Diseases Research ISSTDR  ” London, 2009

  15. Results (3) : Objective 2 Objective 2 : To increase the critical mass of highly competent medical and paramedical personnel for the implementation of preventive trials • Participation of five physicians to a 4-week observational training session in clinical research in Canada • Participation of a Beninese sociologist collaborating with the CHA to a one month proficiency training session in April-May 2009 in the Social Sciences department at Laval University • Participation of three technicians to a 6-week laboratory training session in Canada • Two 2-week training sessions (theoretical and practical) in clinical research and laboratory work in Cotonou(19 part./7 women). Participants from Benin, Burkina-Faso, Togo, Gabon, Côte d’Ivoire and Mali.

  16. Results (4) : Objective 2 (continued) • 15 participants have obtained their Research Ethics Certificate after having completed the Ethics course proposed by Family Health International (FHI) on their website • Online course on “Introduction to quality assurance” completed by two Beninese laboratory technicians (3 months)

  17. Results (5) : Objective 3 Objective 3 : To promote the creation of a Research Ethics Committee in Benin • Support for strengthening capacities in Ethics for health research • Establishment of an Ethics Committee (EC) for health research and its equipment (room, computer, printer, internet connection, and recruitment of a secretary) • Nine members (of ten) of this EC have fully completed the online training course on ethics for health research within a specific program at the University of Montreal • President of the Ethics Committee of the Centre hospitalier affilié universitaire de Québec (CHA), traveled to Benin for technical assistance to the newly established Ethics Committee in Benin

  18. Results (6) : Objective 3 (continued) • Organization of meetings with research institutions in Benin to introduce the Ethics Committee • Organization of a meeting with lawyers in June 2008 to help in developing the law on ethics at the national level (prior to the legal recognition of the Ethics Committee) • International registration of the EC to the Office for Human Research Protection (USA) • The EC is totally functional and the budget of the ministry of health is planned to sustain the operations

  19. Results (7) : Objective 4 Objective 4 : To contribute to the establishment of a research unit in HIV and STIs prevention in Benin • Creation and equipment of the Unité de recherche sur la prévention des ISTs et du VIH/Sida (UREPIV) • One librarian have been hired. She is assisted by three local co-investigators directly involved • Subscription to the “ HINARI ” database allowing access to several scientific journals • Subscription to JAIDS, to the “ Médecine et maladies infectieuses ” Journal and to the « Bulletin de la Société de Pathologie Exotique  ” • Affiliated with the “Institut des Sciences Biomédicales Appliquées de l’Université D’Abomey Calavi ”

  20. IDRC synergy funding 2010-12 • Did not get the funding in round 2 of capacity building grants • IDRC synergy funding allowed: • Support the completion of training for 2 Beninese Ph.D. students at Laval • Support the FSW cohort infrastucture for work on prevention issues and HLA-related resistance factors (collaboration with Drs. Cécile Tremblay and Michel Roger, Université de Montréal) • Grant termination: March 2012 • Termination of cohort study: March 2013

  21. CIHR Health Equity Grant 2011-16 • Focus maintained on prevention among sex workers • Broadening of focus from HIV to reproductive health (contraception, pregnancy issues), violence and structural issues • Includes a global preventive intervention with its evaluation • Involvement of knowledge users at government and NGO levels in Benin • Maintenance of capacity building activities: • 5 graduate students at Université d’Abomey-Calavi • 3 graduate students and one post-doc at Université Laval • On site training on analytical methods for qualitative studies

  22. Acknowledgements We wish to thank all the agencies that supported the Benin-Canada collaboration over the years: CIDA, WHO, UNAIDS, CONRAD, GHRI, IDRC, CIHR as well as all the collaborators in Benin, Canada and elsewhere who got involved in these various projects. Above all, we wish to thank the women and men who accepted to participate in the various studies we conducted in the field. Without them, all this work would not have been possible.

  23. THANK YOU

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