“I think the most important thing what I’ve learned is that coordination and collaboration is important [..] it has really opened up our mind to say, okay, so this is what translational science is all about.”

Dr. Mirriam Ethel Nyenje, Senior Public Health Microbiologist and Head of the National Genomics Reference Laboratory at the Public Health Institute of Malawi, reflects on the power of collaboration during the closing week of the AU-EU Health Partnership – a programme designed to strengthen research on mpox and Lassa fever.

During her stay at Makerere University, Mirriam was really encouraged to see the research being conducted by her peers in the Translational Lab. What really caught her eye was the development of the gene extraction kit, which can be used to break down and reduce the genetic makeup of bacteria. “If other institutions are doing the same in Africa, why not us?” she said. Looking back on the Covid-19 pandemic where a lack of supplies and chemicals was a huge issue in Africa, Mirriam hopes that when these gene kits are produced locally, they would not have to rely on Europe or other parts of the world to manufacture reagents to support testing and diagnosis of diseases like mpox.

Mirriam reflects on how the fellowship has really opened her eyes to the importance of good collaboration and coordination in translational research. Within the African context, however, there are still some barriers that hinder researchers in countries like Malawi to exchange samples and work with colleagues in other African countries. She argues that Africa CDC can be a good platform for strengthening collaboration between member states and to bypass some of the trust issues that are hindering collaboration today.

One of the issues when it comes to outbreak response, Mirriam says, is that researchers are being left out of the rapid response teams. She argues that if researchers are included from the beginning, they would be able to help by deploying diagnostic kits and point-of-care (POCT) platforms to test facilities in rural areas and detect the outbreak at a much earlier stage. They would be able to isolate infected people and break the transmission cycle, reducing both the mortality and the cost.

When talking about vaccines, she notes that although a vaccine is deemed safe in Europe, the vaccine might not work as well in Africa because of the different genetic makeup. “I’ve learned that indeed, if we have those locally produced vaccines tested on our own people, the efficacy and even how that vaccine works will have a greater impact than the ones that are procured outside”. She argues that if African countries had better capacity to produce more vaccines themselves, they would not have to wait for and rely on partners to provide vaccines when there is an outbreak. “We know in Malawi when it’s cholera season and where the hotspots are in different districts. Why can’t we give our people these vaccines before the rainy season comes?” Instead, she would like African countries to be able to decide when to administer vaccines and focus more on prevention rather than reaction, which again would lessen the burden on the health sector.

“What I’ve realised from this fellowship is that there’s no strong collaboration between African researchers and universities for Lassa fever and mpox“

Dr. Mariam Kehinde Sulaiman, Medical microbiologist and virologist at the University of Ilorin, Nigeria, reflected on the realities of intra-Africa research collaboration during the closing week of the AU-EU Health Partnership – a programme designed to strengthen research on mpox and Lassa fever.

During the European leg of the fellowship, Mariam spent time reviewing existing literature and noticed a pattern: West-African countries such as Sierra Leone have long collaborated with European partners such as Germany on Lassa fever, a disease predominantly found in West-Africa. East African fellows are studying mpox and collaborating with their own European partners. Even though they are working on different pathogens African researchers would benefit greatly from collaborating with each other and sharing research findings. “Everybody is doing different things in their own little corners”, she said.

A vivid contrast emerged when she witnessed how colleagues from Radboud University responded to the recent Hantavirus outbreak. They immediately mobilised their international network, reaching out to experts from Brazil and Italy to exchange knowledge and experience. “That is not very common in this part of the world [Africa],” she noted.

When asked how the fellowship has changed her views on translational research in health sciences in Africa, Mariam was candid: her institution simply does not have the infrastructure needed to support the full pathway from discovery to application.  “People do science, but they don’t think outside of the box in terms of translational research because we don’t have the infrastructure.” Changing this, she stressed, requires intentional dialogue with university leaders and policymakers. Researchers must be equipped and encouraged to collaborate with partners from outside of Nigeria if they are to develop innovations such as diagnostic kits. “I thought it was just getting to the lab, putting it together, and then it’s just out there. But I realised that I need so much more. If I don’t collaborate with people outside of Nigeria, it’s not going to be possible.”

Beyond practical skills, building a research network became one of the most valuable aspects of her fellowship. She has already begun discussions with colleagues at the University of Ibadan to establish a collaboration. Fellows were also encouraged by the supervisors at Radboud University (Prof. Benjamin Mordmüller, Prof. Marien De Jonge & Prof. Quirijn de Mast) to start drafting new proposals that could spark future joint projects. “It’s not just talk, it is action, encouragement and the willingness to work together” she noted.

Mariam also highlighted the financial constraints that shape research training in Nigeria. Without grant funding, both students and supervisors must pay for research expenses themselves. As a result, she must design student projects carefully, ensuring they remain “meaningful but inexpensive.”

Her visit to the University of Ibadan offered a glimpse of what is possible. There, she learned about innovative, low-cost in-house Polymerase Chain Reaction (PCR) kits used to diagnose mpox, a practical alternative to expensive commercial kits imported from abroad. But cost is only part of the challenge. Procurement delays for reagents can stretch for weeks or months, jeopardising project timelines. “The procurement process is long and cumbersome,” she said. “But with these simple reagents, we can get them locally in Ghana and the work can be done without any delays.”

“I feel that this training has given me sufficient exposure and the skills needed to enter into this space and to make a difference.”

With this encouraging reflection, Dr. Nicholas Bbosa, molecular virologist and pathogen genomics expert at The Medical Research Council (MRC) and Uganda Virus Research Institute (UVRI), looks ahead during the closing week of the AU-EU Health Partnership – a programme designed to strengthen research on mpox and Lassa fever.

During his mobility at the University of Glasgow, Nicholas appreciated that he had the opportunity of adding a new layer of depth to the knowledge he already had in genomics, giving him a “more informative and comprehensive understanding of dynamics of infection”. He said, “in the past, I’d come across them mostly in the area of HIV, but now being applied to mpox, which is currently one of the viruses that I’m interested in and working with, was quite refreshing.” He is eager to bring this expanded expertise back to Uganda and collaborate with fellow scientists working on similar challenges.

After his time at the University of Ghana where he fully immersed himself in computational work on generated genomes, Nicholas was able to identify some markers that could be protective in infected individuals if they are enhanced. This discovery, he explains, has opened a new direction for his future research that could eventually contribute to the area of therapeutics.  

Across the continent Nicholas observes a significant shift: many African institutions have now developed the capacity to conduct modern genomic investigations and generate sequences and genomics data that they previously were unable to do. This progress has reduced the dependence on shipping samples to the Global North where they had the necessary technologies that were previously absent in many African countries. “The idea was just to ship samples,” he recalls. “Data is generated elsewhere. And then you lose that kind of autonomy on the data and the findings.” What is missing today, he argues, is translating basic research into something impactful that can have a tangible result like a diagnostic product or a vaccine. The problem is that many institutions do not have intellectual property policies or Technology Transfer Offices (TTOs). “Many scientists even do not know if those officers exist in the institutions where they are,” he notes.

One thing African universities can do to better respond to epidemics like mpox and Lassa fever, Nicholas reflects, is to “bridge the gap between public health initiatives like surveillance and outbreak response with research.” Secondly, he stresses the importance of supporting TTOs and initiatives that will be important to translate research into something that can have a tangible impact. “I think what African researchers can do better,” Nicholas reflects, “is to tag the public health surveillance and response teams with the researchers. They should move concurrently.” Having enough actionable data could translate into vaccines and therapeutics, and using public health data in research can better inform responses during epidemics.

Nicholas reflects that the translational aspect of research has been missing from health sciences in Africa. Introducing more translational research would increase the capacity to translate knowledge into something actionable that can reach the patients that are suffering from the epidemics. Reflecting on his own experience in Uganda, he says that when an outbreak like mpox happens, most of the diagnostics that are being used to diagnose diseases are imported from Asia. The cost implications of this are enormous, and there is also a danger of running out of testing kits. However, Nicholas argues that this is capacity that can actually be developed locally. “That is one area that would reduce that time of diagnosis and then allow for more timely interventions.”

“You need to design your research in such a way that, right from the outside, you’re thinking of making an impact…”

Mustapha Umar Imam, Professor of biochemistry and Director of the Centre for Vaccine Research and Biotechnology at the Federal University of Lafia, Nigeria shares his reflections on one of the central tensions he observed during the closing week of the AU-EU Health Partnership – a programme designed to strengthen research on mpox and Lassa fever.

During his stay at Pompeu Fabra University, Mustapha was particularly inspired by the hands-on approach of his hosts where fellows and supervisors exchanged and refined their translational research project, with a feedback loop that challenged assumptions and accelerated their understanding of Lassa fever and mpox which they have studied for a long time without access to the same facilities and broader set of ideas they were exposed to in Barcelona.

For Mustapha, this experience further fuelled his interest in Lassa fever. He even shared that he learned more about the virus during his two-week stay in Barcelona than anywhere else. It also prompted deeper reflection on how such expertise and capacity could be cultivated within Nigeria. He stressed that translational research should be strengthened not only by Africa-Europe collaboration but also by intra-Africa collaboration. Drawing from his experience, Mustapha called for African countries to build research ecosystems that can host valuable exchanges that can be creative and adapted to local realities. He is hopeful that the network he developed through the Africa-Europe Clusters of Research Excellence on this fellowship is already laying groundwork for future collaboration, from aiming to secure joint grant applications to establishing shared research pipelines.

Mustapha imagines a future where a discovery made in Nigeria could be rapidly validated by colleagues from across the continent: with the potential innovation tested and eventually taken up by pharmaceutical companies for large-scale production across different countries. Joint funding, he added, could help build the critical mass around which a regulatory ecosystem can be established to make this vision a reality.

The fellowship also reshaped his understanding on the importance of how discoveries can be translated from lab to market to ensure they have an impact within society. “You need to design your research in such a way that, right from the outside, you’re thinking of making an impact,” he reflected.

Another key lesson from the fellowship was the importance of engaging not only regulators and policymakers but also communities. “If we don’t talk to the people that matter and the regulators, for example, policymakers and even people in the community, we cannot make a discovery,” he said. He pointed to the persistent challenge of vaccine hesitancy in Africa. Even when vaccines are free, people often refuse them because they feel disconnected from the research process or distrust the institutions behind it. “With enough funding, universities will be able to expand, do more in terms of disease response, and study diseases that are endemic to Africa, such as Lassa fever”.

“The North-South collaboration is also important of course, but maybe instead of pulling researchers from Africa to go and train in the North, it’s better for researchers from Europe to come and teach African researchers in their own setting”

Dr. Wakisa Kipandula, molecular diagnostics and infectious disease researcher at Kamuzu University of Health Sciences, reflected on how collaboration across continents could be improved during the closing week of the AU-EU Health Partnership – a programme designed to strengthen research on mpox and Lassa fever.

During his visit to the University of Glasgow, one of the things that really impressed Wakisa was seeing the advanced technologies they have developed that can measure immune responses and evaluate the effectiveness of vaccines. “I’m coming from the molecular diagnostics and bacterial genomics background and seeing these assets is really impactful,” he explained. But the experience also highlighted a long-standing imbalance: Much of the research on diseases prevalent in Africa is still carried out in European laboratories. Several projects in Glasgow, he noted, were using samples shipped from Africa. One of the reasons for this, he says, could be that many African researchers simply do not have access to the same technologies. “We should look at how we can best build capacity locally to be able to do the research back home instead of sending the samples all the way to Europe.”

Wakisa emphasises the importance of promoting South-South collaboration, as a lot of African researchers are currently ‘working in silos’ instead of collaborating across institutions. He points out that even though North-South collaborations are important, it means less capacity is being built in Africa itself as many researchers train in the North. Once they return, it is difficult to implement what they have learned in their local settings. Instead, he says, it would be easier for a researcher from Malawi to travel to Uganda to exchange knowledge and do research.

To better respond to Lassa fever and mpox, Wakisa stressed the importance of coordination between governments and universities to combine efforts on outbreak investigation. In Malawi, for example, he says that they need to properly establish a transportation and management network for samples to better respond to the mpox epidemic. One issue, however, is that academic institutions lack funding to buy the necessary equipment and few have labs that can measure vaccine effectiveness. “There is a lack of capacity building to do these investigations in the labs that we have [..] and most universities don’t have a dedicated budget that can support researchers to conduct research on the mpox epidemic or even support the Ministry of Health”.

The experiences Wakisa gained during his time as a fellow in Uganda and Glasgow has changed the way thinks about translational research in the health sciences in Africa. “What I’ve learned so far is that it’s not just about collecting and publishing data, but that the data can be used to save lives”. Seeing how the University of Glasgow has developed technology that can measure the effectiveness of vaccines has inspired him to develop those kinds of technologies in Africa and to use it to work towards preventing future outbreaks rather than just measuring the effect during active outbreaks.