African Heads of State demonstrate leadership on NTDs at the African Union

At the 32nd Ordinary Summit of the African Union, heads of state reviewed progress on neglected tropical diseases (NTDs) as part of a presentation by the Prime Minister of Swaziland on progress against malaria. Countries, including Ghana and Togo, were praised by the assembly for achieving elimination goals for some NTDs with more countries encouraged to follow suit. African leaders have also signed up to an initiative that will provide funding to ensure quality health for their populations.

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Personality Profile – Dr. Obinna Ikechukwu Ekwunife

Dr. Ekwunife Ikechukwu Obinna, a Lecturer at the Department of Clinical Pharmacy and Pharmacy,  Nnamdi Azikiwe University in Nigeria,  is among three (3) ARNTD members who have been awarded the 2018 EDCTP Career Development Award. In this interview, he shares his experience on how early career researchers can prepare applications that could successfully compete in prestigious and competitive grants opportunities such as the EDCTP.

ARNTD: What prompted the focus of this research question/title and what does the whole work entail?
Dr. Obinna: There is a global issue in HIV management which is that retention in care of HIV positive adolescents is poor. These HIV positive adolescents also adhere poorly to their anti-retroviral therapy. Note that with poor retention-in-care and adherence to therapy, viral load increases, the disease worsens and chances of transmission to others increase greatly. This has huge health implication in sub-Saharan Africa that bears about 90% of the global adolescent HIV population.

I also observed in literature that there were few service delivery interventions that have been applied to solve the above mentioned issue. Therefore, we came up with an idea which we termed the incentive scheme. The incentive scheme comprises of cash incentive conditioned on meeting viral load target coupled to motivational interviewing. The incentive scheme aims to keep adolescents with HIV in care and improve their adherence to antiretroviral therapy. Conditional cash incentive has the capacity to increase demand for care and adherence to therapy immediately especially since financial reward could be obtained as target is achieved. Motivational interviewing on the other hand help to sustain the demand for care and adherence to therapy since it helps bring about long lasting character change.

ARNTD: What is the expected outcome and contribution of your research to science?
Dr. Obinna: The findings of the adherence and retention trial (ARA) will provide evidence on the feasibility of applying conditional economic incentives combined with motivational interviewing to improve retention and adherence to antiretroviral therapy of adolescents living with HIV in Nigeria and possibly other sub-Saharan African countries. ARA trial will also develop the research capacity of research assistants (including a PhD student) and the 12 participating health facilities to conduct high quality clinical research. At the end of the research, a workshop on clinical trial will be organised to benefit about 20 to 30 professionals that are interested in clinical trials.

ARNTD: What were the challenges and commitments that went into your application?
Dr. Obinna: Initially, it was difficult to identify experts that could help me in different work packages in the project which I do not have the expertise. However, after a long search, I identified and connected with these experts at the end. Secondly, it was difficult initially to develop the idea I had into a winning proposal especially since previously I did not have any formal training on grant writing. Luckily, in the course of developing the proposal, I was invited to a grant writing workshop by African Research Excellence Fund (AREF). AREF workshop put the pieces of the puzzle together. EDCTP grant writing process is a lengthy one. It took me 3 months, working for 6 hours a day to finish the first draft of the proposal.

ARNTD: What lessons do you have to share with other early stage researchers in grant application process?
Dr. Obinna: I think every early stage researcher should get a skilled mentor(s) because one “can see further standing on the shoulders of giants”. Such a mentor could be a past grant awardee or a grant reviewer. Secondly, I think many young researchers especially in most African countries will need grant writing training such as the one offered by AREF. This is because a grantee has to understand how the reviewers think and what they want in order to successfully win these competitive grants. Lastly, tenacity is key. The catch phrase will be to never give up.

ARNTD: As a winner of a Career Development Fellowship, what does this mean to your overall trajectory of development as a scientist?
Dr. Obinna: My ultimate career goal is to acquire competencies in clinical research (especially clinical trials and health service research). The EDCTP career development fellowship offers a wonderful opportunity for me to develop clinical trial skill. The fellowship offers a major project for my newly formed research group which I started immediately after my return from postdoctoral fellowship in Germany. The fellowship will provide opportunity for my group members to gain competencies as well as practical experience in clinical trials. It is my hope that my research group will develop capacities in clinical trials in the next 2 to 3 years and grow into a clinical research organization in the next 10 years with capacity of acting as future scientific cooperation partner for researchers in developed countries.

Dr. Alexander Kwarteng and Dr. Kingsley Badu, both of the Kwame Nkrumah University of Science and Technology, Ghana, are the other recipients of this award and would also share their perspectives in subsequent interviews.

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