New global clinical trials to tackle key health issues in low- and middle-income countries

Nine new projects have been announced as part of the Joint Global Health Trials programme, an initiative between the Medical Research Council, the Wellcome Trust and the Department for International Development.

The projects, worth a combined £19 million, were funded in the first call for applications and will focus on major causes of death such as HIV, tuberculosis (TB) and malaria, which continue to kill millions of people in Asia and Africa each year.

The large-scale late-stage clinical trials will run for between 18 months and 4.5 years. The problems examined will include reducing the number of people affected by TB in those who are HIV positive, improving malaria diagnosis rates for pregnant women in Indonesia and improving access to feminine hygiene products for adolescent girls in Kenya.

By bringing together three major UK funders of global health research, the Joint Global Health Trials programme aims to provide robust evidence for global health problems and develop interventions that will improve health for populations in low- and middle-income countries.

Dr Mark Palmer, Head of International Strategy at the Medical Research Council (which co-ordinates the Global Health Trials scheme), says: "This scheme will boost the number of large-scale clinical trials taking place in low- and middle-income countries and dramatically improve the evidence that doctors and policy makers use to make decisions in these settings.

"By focusing on clinical trials that take place at the heart of where these diseases have the greatest burden, we're confident that we can significantly improve our understanding of some of the biggest killers in low- and middle-income countries. If we know more about treatments that are effective, and can be implemented safely in the communities that need them most, this scheme will have a tangible impact on the way people are treated for these conditions."

Dr Jimmy Whitworth, Head of International Activities at the Wellcome Trust, adds: "Randomised controlled trials are the gold standard by which health interventions are measured. This new joint scheme aims to accelerate the evaluation of practical and relevant healthcare interventions to tackle some of the biggest threats to human health on the planet.

"Each of the projects funded in this first call promises to make a significant impact in understanding how to meet those challenges and best treat patients in a clinically relevant setting."

Professor Christopher Whitty, Chief Scientific Adviser at the Department for International Development, says: "We are very enthusiastic about this programme; it provides opportunities to test out new approaches to improving the health of the poorest and will give us vital information on which interventions are proven to work. This will help us target UK aid more effectively in the future."

Joint Global Health Trials: details of funded projects
Professor Feiko ter Kuile, Child and Reproductive Health, Liverpool School of Tropical Medicine
Scheduled intermittent-screening with rapid diagnostic tests at ANC to reduce the burden of malaria in Eastern Indonesia: a cluster randomised trial.

Dr Andrew Weeks, Women and Children's Health, University of Liverpool
Reducing complications from preeclampsia in low resource settings: a randomized trial of induction techniques comparing balloon catheter with oral misoprostol.

Dr Jeremy Day, Oxford University Clinical Research Unit, Vietnam
A clinical trial of dexamethasone to improve the outcome of cryptococcal meningitis.

Professor Diana M Gibb, HIV and Infections Group, Clinical Trials Unit, Medical Research Council
Reduction of early mortality in HIV infected adults and children starting anti-retroviral therapy - REALITY.

Professor Mark Hatherill, South African Tuberculosis Vaccine Initiative, University of Cape Town
A randomised controlled trial of MVA85A tuberculosis vaccine prime and selective delayed Bacille Calmette Guerin (BCG) boost in infants of HIV infected mothers.

Dr Badara Cisse, University Cheikh Anta Diop
Randomized trial of spatially targeted malaria control to virtually eliminate malaria in areas of very low incidence and patchy transmission in Senegal.

Professor Alison Grant, Dept of Clinical Research, London School of Hygiene and Tropical Medicine
TB fast track: can a point-of-care TB test-and-treat algorithm reduce early mortality on antiretroviral therapy?

Dr Thuy Le, Oxford University Clinical Research Unit, Vietnam
Itraconazole versus amphotericin B for HIV-associated penicilliosis: a randomised, open-label comparative study (IVAP).

Dr Penelope Phillips-Howard, Centre for Public Health, Liverpool John Moores University
The effectiveness of menstrual cups to reduce school absenteeism, and sexual and reproductive harms in adolescent Kenyan schoolgirls.

Provided by Wellcome Trust